Can you take Conjugated estrogens / meprobamate with Metreleptin?
1 drug interaction and 52 additional warnings found for the following 2 drugs:
- conjugated estrogens/meprobamate
- metreleptin
Drug interactions
Moderate drug interactions
Moderate:
conjugated estrogens metreleptin
Applies to: conjugated estrogens / meprobamate and metreleptin
Metreleptin may reduce the blood levels and effects of conjugated estrogens. If you are using low-dose oral contraceptives, you may have an increased risk of breakthrough bleeding and unintended pregnancy. You should discuss the use of alternative or additional methods of birth control with your healthcare provider. If you take hormone replacement for menopause, notify your doctor if your medication is no longer controlling your symptoms or you experience abnormal bleeding. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
meprobamate Food/Lifestyle
Applies to: conjugated estrogens / meprobamate
Alcohol can increase the nervous system side effects of meprobamate such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with meprobamate. Do not use more than the recommended dose of meprobamate, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.
Minor food/lifestyle interactions
Minor:
conjugated estrogens Food/Lifestyle
Applies to: conjugated estrogens / meprobamate
Information for this minor interaction is available on the professional version.
Disease interactions
50 potential interactions Applies to: 42 conditions, including High Blood Pressure, High Cholesterol, Depression, Migraine, and Weight Loss.
Abnormal Uterine Bleeding
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Abnormal Uterine Bleeding.
The use of estrogens is contraindicated in patients with undiagnosed, abnormal vaginal bleeding. Prolonged (greater than 1 year), unopposed estrogen use (i.e. estrogen without concomitant progestin therapy) has been associated with a significant, dose-related risk of endometrial carcinoma. The risk may be offset substantially by the addition of a progestin but may not be completely abolished. Prior to initiating estrogen therapy, appropriate diagnostic tests should be performed in patients with abnormal vaginal bleeding to rule out endometrial malignancy. The same applies if recurrent or persistent bleeding develops during estrogen therapy.
Acute Alcohol Intoxication
Major:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Acute Alcohol Intoxication.
Anxiolytic, sedative, and hypnotic agents should generally not be given to patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of these agents may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with such agents should be administered cautiously in patients who might be prone to acute alcohol intake.
Alcoholism
Major:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Alcoholism.
Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Alcoholism.
Physical dependence, psychological dependence, and abuse have occurred with the use of meprobamate. Chronic intoxication from prolonged use usually involves ingestion of greater than recommended doses, and it is manifested by ataxia, slurred speech, and vertigo. Careful supervision of dose and amounts prescribed is advised, as well as avoidance of prolonged administration, especially in alcoholics and other patients with known propensity for taking excessive quantities of drugs.
Angioedema
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Angioedema.
The use of exogenous estrogens may induce or exacerbate symptoms of angioedema, particularly in women with hereditary angioedema. Consider the risk versus benefits of estrogen therapy. Close monitoring is recommended when prescribing these agents to patients predisposed to angioedema.
Asphyxia
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Asphyxia.
Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.
Asthma
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Asthma.
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
Autoimmune Disorders
Moderate:
metreleptin
Metreleptin has a moderate potential interaction with Autoimmune Disorders.
Leptin is involved in immune system homeostasis. Patients with acquired lipodystrophies and leptin deficiency may have autoimmune disorders including autoimmune hepatitis and membranoproliferative glomerulonephritis. Progression of autoimmune hepatitis and membranoproliferative glomerulonephritis with massive proteinuria and renal failure has occurred in some patients with acquired generalized lipodystrophy treated with metreleptin, a recombinant analog of human leptin. A causal relationship between metreleptin treatment and the development and/or progression of autoimmune disease has not been established. Until more information is available, the potential benefits and risks of metreleptin treatment should be carefully considered in patients with autoimmune diseases.
Breast Cancer
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Breast Cancer.
When treated with an estrogen, patients with breast cancer and bone metastases may develop severe hypercalcemia, in which case the drug should be stopped and measures be taken to reduce serum calcium levels.
Cerebral Vascular Disorder
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Cerebral Vascular Disorder.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Depression
Major:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Depression.
A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Diabetes Mellitus
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Diabetes Mellitus.
Impaired glucose tolerance has been observed in some patients administered oral contraceptives and appears to be related primarily to the estrogen dose. However, progestogens can increase insulin secretion and produce insulin resistance to varying degrees, depending on the agent. Caution and close monitoring are recommended in patients with diabetes mellitus during therapy with estrogens and/or progestogens, and adjustments made accordingly in their antidiabetic regimen.
Moderate:
metreleptin
Metreleptin has a moderate potential interaction with Diabetes Mellitus.
Metreleptin can cause hypoglycemia. Caution is advised in patients that suffer from hypoglycemia or in diabetic patients in treatment with oral hypoglycemic agents or insulin. A dosage adjustment might be needed.
Drug Dependence
Major:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Drug Dependence.
Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Drug Dependence.
Physical dependence, psychological dependence, and abuse have occurred with the use of meprobamate. Chronic intoxication from prolonged use usually involves ingestion of greater than recommended doses, and it is manifested by ataxia, slurred speech, and vertigo. Careful supervision of dose and amounts prescribed is advised, as well as avoidance of prolonged administration, especially in alcoholics and other patients with known propensity for taking excessive quantities of drugs.
Fluid Retention
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Fluid Retention.
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
Gallbladder Disease
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Gallbladder Disease.
A two- to four-fold increase in risk of gallbladder disease has been noted in women receiving postmenopausal estrogen therapy. The risk for gallbladder disease may be less for premenopausal women using oral contraceptives containing low-dose estrogens and/or progestins. Therapy with estrogens should be administered cautiously in patients with preexisting gallbladder disease or a history of pregnancy-related cholestasis.
Glaucoma/Intraocular Hypertension
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
Heart Failure
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Heart Failure.
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
Hepatic Tumor
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Hepatic Tumor.
The use of oral contraceptives is contraindicated in patients with liver tumors. An increased risk of benign hepatic adenomas and hepatocellular carcinomas has been associated with long-term, oral estrogen- progestin contraceptive use of at least 4 years and 8 years, respectively. Although these tumors are rare and have not been reported with other types of estrogen or progestogen therapies, any preparation containing estrogens and/or progestogens should probably be avoided in patients with existing tumors of the liver. Hepatic hemangiomas and nodular hyperplasia of the liver have been reported with isolated estrogen therapy.
High Blood Pressure
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with High Blood Pressure.
The risk of myocardial infarction and strokes, including those associated with oral contraceptive use and some estrogen use, is increased in patients with hypertension. Moreover, estrogens (and progestogens) may elevate blood pressure and worsen the hypertension, thus compounding the risk. Clinically significant blood pressure increases have been reported during estrogen therapy, particularly in patients receiving high dosages or treated with oral contraceptive combinations having high progestational activity. These effects also increase with duration of therapy and patient age. Therapy with estrogens should be administered cautiously in patients with preexisting hypertension. Some estrogen-based therapies, such as combined hormonal contraceptives, may be contraindicated in patients with uncontrolled hypertension or hypertension with vascular disease. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary. In patients requiring contraception, alternative methods should be considered for those who are hypertensive, over age 35, and smoke.
High Cholesterol
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with High Cholesterol.
Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.
History, Thrombotic/Thromboembolic Disorder
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Hypoglycemia
Moderate:
metreleptin
Metreleptin has a moderate potential interaction with Hypoglycemia.
Metreleptin can cause hypoglycemia. Caution is advised in patients that suffer from hypoglycemia or in diabetic patients in treatment with oral hypoglycemic agents or insulin. A dosage adjustment might be needed.
Hypoparathyroidism
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Hypoparathyroidism.
Estrogens should be used with caution in individuals with severe hypocalcemia or hypoparathyroidism. Estrogen-induced hypocalcemia may occur in patients with hypoparathyroidism; consider whether the benefits of estrogen therapy outweigh the risks.
Immunodeficiency
Major:
metreleptin
Metreleptin has a major potential interaction with Immunodeficiency.
Cases of T-cell lymphoma have been reported during treatment with metreleptin in patients with acquired generalized lipodystrophy. Some, but not all, had immunodeficiency and significant hematologic abnormalities including severe bone marrow abnormalities before the initiation of metreleptin therapy. However, lymphomas and other lymphoproliferative disorders have also been reported in patients with acquired generalized lipodystrophy who did not receive metreleptin, thus a causal relationship with metreleptin has not been established. Acquired lipodystrophies are associated with autoimmune disorders, and the latter is associated with an increased risk of malignancies including lymphomas. Until more information is available, the potential benefits and risks of metreleptin treatment should be carefully considered in patients with acquired generalized lipodystrophy and/or those with significant hematologic abnormalities including leukopenia, neutropenia, bone marrow abnormalities, lymphoma, and/or lymphadenopathy.
Ischemic Heart Disease
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Ischemic Heart Disease.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Liver Disease
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Liver Disease.
Estrogens are primarily metabolized by the liver. Use of estrogen therapy is contraindicated in patients with liver dysfunction or disease. Patients with impaired hepatic function may be at increased risk for adverse effects associated with estrogen administration due to decreased drug clearance. Patients with hepatic hemangiomas are at increased risk of exacerbation with use of estrogens. Therapy with estrogens should be administered cautiously in patients with cholestatic jaundice associated with past estrogen use or with pregnancy. In addition, clinicians should be aware that estrogen therapy may affect liver function tests.
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Liver Disease.
Some anxiolytics, sedatives and hypnotics are extensively metabolized by the liver, and excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects, including central nervous system and respiratory depression, due to drug and metabolite accumulation. Therapy with these drugs should be administered cautiously in such patients, with careful dose selection usually starting at the low end of the dosing range.
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Liver Disease.
In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.
Lymphadenopathy
Major:
metreleptin
Metreleptin has a major potential interaction with Lymphadenopathy.
Cases of T-cell lymphoma have been reported during treatment with metreleptin in patients with acquired generalized lipodystrophy. Some, but not all, had immunodeficiency and significant hematologic abnormalities including severe bone marrow abnormalities before the initiation of metreleptin therapy. However, lymphomas and other lymphoproliferative disorders have also been reported in patients with acquired generalized lipodystrophy who did not receive metreleptin, thus a causal relationship with metreleptin has not been established. Acquired lipodystrophies are associated with autoimmune disorders, and the latter is associated with an increased risk of malignancies including lymphomas. Until more information is available, the potential benefits and risks of metreleptin treatment should be carefully considered in patients with acquired generalized lipodystrophy and/or those with significant hematologic abnormalities including leukopenia, neutropenia, bone marrow abnormalities, lymphoma, and/or lymphadenopathy.
Lymphoma
Major:
metreleptin
Metreleptin has a major potential interaction with Lymphoma.
Cases of T-cell lymphoma have been reported during treatment with metreleptin in patients with acquired generalized lipodystrophy. Some, but not all, had immunodeficiency and significant hematologic abnormalities including severe bone marrow abnormalities before the initiation of metreleptin therapy. However, lymphomas and other lymphoproliferative disorders have also been reported in patients with acquired generalized lipodystrophy who did not receive metreleptin, thus a causal relationship with metreleptin has not been established. Acquired lipodystrophies are associated with autoimmune disorders, and the latter is associated with an increased risk of malignancies including lymphomas. Until more information is available, the potential benefits and risks of metreleptin treatment should be carefully considered in patients with acquired generalized lipodystrophy and/or those with significant hematologic abnormalities including leukopenia, neutropenia, bone marrow abnormalities, lymphoma, and/or lymphadenopathy.
Migraine
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Migraine.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Migraine.
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
Myelodysplastic Diseases
Major:
metreleptin
Metreleptin has a major potential interaction with Myelodysplastic Diseases.
Cases of T-cell lymphoma have been reported during treatment with metreleptin in patients with acquired generalized lipodystrophy. Some, but not all, had immunodeficiency and significant hematologic abnormalities including severe bone marrow abnormalities before the initiation of metreleptin therapy. However, lymphomas and other lymphoproliferative disorders have also been reported in patients with acquired generalized lipodystrophy who did not receive metreleptin, thus a causal relationship with metreleptin has not been established. Acquired lipodystrophies are associated with autoimmune disorders, and the latter is associated with an increased risk of malignancies including lymphomas. Until more information is available, the potential benefits and risks of metreleptin treatment should be carefully considered in patients with acquired generalized lipodystrophy and/or those with significant hematologic abnormalities including leukopenia, neutropenia, bone marrow abnormalities, lymphoma, and/or lymphadenopathy.
Myeloproliferative Disorders
Major:
metreleptin
Metreleptin has a major potential interaction with Myeloproliferative Disorders.
Cases of T-cell lymphoma have been reported during treatment with metreleptin in patients with acquired generalized lipodystrophy. Some, but not all, had immunodeficiency and significant hematologic abnormalities including severe bone marrow abnormalities before the initiation of metreleptin therapy. However, lymphomas and other lymphoproliferative disorders have also been reported in patients with acquired generalized lipodystrophy who did not receive metreleptin, thus a causal relationship with metreleptin has not been established. Acquired lipodystrophies are associated with autoimmune disorders, and the latter is associated with an increased risk of malignancies including lymphomas. Until more information is available, the potential benefits and risks of metreleptin treatment should be carefully considered in patients with acquired generalized lipodystrophy and/or those with significant hematologic abnormalities including leukopenia, neutropenia, bone marrow abnormalities, lymphoma, and/or lymphadenopathy.
Neoplasia, Estrogen Dependent
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Neoplasia, Estrogen Dependent.
The use of estrogens is generally contraindicated in patients with known or suspected estrogen-dependent neoplasia such as breast and endometrial cancer, since it may stimulate tumor proliferation. High dosages of estrogens may be used for the palliative treatment of inoperable, metastatic breast cancer, but only in appropriately selected men and postmenopausal women.
Neutropenia
Major:
metreleptin
Metreleptin has a major potential interaction with Neutropenia.
Cases of T-cell lymphoma have been reported during treatment with metreleptin in patients with acquired generalized lipodystrophy. Some, but not all, had immunodeficiency and significant hematologic abnormalities including severe bone marrow abnormalities before the initiation of metreleptin therapy. However, lymphomas and other lymphoproliferative disorders have also been reported in patients with acquired generalized lipodystrophy who did not receive metreleptin, thus a causal relationship with metreleptin has not been established. Acquired lipodystrophies are associated with autoimmune disorders, and the latter is associated with an increased risk of malignancies including lymphomas. Until more information is available, the potential benefits and risks of metreleptin treatment should be carefully considered in patients with acquired generalized lipodystrophy and/or those with significant hematologic abnormalities including leukopenia, neutropenia, bone marrow abnormalities, lymphoma, and/or lymphadenopathy.
Pancreatitis
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Pancreatitis.
Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.
Porphyria
Major:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Porphyria.
The use of meprobamate is contraindicated in patients with acute intermittent porphyria. Meprobamate has been reported to precipitate acute attacks of porphyria in susceptible patients.
Pulmonary Impairment
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Pulmonary Impairment.
Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.
Renal Dysfunction
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Renal Dysfunction.
Some anxiolytics, sedatives and hypnotics are extensively metabolized by the liver, and excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects, including central nervous system and respiratory depression, due to drug and metabolite accumulation. Therapy with these drugs should be administered cautiously in such patients, with careful dose selection usually starting at the low end of the dosing range.
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Renal Dysfunction.
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
Respiratory Arrest
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Respiratory Arrest.
Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.
Seizures
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Seizures.
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Seizures.
Meprobamate may occasionally precipitate seizures in epileptic patients. Therapy with meprobamate should be administered cautiously in patients with a history of epilepsy.
Thrombotic/Thromboembolic Disorder
Major:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Thrombotic/Thromboembolic Disorder.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Thyroid Disease
Moderate:
conjugated estrogens / meprobamate
The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Thyroid Disease.
When administering estrogen and/or progestogen therapy in patients with thyroid disorders, clinicians should be aware that these hormones may affect thyroid function tests. Patients on thyroid replacement therapy may require higher doses of thyroid hormone and appropriate monitoring. Changes have mostly been reported with the use of combination oral contraceptives. Specifically, thyroid-binding globulin (TBG) may be increased, resulting in elevated circulating total thyroid hormone, as measured by PBI (protein-bound iodine), T4 by column or radioimmunoassay, or T3 by radioimmunoassay. Free T3 resin uptake may be decreased. On the contrary, a decrease in TBG and, consequently, thyroxine concentration, has been reported by the manufacturers of the progestin-only (norethindrone) oral contraceptives.
Urinary Retention
Moderate:
conjugated estrogens / meprobamate
The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Urinary Retention.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
Weight Loss
Major:
metreleptin
Metreleptin has a major potential interaction with Weight Loss.
The use of metreleptin is contraindicated in patients with general obesity not associated with congenital leptin deficiency. Metreleptin has not been shown to be effective in treating general obesity. Moreover, development of anti-metreleptin antibodies with neutralizing activity has been reported in obese patients treated with metreleptin, the clinical consequences of which have not been well characterized but could include inhibition of endogenous leptin action and loss of metreleptin efficacy. Worsening metabolic control and/or severe infection have been reported.
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conjugated estrogens / meprobamate
A total of 695 drugs are known to interact with conjugated estrogens / meprobamate.
- Conjugated estrogens / meprobamate is in the drug class sex hormone combinations.
- Conjugated estrogens / meprobamate is used to treat Menopause.
metreleptin
A total of 219 drugs are known to interact with metreleptin.
- Metreleptin is in the drug class miscellaneous metabolic agents.
- Metreleptin is used to treat Lipodystrophy.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
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