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Drug Interactions between Dep Gynogen and Requip

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

estradiol rOPINIRole

Applies to: Dep Gynogen (estradiol) and Requip (ropinirole)

MONITOR: Coadministration with estrogen-containing drugs may increase the plasma concentrations of ropinirole. Data from a population pharmacokinetic study revealed that estrogens, mainly ethinyl estradiol at 0.6 to 3 mg over a 4-month to 23-year period, reduced the oral clearance of ropinirole by up to 36% in 16 patients. The mechanism of interaction has not been described.

MANAGEMENT: Dosage adjustment for ropinirole should not be necessary in patients already on estrogen therapy because patients must be carefully titrated to tolerance or adequate effect. However, if estrogen therapy is initiated or discontinued during treatment with ropinirole, then patients should be monitored for altered ropinirole effects and the dosage adjusted as necessary. Patients and/or caregivers should be advised to notify the doctor if they experience agitation, impulse control or compulsive behaviors, orthostasis, sedation, confusion, hallucinations, and/or increased dyskinesia, flushing, dry mouth, sweating, or heart rate.

References

  1. "Product Information. Requip (ropinirole)." SmithKline Beecham PROD (2001):

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Drug and food interactions

Moderate

rOPINIRole food

Applies to: Requip (ropinirole)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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Minor

estradiol food

Applies to: Dep Gynogen (estradiol)

Coadministration with grapefruit juice may increase the bioavailability of oral estrogens. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruits. In a small, randomized, crossover study, the administration of ethinyl estradiol with grapefruit juice (compared to herbal tea) increased peak plasma drug concentration (Cmax) by 37% and area under the concentration-time curve (AUC) by 28%. Based on these findings, grapefruit juice is unlikely to affect the overall safety profile of ethinyl estradiol. However, as with other drug interactions involving grapefruit juice, the pharmacokinetic alterations are subject to a high degree of interpatient variability. Also, the effect on other estrogens has not been studied.

References

  1. Weber A, Jager R, Borner A, et al. "Can grapefruit juice influence ethinyl estradiol bioavailability?" Contraception 53 (1996): 41-7
  2. Schubert W, Eriksson U, Edgar B, Cullberg G, Hedner T "Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17B-estradiol." Eur J Drug Metab Pharmacokinet 20 (1995): 219-24

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

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