Drug Interactions between Dull-C and Xulane
This report displays the potential drug interactions for the following 2 drugs:
- Dull-C (ascorbic acid)
- Xulane (ethinyl estradiol/norelgestromin)
Interactions between your drugs
ethinyl estradiol ascorbic acid
Applies to: Xulane (ethinyl estradiol / norelgestromin) and Dull-C (ascorbic acid)
Ascorbic acid may increase the serum levels of estrogens in oral contraceptives. The mechanism may be due to decreased metabolism of the estrogen by competitive inhibition involving ascorbic acid. Consider monitoring the patient more closely for estrogen-related side effects if ascorbic acid is coadministered.
References
- Back DJ, Breckenridge AM, MacIver M, L'e Orme M, Purba H Rowe PH "Interaction of ethinyloestradiol with ascorbic acid in man." Br Med J 282 (1981): 1516
- Morris JC, Beeley L, Ballantine N "Interaction of ethinyloestradiol with ascorbic acid in man." Br Med J 283 (1981): 503
- Briggs MH "Megadose vitamin C and metabolic effects of the pill." Br Med J 283 (1981): 1547
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Drug and food interactions
ethinyl estradiol food
Applies to: Xulane (ethinyl estradiol / norelgestromin)
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
- Weber A, Jager R, Borner A, et al. "Can grapefruit juice influence ethinyl estradiol bioavailability?" Contraception 53 (1996): 41-7
- 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
ethinyl estradiol food
Applies to: Xulane (ethinyl estradiol / norelgestromin)
The central nervous system effects and blood levels of ethanol may be increased in patients taking oral contraceptives, although data are lacking and reports are contradictory. The mechanism may be due to enzyme inhibition. Consider counseling women about this interaction which is unpredictable.
References
- Hobbes J, Boutagy J, Shenfield GM "Interactions between ethanol and oral contraceptive steroids." Clin Pharmacol Ther 38 (1985): 371-80
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.
See also
Report options
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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