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Drug Interactions between emtricitabine / lopinavir / ritonavir / tenofovir disoproxil and estradiol / norethindrone / relugolix

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

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Interactions between your drugs

Major

ritonavir relugolix

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil and estradiol / norethindrone / relugolix

Ritonavir may significantly increase the blood levels of relugolix. This may increase the risk and/or severity of side effects such as hot flushes; weight gain; decreased sex drive; erectile function difficulties; muscle and joint pain; constipation; diarrhea; increases in glucose, triglyceride (fat), and liver enzyme levels; and decreased hemoglobin levels. It may also increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. If you do have to take both medications, you should take relugolix first, then take ritonavir after at least 6 hours to minimize the effects of the interaction. 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.

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Moderate

estradiol ritonavir

Applies to: estradiol / norethindrone / relugolix and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Ritonavir may reduce the blood levels and effects of estradiol. 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.

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Moderate

norethindrone ritonavir

Applies to: estradiol / norethindrone / relugolix and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Ritonavir may reduce the blood levels and effects of norethindrone. If you are using birth control pills or another hormone-type contraceptive such as a patch, shot, vaginal ring or implant, you should talk to your doctor before taking ritonavir. You may need an alternative or additional method of birth control during and for at least two weeks after treatment with ritonavir in order to avoid an unintended pregnancy. Let your doctor know if you experience bleeding outside of your menstrual cycle, since it may indicate reduced effectiveness of norethindrone. 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.

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Moderate

ritonavir tenofovir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Ritonavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. 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.

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Moderate

lopinavir tenofovir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Lopinavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. 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.

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Moderate

lopinavir relugolix

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil and estradiol / norethindrone / relugolix

Using relugolix together with lopinavir can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. 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.

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Drug and food interactions

Moderate

norethindrone food

Applies to: estradiol / norethindrone / relugolix

Grapefruit juice may increase the blood levels of certain medications such as norethindrone. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with norethindrone. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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Moderate

ritonavir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Ritonavir should be taken with food to lessen gastrointestinal side effects. It is important that you take this medication exactly as prescribed by your doctor. Do not change your treatment or stop treatment without first talking to your doctor.

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Moderate

lopinavir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Food may affect the absorption of lopinavir-ritonavir (brand name Kaletra) depending on whether you are taking the oral solution or the tablet. The oral solution should be taken with food to enhance absorption and help it work better. The tablet formulation can be take with or without food. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. 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.

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Minor

estradiol food

Applies to: estradiol / norethindrone / relugolix

Information for this minor interaction is available on the professional version.

Minor

tenofovir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Information for this minor interaction is available on the professional version.

Minor

norethindrone food

Applies to: estradiol / norethindrone / relugolix

Information for this minor interaction is available on the professional version.

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.