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Drug Interactions between enasidenib and Prempro

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

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Interactions between your drugs

Moderate

medroxyPROGESTERone enasidenib

Applies to: Prempro (conjugated estrogens / medroxyprogesterone) and enasidenib

MONITOR: Coadministration with enasidenib may alter the plasma concentrations of hormonal contraceptives. In vitro, enasidenib has been found to both inhibit and induce CYP450 3A4, the isoenzyme primarily responsible for the metabolic clearance of contraceptive hormones. The clinical significance is unknown.

MANAGEMENT: Because use of enasidenib may be associated with fetal harm, it is important that patients not become pregnant during treatment. It may be advisable to monitor patients for potentially altered effects of their hormonal contraceptive during and after treatment with enasidenib. Input from a gynecologist or similar expert on adequate contraception, including emergency contraception, should be sought as needed. Intrauterine systems are unlikely to be significantly affected because of their local action.

References

  1. "Product Information. Idhifa (enasidenib)." Celgene Corporation (2017):

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Drug and food interactions

Minor

conjugated estrogens food

Applies to: Prempro (conjugated estrogens / medroxyprogesterone)

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

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

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