Can you take Estramustine with Vancocin?

Estramustine 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.

Estramustine 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.

Estramustine 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.

Estramustine has a major potential interaction with Cerebral Vascular Disorder.

The use of estramustine, a combination of estradiol and nornitrogen mustard, is contraindicated in patients with active thrombotic or thromboembolic disorders, unless the tumor mass is thought to be the source of these conditions. Estrogens, particularly in high dosages, can increase the risk of thrombotic events, myocardial infarction, and strokes. Therapy with estramustine should be administered cautiously and only after careful consideration of risks and benefits in patients with cerebrovascular disease, coronary artery disease, or a history of thrombotic or thromboembolic disorders.

Estramustine 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.

Estramustine 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.

The vancomycin in Vancocin has a major potential interaction with Hearing Loss.

Intravenous use of vancomycin may cause damage to the auditory branch of the eighth cranial nerve. Permanent hearing loss has been reported. Tinnitus sometimes precedes the onset of deafness, which may progress despite withdrawal of the drug. Therapy with vancomycin, particularly if prolonged (> 10 days), should be administered cautiously in patients with preexisting auditory impairment or tinnitus, since it may delay the recognition or confound the diagnosis of a drug-induced ototoxic effect. To minimize the risk of toxicity, the usual dosage should not be exceeded, use with other ototoxic agents should be avoided, and serum drug concentrations should be periodically determined and dosage adjusted to maintain desired levels. Ototoxicity has generally been associated with serum vancomycin levels of 80 to 100 mcg/mL, although toxic reactions have also been reported at levels as low as 25 mcg/mL. Serial audiograms should be obtained in patients old enough to be tested, and the dosage reduced or therapy withdrawn promptly if signs and symptoms of toxicity develop.

Oral vancomycin is generally not associated with systemic toxicity due to poor absorption from the gastrointestinal tract. However, clinically significant serum concentrations have been reported in some patients following multiple oral doses of vancomycin for active Clostridium difficile pseudomembranous colitis. Therefore, when vancomycin is administered orally, clinicians may want to heed the usual warnings and precautions associated with intravenous use of the drug.

The vancomycin in Vancocin has a moderate potential interaction with Hearing Loss.

Vancomycin is potentially ototoxic when administered intravenously or orally. The risk is higher in older patients, patients receiving higher doses, patients receiving other agents that are ototoxic, and patients who have an underlying hearing loss or renal impairment. Monitor closely for signs and symptoms of ototoxicity, which can include tinnitus, hearing loss, dizziness or vertigo.

Estramustine 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.

Estramustine has a major potential interaction with High Blood Pressure.

The risk of myocardial infarction and strokes, including those associated with estrogen use, may be increased in patients with hypertension. Moreover, estramustine may elevate blood pressure and worsen the hypertension, thus compounding the risk. Therapy with estramustine should be administered cautiously in patients with preexisting hypertension. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted as necessary.

Estramustine has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.

The use of estramustine, a combination of estradiol and nornitrogen mustard, is contraindicated in patients with active thrombotic or thromboembolic disorders, unless the tumor mass is thought to be the source of these conditions. Estrogens, particularly in high dosages, can increase the risk of thrombotic events, myocardial infarction, and strokes. Therapy with estramustine should be administered cautiously and only after careful consideration of risks and benefits in patients with cerebrovascular disease, coronary artery disease, or a history of thrombotic or thromboembolic disorders.

Estramustine has a moderate potential interaction with Hypercalcemia.

Estramustine influences the metabolism of calcium and phosphorus. Intestinal absorption and retention of calcium are increased, which may occasionally result in hypercalcemia. Therapy with estramustine should be administered cautiously in patients with preexisting hypercalcemia, renal dysfunction, or metabolic bone diseases that are associated with hypercalcemia.

Estramustine has a moderate potential interaction with Hyperparathyroidism.

Estramustine influences the metabolism of calcium and phosphorus. Intestinal absorption and retention of calcium are increased, which may occasionally result in hypercalcemia. Therapy with estramustine should be administered cautiously in patients with preexisting hypercalcemia, renal dysfunction, or metabolic bone diseases that are associated with hypercalcemia.

Estramustine has a major potential interaction with Ischemic Heart Disease.

The use of estramustine, a combination of estradiol and nornitrogen mustard, is contraindicated in patients with active thrombotic or thromboembolic disorders, unless the tumor mass is thought to be the source of these conditions. Estrogens, particularly in high dosages, can increase the risk of thrombotic events, myocardial infarction, and strokes. Therapy with estramustine should be administered cautiously and only after careful consideration of risks and benefits in patients with cerebrovascular disease, coronary artery disease, or a history of thrombotic or thromboembolic disorders.

Estramustine 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.

Estramustine 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.

The vancomycin in Vancocin has a moderate potential interaction with Neutropenia.

Reversible neutropenia has been reported with intravenous use of vancomycin, usually starting one week or more after initiation of therapy or after a total dosage of more than 25 g. Thrombocytopenia and agranulocytosis (granulocytes < 500/mm3) has occurred rarely. Patients with preexisting neutropenia should be monitored closely during vancomycin therapy for further decreases in leukocyte counts, and therapy discontinued if appropriate.

The vancomycin in Vancocin has a major potential interaction with Renal Dysfunction.

Intravenous use of vancomycin may be associated with oto- and nephrotoxic effects. Eighth cranial nerve damage may manifest as tinnitus and varying degrees of hearing impairment. Nephrotoxicity is usually evidenced by transient elevations in BUN or serum creatinine concentrations, as well as the presence of hyaline and granular casts and albumin in the urine. Rarely, acute interstitial nephritis has been reported. Although vancomycin-induced nephrotoxicity is generally reversible following discontinuation of the drug, death from uremia has occurred. Therapy with vancomycin should be administered cautiously at reduced dosages in patients with renal impairment, since they may be at increased risk for oto- and nephrotoxicity due to drug accumulation. To minimize the risk of toxicity, the usual dosage should not be exceeded, use with other neuro- and nephrotoxic agents should be avoided, and serum drug concentrations should be periodically determined and dosage adjusted to maintain desired levels. Oto- and nephrotoxicity has generally been associated with serum vancomycin levels of 80 to 100 mcg/mL, although toxic reactions have also been reported at levels as low as 25 mcg/mL. Renal and eighth cranial nerve function should be closely monitored, and the dosage reduced or therapy withdrawn if toxicity develops.

Oral vancomycin is generally not associated with systemic toxicity due to poor absorption from the gastrointestinal tract. However, clinically significant serum concentrations have been reported in some patients following multiple oral doses of vancomycin for active Clostridium difficile pseudomembranous colitis. The risk for systemic adverse effects may be greatest in patients with preexisting renal impairment. Therefore, when vancomycin is administered orally, clinicians may want to heed the usual warnings and precautions associated with intravenous use of the drug.

Estramustine 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.

Estramustine has a moderate potential interaction with Renal Dysfunction.

Estramustine influences the metabolism of calcium and phosphorus. Intestinal absorption and retention of calcium are increased, which may occasionally result in hypercalcemia. Therapy with estramustine should be administered cautiously in patients with preexisting hypercalcemia, renal dysfunction, or metabolic bone diseases that are associated with hypercalcemia.

The vancomycin in Vancocin has a moderate potential interaction with Renal Dysfunction.

Vancomycin is potentially ototoxic when administered intravenously or orally. The risk is higher in older patients, patients receiving higher doses, patients receiving other agents that are ototoxic, and patients who have an underlying hearing loss or renal impairment. Monitor closely for signs and symptoms of ototoxicity, which can include tinnitus, hearing loss, dizziness or vertigo.

Estramustine 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.

The vancomycin in Vancocin has a moderate potential interaction with Thrombocytopenia.

Reversible neutropenia has been reported with intravenous use of vancomycin, usually starting one week or more after initiation of therapy or after a total dosage of more than 25 g. Thrombocytopenia and agranulocytosis (granulocytes < 500/mm3) has occurred rarely. Patients with preexisting neutropenia should be monitored closely during vancomycin therapy for further decreases in leukocyte counts, and therapy discontinued if appropriate.

Estramustine has a major potential interaction with Thrombotic/Thromboembolic Disorder.

The use of estramustine, a combination of estradiol and nornitrogen mustard, is contraindicated in patients with active thrombotic or thromboembolic disorders, unless the tumor mass is thought to be the source of these conditions. Estrogens, particularly in high dosages, can increase the risk of thrombotic events, myocardial infarction, and strokes. Therapy with estramustine should be administered cautiously and only after careful consideration of risks and benefits in patients with cerebrovascular disease, coronary artery disease, or a history of thrombotic or thromboembolic disorders.

Estramustine 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.

The vancomycin in Vancocin has a major potential interaction with Tinnitus.

Intravenous use of vancomycin may cause damage to the auditory branch of the eighth cranial nerve. Permanent hearing loss has been reported. Tinnitus sometimes precedes the onset of deafness, which may progress despite withdrawal of the drug. Therapy with vancomycin, particularly if prolonged (> 10 days), should be administered cautiously in patients with preexisting auditory impairment or tinnitus, since it may delay the recognition or confound the diagnosis of a drug-induced ototoxic effect. To minimize the risk of toxicity, the usual dosage should not be exceeded, use with other ototoxic agents should be avoided, and serum drug concentrations should be periodically determined and dosage adjusted to maintain desired levels. Ototoxicity has generally been associated with serum vancomycin levels of 80 to 100 mcg/mL, although toxic reactions have also been reported at levels as low as 25 mcg/mL. Serial audiograms should be obtained in patients old enough to be tested, and the dosage reduced or therapy withdrawn promptly if signs and symptoms of toxicity develop.

Oral vancomycin is generally not associated with systemic toxicity due to poor absorption from the gastrointestinal tract. However, clinically significant serum concentrations have been reported in some patients following multiple oral doses of vancomycin for active Clostridium difficile pseudomembranous colitis. Therefore, when vancomycin is administered orally, clinicians may want to heed the usual warnings and precautions associated with intravenous use of the drug.