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Can you take Ethinyl estradiol with Myhibbin?

1 drug interaction and 37 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

ethinyl estradiol mycophenolate mofetil

Applies to: ethinyl estradiol and Myhibbin (mycophenolate mofetil)

Mycophenolate mofetil may reduce the blood levels and effects of ethinyl estradiol, which may make it less reliable as a form of birth control. Alternative or additional methods of birth control should be used during treatment with mycophenolate mofetil to avoid unintended pregnancy. This is particularly important because mycophenolate mofetil may cause pregnancy loss in the first trimester and also birth defects in the unborn child. Talk to your gynecologist or other healthcare professional for help in selecting an effective method of birth control that is best for you. If you take hormone replacement for menopause, you should contact your doctor if you experience increased frequency or worsening of your symptoms such as hot flashes, vaginal dryness, or abnormal bleeding. 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

ethinyl estradiol Caffeine

Applies to: ethinyl estradiol

Ethinyl estradiol may increase the blood levels of caffeine. This may increase the risk and/or severity of side effects related to caffeine. Contact your doctor if your condition changes or you experience increased side effects. You may need a dose adjustment or more frequent monitoring 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.

Minor food/lifestyle interactions

Minor:

ethinyl estradiol Food/Lifestyle

Applies to: ethinyl estradiol

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

Minor:

ethinyl estradiol Alcohol (Ethanol)

Applies to: ethinyl estradiol

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

Disease interactions

34 potential interactions Applies to: 31 conditions, including High Blood Pressure, High Cholesterol, Depression, Migraine, and Heart Failure.

Abnormal Uterine Bleeding

Major:

ethinyl estradiol

Ethinyl estradiol 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.

Angioedema

Moderate:

ethinyl estradiol

Ethinyl estradiol has a moderate potential interaction with Angioedema.

The use of exogenous estrogens may induce or exacerbate symptoms of angioedema, particularly in women with hereditary angioedema. Consider the risk versus benefits of estrogen therapy. Close monitoring is recommended when prescribing these agents to patients predisposed to angioedema.

Asthma

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Breast Cancer

Major:

ethinyl estradiol

Ethinyl estradiol 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.

Cerebral Vascular Disorder

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with Cerebral Vascular Disorder.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Depression

Moderate:

ethinyl estradiol

Ethinyl estradiol has a moderate potential interaction with Depression.

The use of oral contraceptives has been associated with an increased incidence of depression. It is uncertain whether this effect is related to the estrogenic or the progestogenic component of the contraceptive, although excess progesterone activity is associated with depression. Patients with a history of depression receiving estrogen and/or progestogen therapy should be followed closely. The manufacturer of medroxyprogesterone recommends monitoring patients who have a history of depression and to not re- administer medroxyprogesterone if depression recurs.

Diabetes Mellitus

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Fluid Retention

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Gallbladder Disease

Moderate:

ethinyl estradiol

Ethinyl estradiol has a moderate potential interaction with Gallbladder Disease.

A two- to four-fold increase in risk of gallbladder disease has been noted in women receiving postmenopausal estrogen therapy. The risk for gallbladder disease may be less for premenopausal women using oral contraceptives containing low-dose estrogens and/or progestins. Therapy with estrogens should be administered cautiously in patients with preexisting gallbladder disease or a history of pregnancy-related cholestasis.

Gastrointestinal Hemorrhage

Moderate:

Myhibbin

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Gastrointestinal Hemorrhage.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

Heart Failure

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Hepatic Tumor

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with Hepatic Tumor.

The use of oral contraceptives is contraindicated in patients with liver tumors. An increased risk of benign hepatic adenomas and hepatocellular carcinomas has been associated with long-term, oral estrogen- progestin contraceptive use of at least 4 years and 8 years, respectively. Although these tumors are rare and have not been reported with other types of estrogen or progestogen therapies, any preparation containing estrogens and/or progestogens should probably be avoided in patients with existing tumors of the liver. Hepatic hemangiomas and nodular hyperplasia of the liver have been reported with isolated estrogen therapy.

High Blood Pressure

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with High Blood Pressure.

The risk of myocardial infarction and strokes, including those associated with oral contraceptive use and some estrogen use, is increased in patients with hypertension. Moreover, estrogens (and progestogens) may elevate blood pressure and worsen the hypertension, thus compounding the risk. Clinically significant blood pressure increases have been reported during estrogen therapy, particularly in patients receiving high dosages or treated with oral contraceptive combinations having high progestational activity. These effects also increase with duration of therapy and patient age. Therapy with estrogens should be administered cautiously in patients with preexisting hypertension. Some estrogen-based therapies, such as combined hormonal contraceptives, may be contraindicated in patients with uncontrolled hypertension or hypertension with vascular disease. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary. In patients requiring contraception, alternative methods should be considered for those who are hypertensive, over age 35, and smoke.

High Cholesterol

Moderate:

ethinyl estradiol

Ethinyl estradiol has a moderate potential interaction with High Cholesterol.

Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.

History, Thrombotic/Thromboembolic Disorder

Major:

ethinyl estradiol

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

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Inflammatory Bowel Disease

Moderate:

Myhibbin

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Inflammatory Bowel Disease.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

Ischemic Heart Disease

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with Ischemic Heart Disease.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Lesch-Nyhan Syndrome

Moderate:

Myhibbin

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Lesch-Nyhan Syndrome.

Mycophenolate mofetil is an inosine monophosphate dehydrogenase (IMPDH) inhibitor; therefore it should be avoided in patients with hereditary deficiencies of hypoxanthine-guanine phosphoribosyl-transferase (HGPRT) such as Lesch-Nyhan and Kelley-Seegmiller syndromes because it may cause an exacerbation of disease symptoms characterized by the overproduction and accumulation of uric acid leading to symptoms associated with gout such as acute arthritis, tophi, nephrolithiasis or urolithiasis and renal disease including renal failure.

Liver Disease

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Moderate:

Myhibbin

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Liver Disease.

Mycophenolate mofetil (inactive) undergoes complete presystemic metabolism to active MPA , further metabolism to inactive forms, some of which undergo enterohepatic circulation producing a second peak of MPA. Alcoholic cirrhosis (parenchymal cell damage) does not appear to affect the metabolism of MPA to inactive forms. Hepatic disease/dysfunction due to other etiologies may induce different effects.

Melasma

Moderate:

ethinyl estradiol

Ethinyl estradiol has a moderate potential interaction with Melasma.

The use of exogenous estrogens may occasionally cause chloasma, especially in women with a history of chloasma gravidarum. Women with a tendency to chloasma should avoid exposure to the sun or ultraviolet radiation while taking combination oral contraceptives.

Migraine

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with Migraine.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Neoplasia, Estrogen Dependent

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with Neoplasia, Estrogen Dependent.

The use of estrogens is generally contraindicated in patients with known or suspected estrogen-dependent neoplasia such as breast and endometrial cancer, since it may stimulate tumor proliferation. High dosages of estrogens may be used for the palliative treatment of inoperable, metastatic breast cancer, but only in appropriately selected men and postmenopausal women.

Neutropenia

Major:

Myhibbin

The mycophenolate mofetil in Myhibbin has a major potential interaction with Neutropenia.

Severe neutropenia has occurred in up to 2% of patients administered mycophenolate. Therapy with mycophenolate should be administered cautiously in patients with or predisposed to neutropenia. Mycophenolate should be discontinued or the dose reduced in patients who develop neutropenia (absolute neutrophil count <1300/mm3). Clinical monitoring of hematopoietic function is recommended. Complete blood counts should be performed weekly during the first month, two times a month during the second and third months, and monthly for the remainder of the first year of treatment.

Pancreatitis

Moderate:

ethinyl estradiol

Ethinyl estradiol has a moderate potential interaction with Pancreatitis.

Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.

Peptic Ulcer

Moderate:

Myhibbin

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Peptic Ulcer.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

Renal Dysfunction

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Moderate:

Myhibbin

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Renal Dysfunction.

Mycophenolate undergoes complete presystemic metabolism to its active form, MPA . Less than 1% of MPA is excreted in the urine. In a single-dose study, the area under the curve (AUC) for MPA in patients with severe chronic renal impairment (creatinine clearance <25 mL/min) was approximately 75% greater than those of healthy volunteers (creatinine clearance >80 mL/min). The AUC for the inactive metabolite was 3 to 6 times higher. Multiple dose studies have not been performed. No data are available for cardiac transplant patients with severe renal impairment and when benefit outweighs risk, therapy with mycophenolate should be administered with extreme caution.

Seizures

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Smoking

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with Smoking.

Cigarette smoking increases the risk of serious cardiovascular events from estrogen-containing combination oral contraceptives (COC). This risk increases with age, particularly in females over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs are contraindicated in females who are over 35 years of age and smoke.

Thrombotic/Thromboembolic Disorder

Major:

ethinyl estradiol

Ethinyl estradiol has a major potential interaction with Thrombotic/Thromboembolic Disorder.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Thyroid Disease

Moderate:

ethinyl estradiol

Ethinyl estradiol 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.

Vaccination

Moderate:

Myhibbin

The mycophenolate mofetil in Myhibbin has a moderate potential interaction with Vaccination.

During treatment with mycophenolate mofetil, the use of live attenuated vaccines should be avoided and patients should be advised that vaccinations may be less effective. Advise patients to discuss with the physician before seeking any immunizations.

More resources

ethinyl estradiol

A total of 525 drugs are known to interact with ethinyl estradiol.

Myhibbin

A total of 365 drugs are known to interact with Myhibbin.

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.