Interactions between Insulin isophane and Menogen HS
2 drug interactions and 53 additional warnings found for the following 2 drugs:
- insulin isophane
- Menogen HS (esterified estrogens/methyltestosterone)
Drug interactions
Moderate drug interactions
Moderate:
methylTESTOSTERone insulin isophane (NPH)
Applies to: Menogen HS (esterified estrogens / methyltestosterone) and insulin isophane
Monitor
The hypoglycemic effect of insulin may be potentiated by certain drugs, including ACE inhibitors, angiotensin receptor blockers (ARBs), 4-aminoquinolines, amylin analogs, anabolic steroids, fibrates, monoamine oxidase inhibitors (MAOIs, including linezolid), salicylates, selective serotonin reuptake inhibitors (SSRIs), sulfonamides, disopyramide, propoxyphene, quinidine, quinine, and ginseng. These drugs may increase the risk of hypoglycemia by enhancing insulin sensitivity (ACE inhibitors, ARBs, fibrates, ginseng); stimulating insulin secretion (salicylates, disopyramide, pentoxifylline, propoxyphene, quinidine, quinine, MAOIs, ginseng); decreasing insulin clearance and resistance (4-aminoquinolines); increasing peripheral glucose utilization (SSRIs, insulin-like growth factor); inhibiting gluconeogenesis (SSRIs, MAOIs, insulin-like growth factor); slowing the rate of gastric emptying (amylin analogs); and/or suppressing postprandial glucagon secretion (amylin analogs). Clinical hypoglycemia has been reported during use of some of these agents alone or with insulin and/or insulin secretagogues. Use of SSRIs has also been associated with loss of awareness of hypoglycemia in isolated cases.
Management
Close monitoring for the development of hypoglycemia is recommended if these drugs are coadministered with insulin, particularly in patients with advanced age and/or renal impairment. The insulin dosage may require adjustment if an interaction is suspected. Patients should be apprised of the signs and symptoms of hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, palpitations), how to treat it, and to contact their physician if it occurs. Patients should be observed for loss of glycemic control when these drugs are withdrawn.
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Moderate:
esterified estrogens insulin isophane (NPH)
Applies to: Menogen HS (esterified estrogens / methyltestosterone) and insulin isophane
Monitor
The efficacy of insulin and other antidiabetic agents may be diminished by certain drugs, including atypical antipsychotics, corticosteroids, diuretics, estrogens, gonadotropin-releasing hormone agonists, human growth hormone, phenothiazines, progestins, protease inhibitors, sympathomimetic amines, thyroid hormones, L-asparaginase, alpelisib, copanlisib, danazol, diazoxide, isoniazid, megestrol, omacetaxine, phenytoin, sirolimus, tagraxofusp, temsirolimus, as well as pharmacologic dosages of nicotinic acid and adrenocorticotropic agents. These drugs may interfere with blood glucose control because they can cause hyperglycemia, glucose intolerance, new-onset diabetes mellitus, and/or exacerbation of preexisting diabetes.
Management
Caution is advised when drugs that can interfere with glucose metabolism are prescribed to patients with diabetes. Close clinical monitoring of glycemic control is recommended following initiation or discontinuation of these drugs, and the dosages of concomitant antidiabetic agents adjusted as necessary. Patients should be advised to notify their physician if their blood glucose is consistently high or if they experience symptoms of severe hyperglycemia such as excessive thirst and increases in the volume or frequency of urination. Likewise, patients should be observed for hypoglycemia when these drugs are withdrawn from their therapeutic regimen.
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- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
- (2019) "Product Information. Elzonris (tagraxofusp)." Stemline Therapeutics
- (2019) "Product Information. Piqray (alpelisib)." Novartis Pharmaceuticals
- Drazilova S, Gazda J, Janicko M, Jarcuska P (2018) "Chronic Hepatitis C Association with Diabetes Mellitus and Cardiovascular Risk in the Era of DAA Therapy" Can J Gastroenterol Hepatol, 1, p. 1-11
- (2026) "Product Information. Awiqli FlexTouch (insulin icodec)." Novo Nordisk Pharmaceuticals Inc
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
insulin isophane (NPH) Food/Lifestyle
Applies to: insulin isophane
Generally avoid
Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.
Management
Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.
References (11)
- Jerntorp P, Almer LO (1981) "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand, 656, p. 33-6
- Jerntorp P, Almer LO, Holin H, et al. (1983) "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol, 24, p. 237-42
- Barnett AH, Spiliopoulos AJ, Pyke DA, et al. (1983) "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia, 24, p. 213-5
- Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A (1987) "Interaction of ethanol and glipizide in humans." Diabetes Care, 10, p. 683-6
- (2002) "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals
- (2002) "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals
- "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
- Skillman TG, Feldman JM (1981) "The pharmacology of sulfonylureas." Am J Med, 70, p. 361-72
- (2002) "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care, 25(Suppl 1), S50-S60
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2026) "Product Information. Awiqli FlexTouch (insulin icodec)." Novo Nordisk Pharmaceuticals Inc
Minor food/lifestyle interactions
Minor:
esterified estrogens Food/Lifestyle
Applies to: Menogen HS (esterified estrogens / methyltestosterone)
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 (2)
- Weber A, Jager R, Borner A, et al. (1996) "Can grapefruit juice influence ethinyl estradiol bioavailability?" Contraception, 53, p. 41-7
- Schubert W, Eriksson U, Edgar B, Cullberg G, Hedner T (1995) "Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17B-estradiol." Eur J Drug Metab Pharmacokinet, 20, p. 219-24
Disease interactions
51 potential interactions Applies to: 38 conditions, including High Blood Pressure, High Cholesterol, Migraine, Underactive Thyroid, and Heart Failure.
Abnormal Uterine Bleeding
Major:
Menogen HS
The esterified estrogens in Menogen HS 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.
Adrenal Insufficiency
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Adrenal Insufficiency.
Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including those who are debilitated or malnourished, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those receiving beta-adrenergic blocking agents.
Angioedema
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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.
Anorexia/Feeding Problems
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Anorexia/Feeding Problems.
Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including those who are debilitated or malnourished, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those receiving beta-adrenergic blocking agents.
Asthma
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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.
Autonomic Neuropathy
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Autonomic Neuropathy.
Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including those who are debilitated or malnourished, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those receiving beta-adrenergic blocking agents.
Benign Prostatic Hyperplasia
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Benign Prostatic Hyperplasia.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Bleeding Disorder
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Bleeding Disorder.
Androgenic anabolic steroids may cause suppression of clotting factors II, V, VII, and X, and an increase in prothrombin time. Androgen therapy should be administered cautiously in patients with bleeding disorders.
Breast Cancer
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Breast Cancer.
When treated with androgenic anabolic steroids, patients with metastatic breast cancer may develop hypercalcemia due to osteolysis. Frequent determination of urine and serum calcium levels is recommended during therapy with androgenic agents. If hypercalcemia occurs, therapy should be stopped. The development of hypercalcemia may indicate progression of metastases to the bone.
Major:
Menogen HS
The esterified estrogens in Menogen HS 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.
Breast Cancer, Male
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Breast Cancer, Male.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Cerebral Vascular Disorder
Major:
Menogen HS
The esterified estrogens in Menogen HS 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.
Diabetes Mellitus
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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.
Moderate:
Menogen HS
The methylTESTOSTERone in Menogen HS has a moderate potential interaction with Diabetes Mellitus.
The metabolic effects of androgenic anabolic steroids may lower blood glucose. Decreased glucose tolerance and increased insulin resistance have also been reported. Patients with diabetes mellitus should be monitored more closely during therapy with androgenic agents, and their antidiabetic regimen adjusted accordingly.
Fluid Retention
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Fluid Retention.
Androgenic anabolic steroids may cause sodium and water 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 fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The esterified estrogens in Menogen HS 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.
Heart Failure
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Heart Failure.
Androgenic anabolic steroids may cause sodium and water 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 fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The esterified estrogens in Menogen HS 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
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with High Cholesterol.
Androgenic anabolic steroids may adversely affect serum lipids, including lowering HDL and elevating LDL levels. These changes can be marked, particularly with the 17-alpha-alkyl derivatives (i.e., fluoxymesterone, methyltestosterone, oxandrolone, oxymetholone, and stanozolol), and may significantly impact the risk of atherosclerosis and coronary artery disease. Patients with preexisting hyperlipoproteinemia may require closer monitoring during therapy with androgenic agents, and adjustments made accordingly in their lipid-lowering regimen. Androgen therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The esterified estrogens in Menogen HS 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.
Hypercalcemia
Moderate:
Menogen HS
The methylTESTOSTERone in Menogen HS has a moderate potential interaction with Hypercalcemia.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Hyperparathyroidism
Moderate:
Menogen HS
The methylTESTOSTERone in Menogen HS has a moderate potential interaction with Hyperparathyroidism.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Hyperthyroidism
Minor:
Menogen HS
The methylTESTOSTERone in Menogen HS has a minor potential interaction with Hyperthyroidism.
When androgenic anabolic steroids are used in patients with thyroid disorders, clinicians should be aware that these agents may affect thyroid function tests. Specifically, thyroid-binding globulin levels may be decreased, resulting in lower total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however.
Hypokalemia
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Hypokalemia.
Hypokalemia may commonly occur during treatment with insulin. Use with caution in patients who may be particularly at risk of developing hypokalemia (e.g., patients using potassium-lowering medications, patients taking medications sensitive to serum potassium concentrations).
Hypoparathyroidism
Moderate:
Menogen HS
The esterified estrogens in Menogen HS has a moderate potential interaction with Hypoparathyroidism.
Estrogens should be used with caution in individuals with severe hypocalcemia or hypoparathyroidism. Estrogen-induced hypocalcemia may occur in patients with hypoparathyroidism; consider whether the benefits of estrogen therapy outweigh the risks.
Ischemic Heart Disease
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Ischemic Heart Disease.
Androgenic anabolic steroids may adversely affect serum lipids, including lowering HDL and elevating LDL levels. These changes can be marked, particularly with the 17-alpha-alkyl derivatives (i.e., fluoxymesterone, methyltestosterone, oxandrolone, oxymetholone, and stanozolol), and may significantly impact the risk of atherosclerosis and coronary artery disease. Patients with preexisting hyperlipoproteinemia may require closer monitoring during therapy with androgenic agents, and adjustments made accordingly in their lipid-lowering regimen. Androgen therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.
Major:
Menogen HS
The esterified estrogens in Menogen HS 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.
Liver Disease
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Liver Disease.
Androgenic anabolic steroids may cause sodium and water 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 fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Liver Disease.
The use of androgenic anabolic steroids may be associated with development of cholestatic hepatitis and jaundice. Other, more serious hepatotoxicities such as peliosis hepatis and hepatocellular neoplasms are rare but may occur with prolonged use or high dosages. These latter toxicities may be fatal and often not recognized until they become life-threatening. Patients with preexisting liver diseases should be monitored more closely during therapy with anabolic steroids if they are used. If liver function declines or toxicity occurs, therapy should be withdrawn and the cause investigated.
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Liver Disease.
Insulin requirements may be diminished in patients with renal or hepatic impairment due to reduced insulin metabolism and, in the latter case, also to reduced capacity for gluconeogenesis. Lower initial dosages may be appropriate, with careful monitoring of plasma glucose levels and dosing adjustments.
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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.
Malnourishment
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Malnourishment.
Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including those who are debilitated or malnourished, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those receiving beta-adrenergic blocking agents.
Migraine
Major:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The esterified estrogens in Menogen HS 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.
Pancreatitis
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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.
Panhypopituitarism
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Panhypopituitarism.
Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including those who are debilitated or malnourished, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those receiving beta-adrenergic blocking agents.
Polycythemia
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Polycythemia.
Androgenic anabolic steroids may cause polycythemia when given in high dosages or for prolonged periods. Patients with preexisting polycythemia may experience worsening of their condition. Frequent monitoring of clinical status and hemoglobin and hematocrit levels is recommended if androgen therapy is administered to these patients.
Prostate Cancer
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Prostate Cancer.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Renal Dysfunction
Major:
Menogen HS
The methylTESTOSTERone in Menogen HS has a major potential interaction with Renal Dysfunction.
Androgenic anabolic steroids may cause sodium and water 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 fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Moderate:
insulin isophane
The insulin isophane (NPH) in insulin isophane has a moderate potential interaction with Renal Dysfunction.
Insulin requirements may be diminished in patients with renal or hepatic impairment due to reduced insulin metabolism and, in the latter case, also to reduced capacity for gluconeogenesis. Lower initial dosages may be appropriate, with careful monitoring of plasma glucose levels and dosing adjustments.
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The methylTESTOSTERone in Menogen HS has a moderate potential interaction with Renal Dysfunction.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Seizures
Moderate:
Menogen HS
The esterified estrogens in Menogen HS 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.
Thrombotic/Thromboembolic Disorder
Major:
Menogen HS
The esterified estrogens in Menogen HS 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:
Menogen HS
The esterified estrogens in Menogen HS 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.
Underactive Thyroid
Minor:
Menogen HS
The methylTESTOSTERone in Menogen HS has a minor potential interaction with Underactive Thyroid.
When androgenic anabolic steroids are used in patients with thyroid disorders, clinicians should be aware that these agents may affect thyroid function tests. Specifically, thyroid-binding globulin levels may be decreased, resulting in lower total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however.
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insulin isophane
A total of 458 drugs are known to interact with insulin isophane.
- Insulin isophane is in the drug class insulin.
- Insulin isophane is used to treat the following conditions:
Menogen HS
A total of 291 drugs are known to interact with Menogen HS.
- Menogen hs is in the drug class sex hormone combinations.
- Menogen hs is used to treat the following conditions:
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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