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Drug Interactions between Kelnor 1/50 and miltefosine

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

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Interactions between your drugs

Moderate

ethinyl estradiol miltefosine

Applies to: Kelnor 1 / 50 (ethinyl estradiol / ethynodiol) and miltefosine

ADDITIONAL CONTRACEPTION RECOMMENDED: The vomiting and/or diarrhea that commonly occur during miltefosine therapy may affect the absorption of oral contraceptives, potentially compromising their efficacy.

MANAGEMENT: Female patients receiving oral contraceptives should be advised to use additional non-hormonal or alternative method(s) of effective contraception if vomiting or diarrhea occurs during miltefosine therapy. This is particularly important because miltefosine may cause fetal harm. Teratogenicity and fetal death were observed in animals administered miltefosine at dosages lower than the recommended human dosage. Females of reproductive potential should use effective contraception during miltefosine therapy and for 5 months after completion of therapy.

References

  1. (2014) "Product Information. Impavido (miltefosine)." Paladin Therapeutics Inc

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Moderate

ethynodiol miltefosine

Applies to: Kelnor 1 / 50 (ethinyl estradiol / ethynodiol) and miltefosine

ADDITIONAL CONTRACEPTION RECOMMENDED: The vomiting and/or diarrhea that commonly occur during miltefosine therapy may affect the absorption of oral contraceptives, potentially compromising their efficacy.

MANAGEMENT: Female patients receiving oral contraceptives should be advised to use additional non-hormonal or alternative method(s) of effective contraception if vomiting or diarrhea occurs during miltefosine therapy. This is particularly important because miltefosine may cause fetal harm. Teratogenicity and fetal death were observed in animals administered miltefosine at dosages lower than the recommended human dosage. Females of reproductive potential should use effective contraception during miltefosine therapy and for 5 months after completion of therapy.

References

  1. (2014) "Product Information. Impavido (miltefosine)." Paladin Therapeutics Inc

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Drug and food interactions

Moderate

miltefosine food

Applies to: miltefosine

ADJUST DOSING INTERVAL: Administration of miltefosine with food may help reduce gastrointestinal adverse effects such as nausea, vomiting, abdominal pain, and diarrhea.

MANAGEMENT: Miltefosine should be administered with meals to help improve gastrointestinal tolerance. Patients should be advised to contact their physician if they develop severe or persistent vomiting or diarrhea, and to drink plenty of fluids to help prevent dehydration and kidney injury.

References

  1. (2014) "Product Information. Impavido (miltefosine)." Paladin Therapeutics Inc

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Minor

ethinyl estradiol food

Applies to: Kelnor 1 / 50 (ethinyl estradiol / ethynodiol)

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. (1996) "Can grapefruit juice influence ethinyl estradiol bioavailability?" Contraception, 53, p. 41-7
  2. 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

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Minor

ethinyl estradiol food

Applies to: Kelnor 1 / 50 (ethinyl estradiol / ethynodiol)

The central nervous system effects and blood levels of ethanol may be increased in patients taking oral contraceptives, although data are lacking and reports are contradictory. The mechanism may be due to enzyme inhibition. Consider counseling women about this interaction which is unpredictable.

References

  1. Hobbes J, Boutagy J, Shenfield GM (1985) "Interactions between ethanol and oral contraceptive steroids." Clin Pharmacol Ther, 38, p. 371-80

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Minor

ethynodiol food

Applies to: Kelnor 1 / 50 (ethinyl estradiol / ethynodiol)

The central nervous system effects and blood levels of ethanol may be increased in patients taking oral contraceptives, although data are lacking and reports are contradictory. The mechanism may be due to enzyme inhibition. Consider counseling women about this interaction which is unpredictable.

References

  1. Hobbes J, Boutagy J, Shenfield GM (1985) "Interactions between ethanol and oral contraceptive steroids." Clin Pharmacol Ther, 38, p. 371-80

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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.

See also

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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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