Interactions between Kyleena and Tofacitinib

The levonorgestrel in Kyleena has a major potential interaction with Abnormal Uterine Bleeding.

The use of contraceptives is contraindicated when there is an undiagnosed abnormal genital bleeding. Adequate diagnostic measures should be undertaken to rule out the presence of any malignancy.

The levonorgestrel in Kyleena 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.

The levonorgestrel in Kyleena has a major potential interaction with Breast Cancer.

The use of progestogens is considered by manufacturers to be contraindicated in patients with existing or suspected malignancy of the breast. Some supportive data are available for medroxyprogesterone. Specifically, medroxyprogesterone treatment may be associated with breast cancer, primarily when the drug is administered intramuscularly. A pooled analysis of two case-control studies, one from the World Health Organization and the other from New Zealand, revealed a small overall relative risk of breast cancer in women who have ever used intramuscular medroxyprogesterone acetate. The relative risk was higher in the subgroup of women who had initiated therapy within the previous 5 years. Thus, an increased risk (approximately 2-fold) is associated with intramuscular medroxyprogesterone use in the first 5 years. A more recent U.S. study also found a statistically significant increase in breast cancer risk among recent users (defined as last use within the past five years) who used depo-medroxyprogesterone acetate for 12 months or longer.

Tofacitinib has a major potential interaction with Cardiovascular Conditions and Disorders.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

The levonorgestrel in Kyleena has a moderate potential interaction with Cerebral Vascular Disorder.

The use of levonorgestrel requires careful assessment and caution in conditions of arterial disease, including stroke and myocardial infarction, and also, in patients with increased blood pressure and coagulopathies.

The levonorgestrel in Kyleena 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.

The levonorgestrel in Kyleena 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.

Tofacitinib has a moderate potential interaction with Diabetes Mellitus.

The use of tofacitinib increases the risk of infections. As there is a higher incidence of infection in diabetic patients in general, caution is recommended when treating patients with diabetes.

The levonorgestrel in Kyleena 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.

Tofacitinib has a moderate potential interaction with Gastrointestinal Diverticula.

Tofacitinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with history of diverticulitis or taking NSAIDs). Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation.

Tofacitinib has a moderate potential interaction with Gastrointestinal Obstruction.

As with any other nondeformable material, caution is recommended when administering tofacitinib extended-release tablets to patients with preexisting severe gastrointestinal narrowing (pathologic or iatrogenic). There have been rare reports of obstructive symptoms in patients with known strictures in association with the ingestion of other drugs utilizing a nondeformable extended-release formulation.

Tofacitinib has a moderate potential interaction with Gastrointestinal Perforation.

Tofacitinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with history of diverticulitis or taking NSAIDs). Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation.

The levonorgestrel in Kyleena 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.

Tofacitinib has a moderate potential interaction with Hemoglobinopathy.

Adverse hematologic effects including neutropenia, lymphocytosis, and anemia have been associated with the use of tofacitinib. It is recommended to avoid starting therapy in patients with absolute lymphocyte counts (ALC) less than 500 cells/mm3, absolute neutrophil counts (ANC) less than 1000 cells/mm3, or hemoglobin levels less than 9 g/dL. For persistent ANC of 500 to 1000 cells/mm3, hemoglobin levels less than 8 g/dL, or a hemoglobin level drop greater than 2 g/dL, therapy should be interrupted until ANC is greater than 1000 cells/mm3 and hemoglobin values have normalized. Treatment with tofacitinib is not recommended in patients who develop a confirmed ALC less than 500 cells/mm3 or an ANC less than 500 cells/mm3. Lymphocyte counts should be monitored at baseline and every 3 months thereafter; neutrophil counts and hemoglobin should be monitored at baseline, after 4 to 8 weeks of therapy, and every 3 months thereafter. Treatment should be modified based on ALC, ANC, and/or hemoglobin levels. Caution is recommended in patients who may be at increased risk.

The levonorgestrel in Kyleena 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.

The levonorgestrel in Kyleena has a moderate potential interaction with High Blood Pressure.

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 levonorgestrel in Kyleena has a moderate potential interaction with High Cholesterol.

Some progestogenic agents may elevate plasma LDL levels and/or lower HDL levels, although data have been inconsistent. Patients with preexisting hyperlipidemia may require closer monitoring during progestogen therapy, and adjustments made accordingly in their lipid-lowering regimen.

Tofacitinib has a moderate potential interaction with High Cholesterol.

Treatment with tofacitinib was associated with dose-dependent increases in lipid parameters (including total cholesterol, low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL] cholesterol); maximum effects generally occurred within 6 weeks. Lipid parameters should be assessed about 4 to 8 weeks after initiation of therapy. Patients should be managed according to clinical guidelines for the management of hyperlipidemia.

The levonorgestrel in Kyleena has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.

The use of levonorgestrel requires careful assessment and caution in conditions of arterial disease, including stroke and myocardial infarction, and also, in patients with increased blood pressure and coagulopathies.

Tofacitinib has a major potential interaction with History, Tuberculosis.

Use of tofacitinib should be avoided in patients with an active, serious infection. Patients should be evaluated and tested for latent or active tuberculosis (TB) infection before and per applicable guidelines during use of tofacitinib. Anti-TB therapy should also be considered before use of tofacitinib in patients with history of latent or active TB in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent TB but who have risk factors for TB infection. Consultation with a physician with expertise in the treatment of TB is recommended to aid in the decision about whether initiating anti-TB therapy is appropriate for an individual patient. Patients should be closely monitored for signs/symptoms of TB, including patients who tested negative for latent TB infection before initiating therapy. Patients with latent TB should be treated with standard antimycobacterial therapy before using tofacitinib.

Tofacitinib has a major potential interaction with Immunodeficiency.

Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving tofacitinib. Use of tofacitinib should be avoided in patients with an active, serious infection, including localized infections. The risks and benefits of treatment should be considered before starting tofacitinib in patients: with chronic/recurrent infection, who have been exposed to tuberculosis, with history of serious/opportunistic infection, who have resided/traveled in areas of endemic tuberculosis/mycoses, or with underlying conditions that may predispose them to infection. Patients should be closely monitored for signs/symptoms of infection during and after tofacitinib treatment. Tofacitinib should be interrupted if a patient develops a serious infection, an opportunistic infection, or sepsis. A patient who develops a new infection during treatment with tofacitinib should undergo prompt and complete diagnostic testing appropriate for an immunocompromised patient; appropriate antimicrobial therapy should be started, and the patient should be monitored closely. Caution is also recommended in patients with history of chronic lung disease, or in those who develop interstitial lung disease, as they may be more prone to infections.

Tofacitinib has a major potential interaction with Infection.

Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving tofacitinib. Use of tofacitinib should be avoided in patients with an active, serious infection, including localized infections. The risks and benefits of treatment should be considered before starting tofacitinib in patients: with chronic/recurrent infection, who have been exposed to tuberculosis, with history of serious/opportunistic infection, who have resided/traveled in areas of endemic tuberculosis/mycoses, or with underlying conditions that may predispose them to infection. Patients should be closely monitored for signs/symptoms of infection during and after tofacitinib treatment. Tofacitinib should be interrupted if a patient develops a serious infection, an opportunistic infection, or sepsis. A patient who develops a new infection during treatment with tofacitinib should undergo prompt and complete diagnostic testing appropriate for an immunocompromised patient; appropriate antimicrobial therapy should be started, and the patient should be monitored closely. Caution is also recommended in patients with history of chronic lung disease, or in those who develop interstitial lung disease, as they may be more prone to infections.

Tofacitinib has a moderate potential interaction with Infectious Hepatitis.

Viral reactivation (including cases of herpes virus reactivation [e.g., herpes zoster]) was observed in clinical trials with tofacitinib; postmarketing cases of hepatitis B reactivation have been reported with tofacitinib. Patients should be screened for viral hepatitis in accordance with clinical guidelines before starting therapy with tofacitinib. Close monitoring is recommended, and appropriate supportive treatment should be initiated if appropriate.

The levonorgestrel in Kyleena has a major potential interaction with Liver Disease.

The use of progestogens, in general, is contraindicated in patients with impaired hepatic function or liver disease. There are little or no data concerning the pharmacokinetic disposition of the different progestogens in patients with hepatic disease. However, most hormones, including progestational hormones, are known to be extensively metabolized by the liver. Medroxyprogesterone should not be used by women with significant liver disease and should be discontinued if jaundice or disturbances of liver function occur.

Tofacitinib has a moderate potential interaction with Liver Disease.

Treatment with tofacitinib was associated with an increased incidence of liver enzyme elevation compared to placebo. No dose adjustment of tofacitinib is needed in patients with mild liver dysfunction. Tofacitinib-treated patients with moderate liver dysfunction had greater tofacitinib blood levels than those with normal liver function; therefore, dose adjustment of tofacitinib is recommended in these patients. Tofacitinib has not been studied in patients with severe liver dysfunction, and its use is not recommended in these patients. The safety and efficacy of tofacitinib has not been studied in patients with positive hepatitis B virus or hepatitis C virus serology. Routine monitoring of liver tests and prompt investigation of the causes of liver enzyme elevations is recommended to identify potential cases of drug-induced liver injury; if drug-induced liver injury is suspected, therapy should be interrupted until this diagnosis has been excluded.

Tofacitinib has a moderate potential interaction with Lymphocytopenia.

Adverse hematologic effects including neutropenia, lymphocytosis, and anemia have been associated with the use of tofacitinib. It is recommended to avoid starting therapy in patients with absolute lymphocyte counts (ALC) less than 500 cells/mm3, absolute neutrophil counts (ANC) less than 1000 cells/mm3, or hemoglobin levels less than 9 g/dL. For persistent ANC of 500 to 1000 cells/mm3, hemoglobin levels less than 8 g/dL, or a hemoglobin level drop greater than 2 g/dL, therapy should be interrupted until ANC is greater than 1000 cells/mm3 and hemoglobin values have normalized. Treatment with tofacitinib is not recommended in patients who develop a confirmed ALC less than 500 cells/mm3 or an ANC less than 500 cells/mm3. Lymphocyte counts should be monitored at baseline and every 3 months thereafter; neutrophil counts and hemoglobin should be monitored at baseline, after 4 to 8 weeks of therapy, and every 3 months thereafter. Treatment should be modified based on ALC, ANC, and/or hemoglobin levels. Caution is recommended in patients who may be at increased risk.

The levonorgestrel in Kyleena 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.

Tofacitinib has a moderate potential interaction with Neutropenia.

Adverse hematologic effects including neutropenia, lymphocytosis, and anemia have been associated with the use of tofacitinib. It is recommended to avoid starting therapy in patients with absolute lymphocyte counts (ALC) less than 500 cells/mm3, absolute neutrophil counts (ANC) less than 1000 cells/mm3, or hemoglobin levels less than 9 g/dL. For persistent ANC of 500 to 1000 cells/mm3, hemoglobin levels less than 8 g/dL, or a hemoglobin level drop greater than 2 g/dL, therapy should be interrupted until ANC is greater than 1000 cells/mm3 and hemoglobin values have normalized. Treatment with tofacitinib is not recommended in patients who develop a confirmed ALC less than 500 cells/mm3 or an ANC less than 500 cells/mm3. Lymphocyte counts should be monitored at baseline and every 3 months thereafter; neutrophil counts and hemoglobin should be monitored at baseline, after 4 to 8 weeks of therapy, and every 3 months thereafter. Treatment should be modified based on ALC, ANC, and/or hemoglobin levels. Caution is recommended in patients who may be at increased risk.

Tofacitinib has a major potential interaction with Pulmonary Impairment.

Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving tofacitinib. Use of tofacitinib should be avoided in patients with an active, serious infection, including localized infections. The risks and benefits of treatment should be considered before starting tofacitinib in patients: with chronic/recurrent infection, who have been exposed to tuberculosis, with history of serious/opportunistic infection, who have resided/traveled in areas of endemic tuberculosis/mycoses, or with underlying conditions that may predispose them to infection. Patients should be closely monitored for signs/symptoms of infection during and after tofacitinib treatment. Tofacitinib should be interrupted if a patient develops a serious infection, an opportunistic infection, or sepsis. A patient who develops a new infection during treatment with tofacitinib should undergo prompt and complete diagnostic testing appropriate for an immunocompromised patient; appropriate antimicrobial therapy should be started, and the patient should be monitored closely. Caution is also recommended in patients with history of chronic lung disease, or in those who develop interstitial lung disease, as they may be more prone to infections.

The levonorgestrel in Kyleena 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.

Tofacitinib has a moderate potential interaction with Renal Dysfunction.

No dose adjustment of tofacitinib is needed in patients with mild renal dysfunction. Tofacitinib-treated patients with moderate and severe renal dysfunction had greater tofacitinib blood levels than those with normal renal function; therefore, dose adjustment of tofacitinib is recommended in patients with moderate or severe renal dysfunction (including but not limited to those with severe dysfunction undergoing hemodialysis). Caution should be exercised when using tofacitinib in these patients.

The levonorgestrel in Kyleena 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.

Tofacitinib has a major potential interaction with Smoking.

In a major safety study of a Janus kinase (JAK) inhibitor, tofacitinib, in rheumatoid arthritis patients 50 years and older with at least 1 cardiovascular risk factor, higher rates of all-cause mortality (including sudden cardiovascular death) and major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke) were observed with the JAK inhibitor when compared with tumor necrosis factor (TNF) blockers. Patients who were current or past smokers had an additional increased risk. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including baricitinib, upadacitinib, ruxolitinib, fedratinib, ritlecitinib, deuruxolitinib, and pacritinib. Consider the benefits and risks for each individual patient prior and during treatment with JAK inhibitors, especially in patients with other cardiovascular risk factors, history of cardiovascular events, and patients who are current or past smokers. Patients should be informed about the symptoms of serious cardiovascular events and what to do if they occur.

Tofacitinib has a major potential interaction with Smoking.

Malignancies (including lymphomas and solid tumors) have been reported in patients treated with tofacitinib, baricitinib, upadacitinib, deuruxolitinib and other Janus kinase (JAK) inhibitors used to treat inflammatory conditions. Patients who are current or past smokers are at additional increased risk of malignancies. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, pacritinib, and fedratinib. Before starting or continuing therapy, the benefits and risks for the individual patient should be considered, especially in patients with a known malignancy (other than successfully treated nonmelanoma skin cancer), patients who develop a malignancy during therapy, and patients who are current or past smokers. Periodic skin examination is recommended for patients who are at increased risk for skin cancer.

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

Thrombosis (including deep venous thrombosis, pulmonary embolism, cerebral venous sinus thrombosis, and arterial thrombosis) has occurred in patients treated for inflammatory conditions with Janus kinase (JAK) inhibitors, including baricitinib, tofacitinib, deuruxolitinib and upadacitinib. Many of these adverse events were serious and some resulted in death. Based on a shared mechanism of action, this risk should be considered for other JAK inhibitors, including ruxolitinib, fedratinib, and pacritinib. In general, JAK inhibitors should be avoided in patients who may be at increased risk of thrombosis. Tofacitinib should be used at the lowest effective dose and for the shortest duration needed to achieve/maintain therapeutic response when treating ulcerative colitis. If symptoms of thrombosis occur in any patients receiving JAK inhibitors, treatment should be discontinued and patients should be evaluated promptly and treated appropriately.

The levonorgestrel in Kyleena has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.

The use of levonorgestrel requires careful assessment and caution in conditions of arterial disease, including stroke and myocardial infarction, and also, in patients with increased blood pressure and coagulopathies.

The levonorgestrel in Kyleena 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.

Tofacitinib has a major potential interaction with Tuberculosis, Active.

Use of tofacitinib should be avoided in patients with an active, serious infection. Patients should be evaluated and tested for latent or active tuberculosis (TB) infection before and per applicable guidelines during use of tofacitinib. Anti-TB therapy should also be considered before use of tofacitinib in patients with history of latent or active TB in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent TB but who have risk factors for TB infection. Consultation with a physician with expertise in the treatment of TB is recommended to aid in the decision about whether initiating anti-TB therapy is appropriate for an individual patient. Patients should be closely monitored for signs/symptoms of TB, including patients who tested negative for latent TB infection before initiating therapy. Patients with latent TB should be treated with standard antimycobacterial therapy before using tofacitinib.

Tofacitinib has a major potential interaction with Tuberculosis, Latent.

Use of tofacitinib should be avoided in patients with an active, serious infection. Patients should be evaluated and tested for latent or active tuberculosis (TB) infection before and per applicable guidelines during use of tofacitinib. Anti-TB therapy should also be considered before use of tofacitinib in patients with history of latent or active TB in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent TB but who have risk factors for TB infection. Consultation with a physician with expertise in the treatment of TB is recommended to aid in the decision about whether initiating anti-TB therapy is appropriate for an individual patient. Patients should be closely monitored for signs/symptoms of TB, including patients who tested negative for latent TB infection before initiating therapy. Patients with latent TB should be treated with standard antimycobacterial therapy before using tofacitinib.

Tofacitinib has a moderate potential interaction with Varicella-Zoster.

Viral reactivation (including cases of herpes virus reactivation [e.g., herpes zoster]) was observed in clinical trials with tofacitinib; postmarketing cases of hepatitis B reactivation have been reported with tofacitinib. Patients should be screened for viral hepatitis in accordance with clinical guidelines before starting therapy with tofacitinib. Close monitoring is recommended, and appropriate supportive treatment should be initiated if appropriate.

The levonorgestrel in Kyleena has a minor potential interaction with Weight Loss.

Progestogens can cause weight gain, which may be significant (as is the case with parenteral medroxyprogesterone) and undesirable in obese patients attempting to lose weight.