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Drug Interactions between Lunelle and metreleptin

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

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Interactions between your drugs

Moderate

medroxyPROGESTERone metreleptin

Applies to: Lunelle (estradiol / medroxyprogesterone) and metreleptin

MONITOR: Treatment with metreleptin, a recombinant analog of human leptin, may affect the pharmacokinetics of drugs that are primarily metabolized by CYP450 isoenzymes. In leptin-deficient obese mice, administration of leptin has been shown to alter the hepatic levels of some CYP450 isoenzymes.

MANAGEMENT: Caution is advised when metreleptin is prescribed to patients receiving drugs with a narrow therapeutic index that are substrates of CYP450 isoenzymes, such as macrolide immunosuppressants, oral contraceptives, cyclosporine, theophylline, and warfarin. Clinical and laboratory monitoring are recommended following the initiation, discontinuation or change of dosage of metreleptin, and the individual dosage of the concomitant agents adjusted as needed.

References

  1. (2014) "Product Information. Myalept (metreleptin)." Bristol-Myers Squibb

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Drug and food interactions

Minor

estradiol food

Applies to: Lunelle (estradiol / medroxyprogesterone)

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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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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