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Drug Interactions between Microgestin Fe 1/20 and vadadustat

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

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Interactions between your drugs

Moderate

ethinyl estradiol vadadustat

Applies to: Microgestin Fe 1 / 20 (ethinyl estradiol / norethindrone) and vadadustat

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with vadadustat may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 and/or CYP450 2C8 isoenzymes. Vadadustat is an inhibitor of CYP450 3A4 and CYP450 2C8 in vitro. However, clinical data are not available.

MANAGEMENT: Some authorities recommend using caution when vadadustat is used concomitantly with drugs that are substrates of CYP450 3A4 and/or CYP450 2C8, particularly sensitive substrates or those with a narrow therapeutic range. Monitoring for signs and symptoms of increased exposure to the CYP450 3A4 and/or CYP450 2C8 substrate should be considered whenever vadadustat is added to or withdrawn from therapy. The prescribing information for concomitant medications may be consulted to assess the benefits versus risks of coadministration, as well as any dosage adjustments that may be required during coadministration and/or following the discontinuation of a CYP450 3A4 and/or CYP450 2C8 inhibitor.

Moderate

norethindrone vadadustat

Applies to: Microgestin Fe 1 / 20 (ethinyl estradiol / norethindrone) and vadadustat

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with vadadustat may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 and/or CYP450 2C8 isoenzymes. Vadadustat is an inhibitor of CYP450 3A4 and CYP450 2C8 in vitro. However, clinical data are not available.

MANAGEMENT: Some authorities recommend using caution when vadadustat is used concomitantly with drugs that are substrates of CYP450 3A4 and/or CYP450 2C8, particularly sensitive substrates or those with a narrow therapeutic range. Monitoring for signs and symptoms of increased exposure to the CYP450 3A4 and/or CYP450 2C8 substrate should be considered whenever vadadustat is added to or withdrawn from therapy. The prescribing information for concomitant medications may be consulted to assess the benefits versus risks of coadministration, as well as any dosage adjustments that may be required during coadministration and/or following the discontinuation of a CYP450 3A4 and/or CYP450 2C8 inhibitor.

Drug and food interactions

Moderate

norethindrone food

Applies to: Microgestin Fe 1 / 20 (ethinyl estradiol / norethindrone)

Grapefruit juice may increase the blood levels of certain medications such as norethindrone. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with norethindrone. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

Moderate

vadadustat food

Applies to: vadadustat

Consumer information for this interaction is not currently available.

MONITOR: Smoking and alcohol consumption during therapy with vadadustat may increase the risk of gastrointestinal erosions. Serious erosions, including gastrointestinal bleeding and the need for red blood cell transfusions, have been reported during vadadustat clinical trials. Patients with a history of gastrointestinal erosion, peptic ulcer disease, and current tobacco smokers and alcohol drinkers may be at higher risk of gastrointestinal injury.

MANAGEMENT: Caution is advised if vadadustat is prescribed to current tobacco smokers or alcohol drinkers. Patients should be advised to contact their physician if they develop potential signs and symptoms of gastrointestinal injury such as abdominal pain, hematemesis, trouble swallowing, chest or throat pain, and/or black, tarry stools.

Moderate

ethinyl estradiol food

Applies to: Microgestin Fe 1 / 20 (ethinyl estradiol / norethindrone)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of ethinyl estradiol may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 1A2. In a study of 30 healthy volunteers administered the CYP450 1A2 substrate tizanidine, the systemic exposure (AUC) of tizanidine was 3.9 times greater in women using an oral contraceptive containing ethinyl estradiol.

MANAGEMENT: Patients should be monitored for increased adverse effects of the CYP450 1A2 substrate during concomitant use with ethinyl estradiol. Product labeling for the specific CYP450 1A2 substrate should be consulted for additional recommendations.

Minor

ethinyl estradiol food

Applies to: Microgestin Fe 1 / 20 (ethinyl estradiol / norethindrone)

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

Minor

ethinyl estradiol food

Applies to: Microgestin Fe 1 / 20 (ethinyl estradiol / norethindrone)

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

Minor

norethindrone food

Applies to: Microgestin Fe 1 / 20 (ethinyl estradiol / norethindrone)

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

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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