Skip to main content

Drug Interactions between morphine liposomal and Premphase

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

Edit list (add/remove drugs)

Interactions between your drugs

Minor

medroxyPROGESTERone morphine liposomal

Applies to: Premphase (conjugated estrogens / medroxyprogesterone) and morphine liposomal

Oral contraceptives induce glucuronidation and may decrease plasma concentrations of morphine, diamorphine, and other opioids. Oral contraceptives may influence opioid analgesic effects and opioid dosage may need to be adjusted. However, the clinical significance of this interaction has not been established.

References (5)
  1. Shenfield GM, Griffin JM (1991) "Clinical pharmacokinetics of contraceptive steroids: an update." Clin Pharmacokinet, 20, p. 15-37
  2. (2001) "Product Information. NuvaRing (ethinyl estradiol-etonogestrel)." Organon
  3. Cerner Multum, Inc. (2015) "Canadian Product Information."
  4. (2022) "Product Information. VyLibra (ethinyl estradiol-norgestimate)." Afaxys Inc.
  5. Ribeiro-Dasilva MC, Shinal RM, Glover T, Williams RS, Staud R, Riley JL 3rd, Fillingim RB (2011) "Evaluation of menstrual cycle effects on morphine and pentazocine analgesia" Pain, 152, p. 614-622

Drug and food interactions

Minor

conjugated estrogens food

Applies to: Premphase (conjugated estrogens / 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 (2)
  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

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

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer