Can you take Nuvelle TS Phase I with Sulfinpyrazone?
1 drug interaction and 34 additional warnings found for the following 2 drugs:
- Nuvelle TS Phase I (estradiol)
- sulfinpyrazone
Drug interactions
Moderate drug interactions
Moderate:
sulfinpyrazone estradiol
Applies to: sulfinpyrazone and Nuvelle TS Phase I (estradiol)
Sulfinpyrazone may reduce the blood levels and effects of estradiol.
If you are using low-dose oral contraceptives, you may have an increased risk of breakthrough bleeding and unintended pregnancy. You should discuss the use of alternative or additional methods of birth control with your healthcare provider.
If you take hormone replacement for menopause, notify your doctor if your medication is no longer controlling your symptoms or you experience abnormal bleeding.
You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Minor food/lifestyle interactions
Minor:
estradiol Food/Lifestyle
Applies to: Nuvelle TS Phase I (estradiol)
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.
The information above is from our professional interaction data. Consumer information is not available for this interaction.
Disease interactions
33 potential interactions Applies to: 31 conditions, including High Blood Pressure, High Cholesterol, Migraine, Heart Failure, and Asthma.
Abnormal Uterine Bleeding
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with Abnormal Uterine Bleeding.
The use of estrogens is contraindicated in patients with undiagnosed, abnormal vaginal bleeding. Prolonged (greater than 1 year), unopposed estrogen use (i.e. estrogen without concomitant progestin therapy) has been associated with a significant, dose-related risk of endometrial carcinoma. The risk may be offset substantially by the addition of a progestin but may not be completely abolished. Prior to initiating estrogen therapy, appropriate diagnostic tests should be performed in patients with abnormal vaginal bleeding to rule out endometrial malignancy. The same applies if recurrent or persistent bleeding develops during estrogen therapy.
Anemia
Major:
sulfinpyrazone
Sulfinpyrazone has a major potential interaction with Anemia.
The use of sulfinpyrazone is contraindicated in patients with a current or past history of blood dyscrasias. Anemia, leukopenia, agranulocytosis, thrombocytopenia, and aplastic anemia have been reported rarely with sulfinpyrazone use. Phenylbutazone, a structurally related agent, has been associated frequently with bone marrow suppression, as well as an increased risk of leukemia. Periodic blood counts are recommended when sulfinpyrazone or other pyrazole compounds are used.
Angioedema
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a moderate potential interaction with Angioedema.
The use of exogenous estrogens may induce or exacerbate symptoms of angioedema, particularly in women with hereditary angioedema. Consider the risk versus benefits of estrogen therapy. Close monitoring is recommended when prescribing these agents to patients predisposed to angioedema.
Asthma
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
Bone Marrow Depression/Low Blood Counts
Major:
sulfinpyrazone
Sulfinpyrazone has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
The use of sulfinpyrazone is contraindicated in patients with a current or past history of blood dyscrasias. Anemia, leukopenia, agranulocytosis, thrombocytopenia, and aplastic anemia have been reported rarely with sulfinpyrazone use. Phenylbutazone, a structurally related agent, has been associated frequently with bone marrow suppression, as well as an increased risk of leukemia. Periodic blood counts are recommended when sulfinpyrazone or other pyrazole compounds are used.
Breast Cancer
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with Breast Cancer.
When treated with an estrogen, patients with breast cancer and bone metastases may develop severe hypercalcemia, in which case the drug should be stopped and measures be taken to reduce serum calcium levels.
Cerebral Vascular Disorder
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with Cerebral Vascular Disorder.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Dehydration
Moderate:
sulfinpyrazone
Sulfinpyrazone has a moderate potential interaction with Dehydration.
Adequate hydration is necessary during therapy with sulfinpyrazone to prevent the renal precipitation of urates. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluid. In general, fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline or neutral urine is also desirable.
Diabetes Mellitus
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
Diarrhea
Moderate:
sulfinpyrazone
Sulfinpyrazone has a moderate potential interaction with Diarrhea.
Adequate hydration is necessary during therapy with sulfinpyrazone to prevent the renal precipitation of urates. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluid. In general, fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline or neutral urine is also desirable.
Fluid Retention
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
Gallbladder Disease
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a moderate potential interaction with Gallbladder Disease.
A two- to four-fold increase in risk of gallbladder disease has been noted in women receiving postmenopausal estrogen therapy. The risk for gallbladder disease may be less for premenopausal women using oral contraceptives containing low-dose estrogens and/or progestins. Therapy with estrogens should be administered cautiously in patients with preexisting gallbladder disease or a history of pregnancy-related cholestasis.
Gastritis/Duodenitis
Major:
sulfinpyrazone
Sulfinpyrazone has a major potential interaction with Gastritis/Duodenitis.
The use of sulfinpyrazone is contraindicated in patients with active peptic ulcer disease or symptoms of gastrointestinal inflammation or ulceration. Sulfinpyrazone may commonly cause upper gastrointestinal irritation. It may also aggravate or reactivate peptic ulcer. Therapy with sulfinpyrazone may be administered cautiously in patients with a history of healed peptic ulcer. Taking the medication with food, milk, or antacids may lessen GI adverse effects.
Heart Failure
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
High Blood Pressure
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with High Blood Pressure.
The risk of myocardial infarction and strokes, including those associated with oral contraceptive use and some estrogen use, is increased in patients with hypertension. Moreover, estrogens (and progestogens) may elevate blood pressure and worsen the hypertension, thus compounding the risk. Clinically significant blood pressure increases have been reported during estrogen therapy, particularly in patients receiving high dosages or treated with oral contraceptive combinations having high progestational activity. These effects also increase with duration of therapy and patient age. Therapy with estrogens should be administered cautiously in patients with preexisting hypertension. Some estrogen-based therapies, such as combined hormonal contraceptives, may be contraindicated in patients with uncontrolled hypertension or hypertension with vascular disease. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary. In patients requiring contraception, alternative methods should be considered for those who are hypertensive, over age 35, and smoke.
High Cholesterol
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a moderate potential interaction with High Cholesterol.
Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.
History, Peptic Ulcer
Major:
sulfinpyrazone
Sulfinpyrazone has a major potential interaction with History, Peptic Ulcer.
The use of sulfinpyrazone is contraindicated in patients with active peptic ulcer disease or symptoms of gastrointestinal inflammation or ulceration. Sulfinpyrazone may commonly cause upper gastrointestinal irritation. It may also aggravate or reactivate peptic ulcer. Therapy with sulfinpyrazone may be administered cautiously in patients with a history of healed peptic ulcer. Taking the medication with food, milk, or antacids may lessen GI adverse effects.
History, Thrombotic/Thromboembolic Disorder
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
History of Blood Dyscrasias
Major:
sulfinpyrazone
Sulfinpyrazone has a major potential interaction with History of Blood Dyscrasias.
The use of sulfinpyrazone is contraindicated in patients with a current or past history of blood dyscrasias. Anemia, leukopenia, agranulocytosis, thrombocytopenia, and aplastic anemia have been reported rarely with sulfinpyrazone use. Phenylbutazone, a structurally related agent, has been associated frequently with bone marrow suppression, as well as an increased risk of leukemia. Periodic blood counts are recommended when sulfinpyrazone or other pyrazole compounds are used.
Hypoparathyroidism
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a moderate potential interaction with Hypoparathyroidism.
Estrogens should be used with caution in individuals with severe hypocalcemia or hypoparathyroidism. Estrogen-induced hypocalcemia may occur in patients with hypoparathyroidism; consider whether the benefits of estrogen therapy outweigh the risks.
Ischemic Heart Disease
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with Ischemic Heart Disease.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Liver Disease
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a moderate potential interaction with Liver Disease.
Estrogens are primarily metabolized by the liver. Use of estrogen therapy is contraindicated in patients with liver dysfunction or disease. Patients with impaired hepatic function may be at increased risk for adverse effects associated with estrogen administration due to decreased drug clearance. Patients with hepatic hemangiomas are at increased risk of exacerbation with use of estrogens. Therapy with estrogens should be administered cautiously in patients with cholestatic jaundice associated with past estrogen use or with pregnancy. In addition, clinicians should be aware that estrogen therapy may affect liver function tests.
Migraine
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with Migraine.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
Neoplasia, Estrogen Dependent
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with Neoplasia, Estrogen Dependent.
The use of estrogens is generally contraindicated in patients with known or suspected estrogen-dependent neoplasia such as breast and endometrial cancer, since it may stimulate tumor proliferation. High dosages of estrogens may be used for the palliative treatment of inoperable, metastatic breast cancer, but only in appropriately selected men and postmenopausal women.
Pancreatitis
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a moderate potential interaction with Pancreatitis.
Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.
Peptic Ulcer
Major:
sulfinpyrazone
Sulfinpyrazone has a major potential interaction with Peptic Ulcer.
The use of sulfinpyrazone is contraindicated in patients with active peptic ulcer disease or symptoms of gastrointestinal inflammation or ulceration. Sulfinpyrazone may commonly cause upper gastrointestinal irritation. It may also aggravate or reactivate peptic ulcer. Therapy with sulfinpyrazone may be administered cautiously in patients with a history of healed peptic ulcer. Taking the medication with food, milk, or antacids may lessen GI adverse effects.
Renal Dysfunction
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
Moderate:
sulfinpyrazone
Sulfinpyrazone has a moderate potential interaction with Renal Dysfunction.
Renal failure has occasionally been reported with the use of sulfinpyrazone. Therapy with sulfinpyrazone should be administered cautiously in patients with significant renal impairment. Adequate hydration and periodic monitoring of renal function are recommended.
Seizures
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
Thrombotic/Thromboembolic Disorder
Major:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I has a major potential interaction with Thrombotic/Thromboembolic Disorder.
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.
Thyroid Disease
Moderate:
Nuvelle TS Phase I
The estradiol in Nuvelle TS Phase I 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.
Vomiting
Moderate:
sulfinpyrazone
Sulfinpyrazone has a moderate potential interaction with Vomiting.
Adequate hydration is necessary during therapy with sulfinpyrazone to prevent the renal precipitation of urates. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluid. In general, fluid intake sufficient to yield a daily urinary output of at least 2 liters is recommended. Maintenance of a slightly alkaline or neutral urine is also desirable.
More resources
Nuvelle TS Phase I
A total of 447 drugs are known to interact with Nuvelle TS Phase I.
- Nuvelle ts phase i is in the drug class estrogens.
- Nuvelle ts phase i is used to treat Postmenopausal Symptoms.
sulfinpyrazone
A total of 402 drugs are known to interact with sulfinpyrazone.
- Sulfinpyrazone is in the drug class antigout agents.
- Sulfinpyrazone is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.