Drug Interactions between ospemifene and troleandomycin

Food significantly increases the absorption of ospemifene. You should take ospemifene with a meal, preferably at the same time each day. Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication.

The use of ospemifene is contraindicated in women with any undiagnosed abnormal genital bleeding. There is an increased risk of endometrial hyperplasia and endometrial cancer in patients using estrogens. Adequate diagnostic measures should be undertaken to rule out malignancy in any postmenopausal woman with undiagnosed persistent or recurring abnormal genital bleeding.

Troleandomycin is primarily excreted by the liver and may accumulate in patients with impaired hepatic function. In addition, the use of troleandomycin has been associated with an allergic type of cholestatic hepatitis, particularly in patients receiving the drug for more than 2 weeks or given repeated courses. Therapy with troleandomycin should be administered cautiously in patients with liver and/or biliary disease. Liver function tests should be monitored during prolonged or repeated courses of therapy, and the drug discontinued if abnormalities develop.

There is a reported increase of stroke and deep vein thrombosis (DVT) in postmenopausal women receiving oral conjugated estrogens. Ospemifene should be prescribed for the shortest duration consistent with treatment goals, weighting risks and benefits for each woman. Ospemifene is contraindicated in women with active DVT, pulmonary embolism, active arterial thromboembolic disease (such as stroke or myocardial infarctions), or a history of any of these conditions. Other risk factors for cardiovascular disorders and/or venous thromboembolism such as hypertension, diabetes, smoking, hypercholesterolemia, obesity, lupus erythematosus (in personal or family history), should be evaluated and managed appropriately.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

There is a reported increase of stroke and deep vein thrombosis (DVT) in postmenopausal women receiving oral conjugated estrogens. Ospemifene should be prescribed for the shortest duration consistent with treatment goals, weighting risks and benefits for each woman. Ospemifene is contraindicated in women with active DVT, pulmonary embolism, active arterial thromboembolic disease (such as stroke or myocardial infarctions), or a history of any of these conditions. Other risk factors for cardiovascular disorders and/or venous thromboembolism such as hypertension, diabetes, smoking, hypercholesterolemia, obesity, lupus erythematosus (in personal or family history), should be evaluated and managed appropriately.

Troleandomycin is primarily excreted by the liver and may accumulate in patients with impaired hepatic function. In addition, the use of troleandomycin has been associated with an allergic type of cholestatic hepatitis, particularly in patients receiving the drug for more than 2 weeks or given repeated courses. Therapy with troleandomycin should be administered cautiously in patients with liver and/or biliary disease. Liver function tests should be monitored during prolonged or repeated courses of therapy, and the drug discontinued if abnormalities develop.

Ospemifene should not be used in women with severe hepatic impairment, as the pharmacokinetics have not been studied in these patients. No clinically important differences were observed in women with mild to moderate hepatic impairment when compared to healthy women, therefore no dose adjustment is needed in these patients.

There is a reported increase of stroke and deep vein thrombosis (DVT) in postmenopausal women receiving oral conjugated estrogens. Ospemifene should be prescribed for the shortest duration consistent with treatment goals, weighting risks and benefits for each woman. Ospemifene is contraindicated in women with active DVT, pulmonary embolism, active arterial thromboembolic disease (such as stroke or myocardial infarctions), or a history of any of these conditions. Other risk factors for cardiovascular disorders and/or venous thromboembolism such as hypertension, diabetes, smoking, hypercholesterolemia, obesity, lupus erythematosus (in personal or family history), should be evaluated and managed appropriately.

Ospemifene has not been adequately studied in women with breast cancer, therefore should not be used in women with known, suspected or with a history of breast cancer. Additionally, ospemifene is contraindicated in the presence of any known or suspected estrogen-dependent neoplasia.

There is a reported increase of stroke and deep vein thrombosis (DVT) in postmenopausal women receiving oral conjugated estrogens. Ospemifene should be prescribed for the shortest duration consistent with treatment goals, weighting risks and benefits for each woman. Ospemifene is contraindicated in women with active DVT, pulmonary embolism, active arterial thromboembolic disease (such as stroke or myocardial infarctions), or a history of any of these conditions. Other risk factors for cardiovascular disorders and/or venous thromboembolism such as hypertension, diabetes, smoking, hypercholesterolemia, obesity, lupus erythematosus (in personal or family history), should be evaluated and managed appropriately.