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Drug Interactions between phenylbutazone and Zovia 1/50E

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

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Interactions between your drugs

Moderate

ethinyl estradiol phenylbutazone

Applies to: Zovia 1 / 50E (ethinyl estradiol / ethynodiol) and phenylbutazone

ADDITIONAL CONTRACEPTION RECOMMENDED: Limited clinical data suggest that phenylbutazone may reduce the efficacy of contraceptive hormones, potentially resulting in menstrual abnormalities (e.g., breakthrough bleeding, amenorrhea, irregular menses) or unintended pregnancy. The proposed mechanism is accelerated clearance of the hormones due to induction of hepatic CYP450 enzymes by phenylbutazone.

MANAGEMENT: Women using low-dose hormonal contraceptives should be advised of the risk of breakthrough bleeding and unintended pregnancy during concomitant therapy with phenylbutazone. Alternative or additional methods of birth control should be used during and probably for at least one week after short-term and up to one month after long-term (greater than 4 weeks) phenylbutazone therapy. Intrauterine systems are unlikely to be significantly affected because of their local action. Input from a gynecologist or similar expert on adequate contraception, including emergency contraception, should be sought as needed.

References

  1. Kleier DJ, Tucker JE (1987) "Oral contraceptive failure secondary to dentally prescribed drugs: fact or fiction?" J Colo Dent Assoc, 66, p. 5-6
  2. (2001) "Product Information. NuvaRing (ethinyl estradiol-etonogestrel)." Organon
  3. (2001) "Product Information. Ortho Evra (ethinyl estradiol-norelgestromin)." Janssen Pharmaceuticals
  4. Faculty of Sexual & Reproductive Healthcare (2016) "FSRH Clinical Guidance: Drug Interactions with Hormonal Contraception. file:///C:/Users/df033684/Downloads/ceuguidancedruginteractionshormonal.pdf"
View all 4 references

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Moderate

phenylbutazone ethynodiol

Applies to: phenylbutazone and Zovia 1 / 50E (ethinyl estradiol / ethynodiol)

ADDITIONAL CONTRACEPTION RECOMMENDED: Limited clinical data suggest that phenylbutazone may reduce the efficacy of contraceptive hormones, potentially resulting in menstrual abnormalities (e.g., breakthrough bleeding, amenorrhea, irregular menses) or unintended pregnancy. The proposed mechanism is accelerated clearance of the hormones due to induction of hepatic CYP450 enzymes by phenylbutazone.

MANAGEMENT: Women using low-dose hormonal contraceptives should be advised of the risk of breakthrough bleeding and unintended pregnancy during concomitant therapy with phenylbutazone. Alternative or additional methods of birth control should be used during and probably for at least one week after short-term and up to one month after long-term (greater than 4 weeks) phenylbutazone therapy. Intrauterine systems are unlikely to be significantly affected because of their local action. Input from a gynecologist or similar expert on adequate contraception, including emergency contraception, should be sought as needed.

References

  1. Kleier DJ, Tucker JE (1987) "Oral contraceptive failure secondary to dentally prescribed drugs: fact or fiction?" J Colo Dent Assoc, 66, p. 5-6
  2. (2001) "Product Information. NuvaRing (ethinyl estradiol-etonogestrel)." Organon
  3. (2001) "Product Information. Ortho Evra (ethinyl estradiol-norelgestromin)." Janssen Pharmaceuticals
  4. Faculty of Sexual & Reproductive Healthcare (2016) "FSRH Clinical Guidance: Drug Interactions with Hormonal Contraception. file:///C:/Users/df033684/Downloads/ceuguidancedruginteractionshormonal.pdf"
View all 4 references

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Drug and food interactions

Minor

ethinyl estradiol food

Applies to: Zovia 1 / 50E (ethinyl estradiol / ethynodiol)

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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Minor

ethinyl estradiol food

Applies to: Zovia 1 / 50E (ethinyl estradiol / ethynodiol)

The central nervous system effects and blood levels of ethanol may be increased in patients taking oral contraceptives, although data are lacking and reports are contradictory. The mechanism may be due to enzyme inhibition. Consider counseling women about this interaction which is unpredictable.

References

  1. Hobbes J, Boutagy J, Shenfield GM (1985) "Interactions between ethanol and oral contraceptive steroids." Clin Pharmacol Ther, 38, p. 371-80

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Minor

ethynodiol food

Applies to: Zovia 1 / 50E (ethinyl estradiol / ethynodiol)

The central nervous system effects and blood levels of ethanol may be increased in patients taking oral contraceptives, although data are lacking and reports are contradictory. The mechanism may be due to enzyme inhibition. Consider counseling women about this interaction which is unpredictable.

References

  1. Hobbes J, Boutagy J, Shenfield GM (1985) "Interactions between ethanol and oral contraceptive steroids." Clin Pharmacol Ther, 38, p. 371-80

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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

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