Can you take Progynova TS with Telithromycin?

Telithromycin has a major potential interaction with Abnormal Electrocardiogram.

Telithromycin may prolong the QTc interval of the electrocardiogram in some patients. QTC prolongation has been associated with an increased risk of ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes. No cardiovascular morbidity or mortality attributable to QTc prolongation occurred with telithromycin treatment in nearly 5000 patients in clinical efficacy trials, including 204 patients who had a prolonged QTc interval at baseline. In addition, a pharmacokinetic study found no significant QT prolongation in 34 healthy volunteers at all heart rates tested following telithromycin administered as repeated doses of 800 mg or as single doses of up to 2400 mg. Nevertheless, therapy with telithromycin should be avoided in patients with preexisting arrhythmia or congenital prolongation of the QTc interval. It should also be avoided in the presence of proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia; clinically significant bradycardia; or concomitant use of class IA or III antiarrhythmic drugs or other medications that are known to produce an increase in the QTc interval.

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Alcoholism.

Hepatic dysfunction, including elevated liver enzymes and hepatitis, with or without jaundice, has been reported with the use of telithromycin. Although these events are generally reversible, liver failure resulting in transplantation or death has been reported rarely during postmarketing use. Alcohol use may have been a contributing factor in some of the severe cases. Therapy with telithromycin should preferably be avoided in patients with alcoholism, liver disease, or a prior history of hepatitis/jaundice associated with use of the drug. Patients treated with telithromycin should be instructed to discontinue the drug and seek medical attention promptly if signs and symptoms of hepatic injury develop such as fever, pruritus, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

The pharmacokinetics of telithromycin is not significantly altered in the presence of hepatic impairment due to a compensatory increase in renal elimination. No dosage adjustment is necessary unless renal function is also severely impaired (CrCl < 30 mL/min).

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Arrhythmia.

Telithromycin may prolong the QTc interval of the electrocardiogram in some patients. QTC prolongation has been associated with an increased risk of ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes. No cardiovascular morbidity or mortality attributable to QTc prolongation occurred with telithromycin treatment in nearly 5000 patients in clinical efficacy trials, including 204 patients who had a prolonged QTc interval at baseline. In addition, a pharmacokinetic study found no significant QT prolongation in 34 healthy volunteers at all heart rates tested following telithromycin administered as repeated doses of 800 mg or as single doses of up to 2400 mg. Nevertheless, therapy with telithromycin should be avoided in patients with preexisting arrhythmia or congenital prolongation of the QTc interval. It should also be avoided in the presence of proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia; clinically significant bradycardia; or concomitant use of class IA or III antiarrhythmic drugs or other medications that are known to produce an increase in the QTc interval.

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Autoimmune Hepatitis.

The use of telithromycin is contraindicated in patients with previous history of hepatitis and/or jaundice associated with the use of any macrolide antibacterial agent.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Electrolyte Abnormalities.

Telithromycin may prolong the QTc interval of the electrocardiogram in some patients. QTC prolongation has been associated with an increased risk of ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes. No cardiovascular morbidity or mortality attributable to QTc prolongation occurred with telithromycin treatment in nearly 5000 patients in clinical efficacy trials, including 204 patients who had a prolonged QTc interval at baseline. In addition, a pharmacokinetic study found no significant QT prolongation in 34 healthy volunteers at all heart rates tested following telithromycin administered as repeated doses of 800 mg or as single doses of up to 2400 mg. Nevertheless, therapy with telithromycin should be avoided in patients with preexisting arrhythmia or congenital prolongation of the QTc interval. It should also be avoided in the presence of proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia; clinically significant bradycardia; or concomitant use of class IA or III antiarrhythmic drugs or other medications that are known to produce an increase in the QTc interval.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

Telithromycin has a moderate potential interaction with Hemodialysis.

The effect of hemodialysis on removing telithromycin from the body has not been studied. Doses should be given after the dialysis session on dialysis days.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Hypokalemia.

Telithromycin may prolong the QTc interval of the electrocardiogram in some patients. QTC prolongation has been associated with an increased risk of ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes. No cardiovascular morbidity or mortality attributable to QTc prolongation occurred with telithromycin treatment in nearly 5000 patients in clinical efficacy trials, including 204 patients who had a prolonged QTc interval at baseline. In addition, a pharmacokinetic study found no significant QT prolongation in 34 healthy volunteers at all heart rates tested following telithromycin administered as repeated doses of 800 mg or as single doses of up to 2400 mg. Nevertheless, therapy with telithromycin should be avoided in patients with preexisting arrhythmia or congenital prolongation of the QTc interval. It should also be avoided in the presence of proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia; clinically significant bradycardia; or concomitant use of class IA or III antiarrhythmic drugs or other medications that are known to produce an increase in the QTc interval.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Liver Disease.

Hepatic dysfunction, including elevated liver enzymes and hepatitis, with or without jaundice, has been reported with the use of telithromycin. Although these events are generally reversible, liver failure resulting in transplantation or death has been reported rarely during postmarketing use. Alcohol use may have been a contributing factor in some of the severe cases. Therapy with telithromycin should preferably be avoided in patients with alcoholism, liver disease, or a prior history of hepatitis/jaundice associated with use of the drug. Patients treated with telithromycin should be instructed to discontinue the drug and seek medical attention promptly if signs and symptoms of hepatic injury develop such as fever, pruritus, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

The pharmacokinetics of telithromycin is not significantly altered in the presence of hepatic impairment due to a compensatory increase in renal elimination. No dosage adjustment is necessary unless renal function is also severely impaired (CrCl < 30 mL/min).

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Magnesium Imbalance.

Telithromycin may prolong the QTc interval of the electrocardiogram in some patients. QTC prolongation has been associated with an increased risk of ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes. No cardiovascular morbidity or mortality attributable to QTc prolongation occurred with telithromycin treatment in nearly 5000 patients in clinical efficacy trials, including 204 patients who had a prolonged QTc interval at baseline. In addition, a pharmacokinetic study found no significant QT prolongation in 34 healthy volunteers at all heart rates tested following telithromycin administered as repeated doses of 800 mg or as single doses of up to 2400 mg. Nevertheless, therapy with telithromycin should be avoided in patients with preexisting arrhythmia or congenital prolongation of the QTc interval. It should also be avoided in the presence of proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia; clinically significant bradycardia; or concomitant use of class IA or III antiarrhythmic drugs or other medications that are known to produce an increase in the QTc interval.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Myasthenia Gravis.

Telithromycin is contraindicated in patients with myasthenia gravis. There have been reports of fatal and life-threatening respiratory failure in patients with myasthenia gravis associated with the use of this drug.

The estradiol in Progynova TS 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.

Telithromycin has a major potential interaction with Noninfectious Colitis.

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.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

Telithromycin has a moderate potential interaction with Renal Dysfunction.

Telithromycin is eliminated by both renal and hepatic routes. In a multiple-dose study of subjects with varying degrees of renal impairment, patients classified as having severely impaired renal function (CrCl < 30 mL/min) had a 1.4-fold increase in steady-state peak plasma concentration (Cmax) and a 1.9-fold increase in systemic exposure (AUC) of telithromycin compared to healthy volunteers following administration of 800 mg once daily for 5 days. Renal excretion may serve as a compensatory elimination pathway for telithromycin in situations where metabolic clearance is impaired. In one study, coadministration of ketoconazole (which inhibits metabolism of telithromycin via CYP450 3A4) in 2 patients with severe renal impairment resulted in a 4- to 5-fold increase in telithromycin AUC compared to that in healthy subjects with normal renal function receiving telithromycin alone. Since patients with severe renal impairment are prone to conditions that may impair their metabolic clearance, telithromycin dosage should be reduced to 600 mg once daily in patients with severe renal impairment (CrCl < 30 mL/min), including those undergoing dialysis. The dosage should be further reduced to 400 mg once daily if there is coexisting hepatic impairment.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.

The estradiol in Progynova TS 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.