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Ortho-Est and Alcohol/Food Interactions

There are 3 alcohol/food/lifestyle interactions with Ortho-Est (estropipate).

Minor

estropipate food

Minor Food Interaction

Information for this minor interaction is available on the professional version.

Major

High Blood Pressure (Hypertension)

Major Potential Hazard, High plausibility

estrogens - hypertension

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. 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be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary.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.

References

  1. Leiman G (1972) "Depo-medroxyprogesterone acetate as a contraceptive agent: its effect on weight and blood pressure." Am J Obstet Gynecol, 114, p. 97-102
  2. Williams RS (1992) "Benefits and risks of oral contraceptive use." Postgrad Med, 92, p. 155-7
  3. Crane MG, Harris JJ (1978) "Estrogens and hypertension: effect of discontinuing estrogens on blood pressure, exchangeable sodium, and the renin-aldosterone system." Am J Med Sci, 276, p. 33-55
  4. Crane MG, Harris JJ, Winsor W 3d (1971) "Hypertension, oral contraceptive agents, and conjugated estrogens." Ann Intern Med, 74, p. 13-21
  5. Rosenberg L, Slone D, Shapiro S, Kaufman D, Stolley PD, Miettinen OS (1980) "Noncontraceptive estrogens and myocardial infarction in young women." JAMA, 244, p. 339-42
  6. Jick H, Dinan B, Rothman KJ (1978) "Noncontraceptive estrogens and nonfatal myocardial infarction." JAMA, 239, p. 1407-8
  7. Wren BG, Routledge DA (1981) "Blood pressure changes: oestrogens in climacteric women." Med J Aust, 2, p. 528-31
  8. Rosenberg L, Palmer JR, Lesko SM, Shapiro S (1990) "Oral contraceptive use and the risk of myocardial infarction." Am J Epidemiol, 131, p. 1009-16
  9. Thorogood M, Mann J, Murphy M, Vessey M (1992) "Fatal stroke and use of oral contraceptives: findings from a case- control study." Am J Epidemiol, 136, p. 35-45
  10. Leaf DA, Bland D, Schaad D, Neighbor WE, Scott CS (1991) "Oral contraceptive use and coronary risk factors in women." Am J Med Sci, 301, p. 365-8
  11. Thorneycroft IH (1990) "Oral contraceptives and myocardial infarction." Am J Obstet Gynecol, 163, p. 1393-7
  12. Lidegaard O (1993) "Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study." BMJ, 306, p. 956-63
  13. Derman RJ (1990) "Oral contraceptives and cardiovascular risk. Taking a safe course of action." Postgrad Med, 88, p. 119-22
  14. Hannaford PC, Croft PR, Kay CR (1994) "Oral contraception and stroke. Evidence from the Royal College of General Practitioners' Oral Contraception Study." Stroke, 25, p. 935-42
  15. Steinberg WM (1989) "Oral contraception: risks and benefits." Adv Contracept, 5, p. 219-28
  16. Peterson HB, Lee NC (1990) "Long-term health risks and benefits of oral contraceptive use." Obstet Gynecol Clin North Am, 17, p. 775-88
  17. Derman R (1989) "Oral contraceptives: a reassessment." Obstet Gynecol Surv, 44, p. 662-8
  18. Belchetz PE (1994) "Hormonal treatment of postmenopausal women." N Engl J Med, 330, p. 1062-71
  19. Stampfer MJ, Colditz GA, Willett WC, et al. (1991) "Postmenopausal estrogen and cardiovascular disease. Ten-year follow-up from the Nurses' Health Study." N Engl J Med, 325, p. 756-62
  20. Barrett-Connor E, Bush TL (1991) "Estrogen and coronary heart disease in women." JAMA, 265, p. 1861-7
  21. Barrett-Connor E, Wingard DL, Criqui MH (1989) "Postmenopausal estrogen use and heart disease risk factors in the 1980s. Rancho Bernardo, Calif, revisited." JAMA, 261, p. 1095-2100
  22. Mishell DR (1989) "Contraception." N Engl J Med, 320, p. 777-85
  23. (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
  24. Schwartz J, Freeman R, Frishman W (1995) "Clinical pharmacology of estrogens: cardiovascular actions and cardioprotective benefits of replacement therapy in postmenopausal women." J Clin Pharmacol, 35, p. 1-16
  25. The Writing Group for the PEPI Trial (1995) "Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial." JAMA, 273, p. 199-208
  26. (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
  27. (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
  28. (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
  29. (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
  30. Norris LA, Bonnar J (1996) "The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives." Br J Obstet Gynaecol, 103, p. 261-7
  31. Levine AB, Teppa J, Mcgough B, Cowchock FS (1996) "Evaluation of the prethrombotic state in pregnancy and in women using oral contraceptives." Contraception, 53, p. 255-7
  32. Petitti DB, Sidney S, Bernstein A, Wolf S, Quesenberry C, Ziel HK (1996) "Stroke in users of low-dose oral contraceptives." N Engl J Med, 335, p. 8-15
  33. Speroff L (1996) "Oral contraceptives and venous thromboembolism." Int J Gynaecol Obstet, 54, p. 45-50
  34. Poulter NR, Chang CL, Farley TMM, Meirik O, Marmot MG, Debertribeiro M, Medina E, Artigas J, Shen H, Zhong YH, Zhang DW, (1996) "Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study." Lancet, 348, p. 498-505
  35. Poulter NR, Chang CL, Farley TMM, Meirik O, Marmot MG (1996) "Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case-control study." Lancet, 348, p. 505-10
  36. Piegsa K, Guillebaud J (1996) "Oral contraceptives and the risk of DVT." Practitioner, 240, p. 544
  37. Martinelli I, Rosendaal FR, Vandenbroucke JP, Mannucci PM (1996) "Oral contraceptives are a risk factor for cerebral vein thrombosis." Thromb Haemost, 76, p. 477-8
  38. Farley TMM, Meirik O, Poulter NR, Chang CL, Marmot MG (1996) "Oral contraceptives and thrombotic diseases: impact of new epidemiological studies." Contraception, 54, p. 193-5
  39. "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
  40. (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
  41. "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
  42. (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
  43. (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
  44. (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
  45. "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
  46. Sidney S, Petitti DB, Quesenberry CP (1997) "Myocardial infarction and the use of estrogen and estrogen-progestogen in postmenopausal women." Ann Intern Med, 127, p. 501-8
  47. (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
  48. Thorogood M (1999) "Risk of stroke in users of oral contraceptives." JAMA, 281, p. 1255-6
  49. "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
  50. (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
  51. "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
  52. (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
  53. (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 53 references
Moderate

High Cholesterol (Hyperlipoproteinemia, Hypertriglyceridemia, Sitosterolemia)

Moderate Potential Hazard, Moderate plausibility

estrogens - hyperlipidemia

Although estrogens have generally favorable effects on plasma lipids, including increases in HDL and decreases in total cholesterol and LDL, they have also been associated with significant elevations in triglyceride levels, particularly when high dosages are used. Severe hyperlipidemia is known to sometimes cause pancreatitis. Patients with preexisting hyperlipidemia may require closer monitoring during estrogen therapy, and adjustments made accordingly in their lipid-lowering regimen.

References

  1. Molitch ME, Oill P, Odell WD (1974) "Massive hyperlipemia during estrogen therapy." JAMA, 227, p. 522-5
  2. Janaud A, Rouffy J, Upmalis D, Dain MP (1992) "A comparison study of lipid and androgen metabolism with triphasic oral contraceptive formulations containing norgestimate or levonorgestrel." Acta Obstet Gynecol Scand Suppl, 156, p. 33-8
  3. Steinberg WM (1989) "Oral contraception: risks and benefits." Adv Contracept, 5, p. 219-28
  4. Burkman RT, Zacur HA, Kimball AW, Kwiterovich P, Bell WR (1989) "Oral contraceptives and lipids and lipoproteins: Part I--Variations in mean levels by oral contraceptive type." Contraception, 40, p. 553-61
  5. Derman R (1989) "Oral contraceptives: a reassessment." Obstet Gynecol Surv, 44, p. 662-8
  6. Godsland IF, Crook D (1994) "Update on the metabolic effects of steroidal contraceptives and their relationship to cardiovascular disease risk." Am J Obstet Gynecol, 170, p. 1528-36
  7. (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
  8. (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
  9. (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
  10. (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
  11. (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
  12. "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
  13. (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
  14. "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
  15. (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
  16. (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
  17. (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
  18. "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
  19. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E (1998) "Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women." JAMA, 280, p. 605-13
  20. (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
  21. "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
  22. (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
  23. "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
  24. (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
  25. (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 25 references

Ortho-Est drug interactions

There are 234 drug interactions with Ortho-Est (estropipate).

Ortho-Est disease interactions

There are 17 disease interactions with Ortho-Est (estropipate) which include:

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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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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