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Drug Interaction Report

6 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Moderate

ketoconazole estradiol

Applies to: ketoconazole, Climara Pro (estradiol / levonorgestrel)

Using ketoconazole and estradiol together may alter the levels of estradiol in your body. This combination may cause nausea, vomiting, or vaginal bleeding. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment if you take 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.

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Moderate

ketoconazole levonorgestrel

Applies to: ketoconazole, Climara Pro (estradiol / levonorgestrel)

Using ketoconazole and levonorgestrel together may alter the levels of levonorgestrel in your body. This combination may cause nausea, vomiting, or vaginal bleeding. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment if you take 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.

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Drug and food interactions

Moderate

ketoconazole food

Applies to: ketoconazole

You should avoid the use of alcohol while being treated with ketoconazole. Ketoconazole may cause liver damage and using it with alcohol or products containing alcohol may increase that risk. In addition, consumption of alcoholic beverages or products containing alcohol during treatment with ketoconazole may trigger a disulfiram-like reaction in some patients, with unpleasant symptoms such as flushing, palpitations, and nausea. Ketoconazole may be taken with or without food. You should avoid consumption of grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with ketoconazole unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of ketoconazole. This may increase the risk and/or severity of side effects and liver problems. You should seek immediate medical attention if you develop signs and symptoms of liver damage during treatment with ketoconazole, such as joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. Talk to your doctor if you have any questions or concerns. 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.

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Moderate

levonorgestrel food

Applies to: Climara Pro (estradiol / levonorgestrel)

Grapefruit juice may increase the blood levels of certain medications such as levonorgestrel. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with levonorgestrel. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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Minor

estradiol food

Applies to: Climara Pro (estradiol / levonorgestrel)

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

Minor

levonorgestrel food

Applies to: Climara Pro (estradiol / levonorgestrel)

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

Therapeutic duplication warnings

No duplication 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.


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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.

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Further information

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