Drug Interaction Report

Ethinyl estradiol may increase the blood levels of fenfluramine. This may increase the risk and/or severity of side effects such as diarrhea, drowsiness, lethargy, decreased appetite, weight loss, blood pressure increases, valvular heart disease (problems with the valves in the heart), and pulmonary arterial hypertension (high blood pressure in the arteries of the lungs) . Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use 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.

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with fenfluramine may decrease the plasma concentrations and therapeutic efficacy of drugs that are substrates of the CYP450 2B6 and/or CPY3A4 isoenzymes. The proposed mechanism, based on in vitro data, might be increased clearance due to induction of CYP450 2B6 and intestinal CYP450 3A4.

MANAGEMENT: Caution and monitoring are recommended if fenfluramine is used concomitantly with drugs that are substrates of CYP450 2B6 and/or CYP450 3A4, particularly sensitive substrates or those with a narrow therapeutic range. Monitoring for potential loss of therapeutic efficacy is recommended. The prescribing information for concomitant medications may be consulted to assess the benefits versus risks of coadministration, as well as any dosage adjustments that may be required during coadministration and/or following the discontinuation of a CYP450 2B6 and/or CYP450 3A4 inducer.

Using fenfluramine with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. In addition, you may also be more likely to experience nervous system side effects such as dizziness, drowsiness, depression, and difficulty concentrating. You should avoid or limit the use of alcohol while being treated with fenfluramine. Do not use more than the recommended dose of fenfluramine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

Grapefruit juice may increase the blood levels of certain medications such as etonogestrel. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with etonogestrel. 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.

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of ethinyl estradiol may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 1A2. In a study of 30 healthy volunteers administered the CYP450 1A2 substrate tizanidine, the systemic exposure (AUC) of tizanidine was 3.9 times greater in women using an oral contraceptive containing ethinyl estradiol.

MANAGEMENT: Patients should be monitored for increased adverse effects of the CYP450 1A2 substrate during concomitant use with ethinyl estradiol. Product labeling for the specific CYP450 1A2 substrate should be consulted for additional recommendations.

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

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