Concurrent administration may increase estrogen elimination. Concurrent administration may increase estrogen elimination. Pioglitazone; Metformin: (Minor) Monitor blood glucose periodically in patients on metformin for changes in glycemic control when hormone therapy is instituted or discontinued. Higher-dose hormonal regimens may be indicated where acceptable or applicable. The presence or absence of a concomitant progestin may influence the significance of any hormonal effect on glucose homeostasis. The alternative or additional contraceptive agent may need to be continued for 1 month after discontinuation of topiramate. Coadministration of an oral contraceptive containing 30 mcg of ethinyl estradiol has been observed to decrease the AUC and Cmax of lamotrigine by 52% and 39%, respectively. Higher-dose hormonal regimens may be indicated where acceptable or applicable. The lowest effective dose of ESTRACE has not been determined. Candesartan: (Minor) Estrogens can induce fluid retention and may increase blood pressure in some patients; patients who are receiving antihypertensive agents concurrently with hormonal contraceptives should be monitored for antihypertensive effectiveness. It is used by women to help reduce vaginal symptoms of menopause (such as vaginal dryness /burning/ itching ). It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma levels of oral contraceptives. Because romidepsin can cause fetal harm if administered to a pregnant woman, females of reproductive potential should use an alternative effective contraception method (e.g., condoms or intrauterine devices) during treatment with romidepsin and for at least 1 month after the final dose. In postmenopausal women with low bone mineral density, there is good evidence that standard-dose estrogen therapy reduces the risk for osteoporotic fractures, including hip, spine, and all non-spine fractures; however, estrogens are not generally recommended as a first-line prevention tactic due to the known risks of estrogen treatment (e.g., thromboembolism, cerebrovascular events) relative to other treatments. Estrogens are CYP3A4 substrates and barbiturate are strong CYP3A4 inducers. Alternative or additional contraception may be advisable. In the US - Call your doctor for medical advice about side effects. To allow for normal breast and uterine development, guidelines advise the delay of the addition of progestin (given for 1 week per month) at least 1 to 2 years after starting estrogen or when breakthrough bleeding occurs. In post-menopausal use, amenorrhea occurs in most women within several months of oral estrogen use. Ketoconazole: (Minor) As ketoconazole inhibits CYP3A4 activity, serum estrogen concentrations and estrogenic-related side effects (e.g., nausea, breast tenderness) may potentially increase when coadministered with either estrogens or combined hormonal contraceptives. In postmenopausal women, a significant proportion of the circulating estrogens exist as sulfate conjugates, especially estrone sulfate, which serves as a circulating reservoir for the formation of more active estrogens. Eprosartan; Hydrochlorothiazide, HCTZ: (Minor) Estrogens can induce fluid retention and may increase blood pressure in some patients; patients who are receiving antihypertensive agents concurrently with hormonal contraceptives should be monitored for antihypertensive effectiveness. The decision on when to resume estrogens after such procedures or conditions would be based on the perceived additional thromboembolic risk from estrogen use and the need for estrogen therapy; resume only after the patient is fully ambulatory. There are no data with the use of estradiol in pregnant women; however, epidemiologic studies and meta-analyses have not found an increased risk of genital or nongenital birth defects (including cardiac anomalies and limb-reduction defects) following inadvertent exposure to combined hormonal contraceptives (estrogen and progestins) during early pregnancy. Adding a progestin to estrogen therapy has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer. Drugs that inhibit CYP3A4 such as clarithromycin may increase plasma concentrations of estrogens and cause estrogen-related side effects such as nausea and breast tenderness. Estrogens are CYP3A4 substrates and barbiturate are strong CYP3A4 inducers. clotrimazole, econazole nitrate, or miconazole) inserted high into the vagina. After an average follow-up of 5.6 years, the relative risk for ovarian cancer for estrogen plus progestin versus placebo was 1.58 (95% CI 0.77 to 3.24). Furosemide: (Minor) Estrogens can induce fluid retention and may increase blood pressure in some patients; patients who are receiving antihypertensive agents concurrently with hormone therapy should be monitored for antihypertensive effectiveness. Irbesartan; Hydrochlorothiazide, HCTZ: (Minor) Estrogens can induce fluid retention and may increase blood pressure in some patients; patients who are receiving antihypertensive agents concurrently with hormonal contraceptives should be monitored for antihypertensive effectiveness. Tranexamic Acid: (Contraindicated) Tranexamic acid is contraindicated in women who are using combination hormonal contraception containing an estrogen and a progestin. The dosage refers to how much of the active ingredient (sildenafil citrate) is in the tablet. Last updated on Dec 5, 2022. Some products that may interact with this drug include: aromatase inhibitors (such as anastrozole, exemestane, letrozole), fulvestrant, ospemifene, raloxifene, tamoxifen, toremifene, tranexamic acid. Patients taking these hormones for other indications may need to be monitored for reduced clinical effect while on nevirapine, with dose adjustments made based on clinical efficacy. Some hypothyroid patients on estrogen may require larger doses of thyroid hormones. Sotorasib: (Major) Women taking both estrogens and sotorasib should report breakthrough bleeding to their prescribers. Use of ESTRACE alone or in combination with a progestin, should be limited to the shortest duration consistent with treatment goals and risks for the individual woman. Omadacycline: (Moderate) It was previously thought that antibiotics may decrease the effectiveness of oral contraceptives containing estrogens due to stimulation of estrogen metabolism or a reduction in estrogen enterohepatic circulation via changes in GI flora. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Estrogens are CYP3A4 substrates and barbiturate are strong CYP3A4 inducers. Levothyroxine: (Minor) The administration of estrogens can increase circulating concentrations of thyroxine-binding globulin, sex hormone-binding globulin, and cortisol-binding globulin. Estrogens are CYP3A4 substrates and barbiturate are strong CYP3A4 inducers. Decisions regarding whether to continue systemic HRT in women aged older than 60 years should be made on an individual basis for quality of life, persistent vasomotor symptoms, or prevention of bone loss and fracture, with consideration given to alternative treatments for prevention of bone loss and other health issues. Changes in glucose tolerance occur more commonly in patients receiving 50 mcg or more of ethinyl estradiol (or equivalent) per day in combined oral contraceptives (COCs), which are not commonly used in practice since the marketing of lower dose COCs, patches, injections and rings. Estrace is also available as a vaginal cream. Another review of the subject concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines and penicillin derivatives. Concurrent use may increase the exposure of corticosteroids. Coadministration of a COC (containing 20 mcg ethinyl estradiol/0.1 mg levonorgestrel) following administration of elagolix 200 mg twice daily for 14 days increases the plasma ethinyl estradiol concentration by 2.2-fold compared to this COC alone; this may lead to increased risk of ethinyl estradiol-related adverse events including thromboembolic disorders and vascular events. Progestins may lower this chance. Cosyntropin: (Minor) Use cosyntropin cautiously in patients taking estrogens as these patients may exhibit abnormally high basal plasma cortisol concentrations and a decreased response to the test. To make sure this medicine is safe for you, tell your doctor if you have ever had: liver problems, or jaundice caused by pregnancy or taking hormones; porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); Using estradiol may increase your risk of cancer of the breast, uterus, or ovaries. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Estrogen therapy is contraindicated in patients with known estrogen-dependent malignancies. Higher-dose hormonal regimens may be indicated where acceptable or applicable. Vaginal cream (Estrace):Wash and dry hands before handling. Ritonavir is a substrate and inhibitor of CYP3A4. Canagliflozin; Metformin: (Minor) Monitor blood glucose periodically in patients on metformin for changes in glycemic control when hormone therapy is instituted or discontinued. You should not use Estrace if you have: undiagnosed vaginal bleeding, liver disease, a bleeding disorder, if you will be having major surgery, or if you have ever had a heart attack, a stroke, a blood clot, or cancer of the breast, uterus/cervix, or vagina. For treatment of moderate to severe vasomotor symptoms, vulval and vaginal atrophy associated with the menopause, the lowest dose and regimen that will control symptoms should be chosen and medication should be discontinued as promptly as possible. Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements): (Moderate) Either additive or antagonistic effects could potentially occur if prasterone is combined with estrogen therapy. Concurrent use may increase the exposure of corticosteroids. Carbamazepine: (Major) Advise patients taking estrogen hormones for contraception to consider an alternate or additional form of contraception, such as nonhormonal and/or barrier methods, during and for at least 1 month following discontinuation of carbamazepine. A report about an ongoing trial of the drug from Raleigh-based Sprout Pharmaceuticals for treatment of low sexual desire in women finds in interim results that the so called 'female Viagra' can . Therefore, do not coadminister estrogens, combined hormonal oral contraceptives, or non-oral combination contraceptives together with tranexamic acid. Estrogens can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Estrogens also undergo enterohepatic recirculation via sulfate and glucuronide conjugation in the liver, biliary secretion of conjugates into the intestine, and hydrolysis in the gut followed by reabsorption. However, the effect of tigecycline specifically on the efficacy of oral contraceptives is unknown. Changes in glucose tolerance occur more commonly in patients receiving 50 mcg or more of ethinyl estradiol (or equivalent) per day in combined oral contraceptives (COCs), which are not commonly used in practice since the marketing of lower dose COCs, patches, injections and rings. Lorlatinib: (Major) Women taking both estrogens and lorlatinib should report breakthrough bleeding to their prescribers. Treatment continues for reproductive life. For hypogonadism, women are treated for the period of reproductive life until the time of natural menopause, which maintains feminization and prevents bone loss. In women with an intact uterus, estrogen may be given cyclically or combined with a progestin for at least 10 to 14 days per month to minimize the risk of endometrial hyperplasia. Reassess periodically as clinically indicated to determine if hormone therapy is still appropriate. (Major) The concomitant use of romidepsin and estradiol valerate may reduce the efficacy of estradiol valerate. Use a new applicator containing an estradiol vaginal tablet each day, preferably at the same time each day; if the tablet has fallen out of the applicator, but is still contained in the packaging, carefully place it back into the applicator with clean dry hands. Talk to your doctor about lifestyle changes that might benefit you. The usual dose is estradiol valerate 10 mg to 20 mg IM every 4 weeks. Not a Member? Concurrent use may increase the exposure of corticosteroids. Estradiol products are administered orally, intramuscularly, vaginally, transdermally, and topically. Not all possible interactions are listed in this medication guide. Estrogens should also be used cautiously in patients with acute intermittent, or variegate hepatic porphyria, which can be exacerbated. The presence or absence of a concomitant progestin may influence the significance of any hormonal effect on glucose homeostasis. Consider each woman's net balance of individual benefits and harms. The current match involves a Texas lawsuit . Patients taking these hormones for other indications may need to be monitored for reduced clinical effect while on tazemetostat, with dose adjustments made based on clinical efficacy. In patients with pre-existing hypertriglyceridemia, estrogen therapy may be associated with elevations of plasma triglycerides leading to pancreatitis and other complications. Estradiol is minimally metabolized in the skin, thus higher therapeutic estradiol serum levels are present, and more closely approximate natural premenopausal concentrations. If appropriate, insert a new system. Serum estrogen concentrations and estrogenic-related side effects (e.g., nausea, breast tenderness) may potentially increase when verapamil is coadministered with either estrogens or combined hormonal contraceptives. Patients taking these hormones for other indications may need to be monitored for reduced clinical effect while on barbiturates, with dose adjustments made based on clinical efficacy. Higher-dose hormonal regimens may be indicated where acceptable or applicable. Phenobarbital: (Major) Women taking both estrogens and barbiturates should report breakthrough bleeding to their prescribers. Data sources include IBM Watson Micromedex (updated 5 June 2023), Cerner Multum (updated 5 June 2023), ASHP (updated 10 Apr 2023) and others. Generally, when used in a postmenopausal woman with an intact uterus, a progestin should also be considered to reduce the risk of endometrial hyperplasia. Ribociclib; Letrozole: (Contraindicated) Estrogens, including hormonal contraceptives, could interfere competitively with the pharmacologic action of the aromatase inhibitors. It is used by women to help reduce vaginal symptoms of menopause (such as vaginal dryness/burning/itching). Changes in glucose tolerance occur more commonly in patients receiving 50 mcg or more of ethinyl estradiol (or equivalent) per day in combined oral contraceptives (COCs), which are not commonly used in practice since the marketing of lower dose COCs, patches, injections and rings. Estrace is also available as a vaginal cream. Patients with systemic lupus erythematosus (SLE), particularly those with hypercoagulable conditions (e.g., antiphospholipid antibodies), may have increased risk for thromboembolism. Estradiol is a substrate of UGT1A1. 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