Modify Therapy/Monitor Closely. Coadministration of belzutifan with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. . Use Caution/Monitor. The efficacy of hormonal contraceptives may be reduced. Written by Cerner Multum. Monitor Closely (3)tazemetostat will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Low risk of contraceptive failure. timolol and drospirenone both increase serum potassium. Chewable Sildenafil. Effect of interaction is not clear, use caution. Monitor Closely (1)iloperidone increases levels of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Overdose may cause nausea or vaginal bleeding. Serious - Use Alternative (2)saquinavir will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (2)ethinylestradiol will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ethinylestradiol will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Low risk of contraceptive failure. drospirenone increases and cyclopenthiazide decreases serum potassium. rifampin will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Fostemsavir inhibits BCRP transporters. Additive hypotensive effects. Applies only to oral forms of hormone. Monitor for glycemic control in diabetic patients. Contraindicated. Mechanism: pharmacodynamic synergism. The efficacy of hormonal contraceptives may be reduced. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects. Use Caution/Monitor. Use Caution/Monitor. Hyperkalemia. If you have a prolonged erection that lasts longer . Most You can use Cialis on a daily basis at a lower dosage. Minor/Significance Unknown. Common side effects include headache, muscle pain, flushed skin, and nausea. Comment: CYP450 activity in the liver is down regulated by infection and inflammation stimuli including cytokines (eg, IL-6); inhibition of IL-6 by siltuximab may restore CYP450 enzymatic activity; caution if coadministered with CYP substrates that have a narrow therapeutic index.siltuximab, ethinylestradiol. Avoid or Use Alternate Drug. Mechanism: unspecified interaction mechanism. Coadministration of mobocertinib with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. Brigatinib can cause fetal harm. Efficacy of hormonal contraceptives may be reduced. Monitor Closely (1)drospirenone increases and metaproterenol decreases serum potassium. Increased antidepressant serum concentrations may occur. Use Caution/Monitor. Avoid or Use Alternate Drug. Effect of interaction is not clear, use caution. Serious - Use Alternative (1)conivaptan will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ramipril, drospirenone. atazanavir, drospirenone. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown. Coadministration of belzutifan with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. rufinamide decreases effects of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)telmisartan and drospirenone both increase serum potassium. Minor/Significance Unknown. Use Caution/Monitor. Minor (1)ethinylestradiol will increase the level or effect of duloxetine by affecting hepatic enzyme CYP1A2 metabolism. See drug monograph for specific dosage modification. Use Caution/Monitor. Minor/Significance Unknown. The efficacy of hormonal contraceptives may be reduced. Recommended dose of rasagiline is 0.5mg daily in combination with CYP1A2 inhibitors. Monitor for glycemic control in diabetic patients. ethinylestradiol will increase the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Closely monitor for signs and symptoms of increased exposure and consider adjusting the dose of these substrates. Use Caution/Monitor. Modify Therapy/Monitor Closely. fexinidazole will increase the level or effect of ethinylestradiol by affecting hepatic enzyme CYP2E1 metabolism. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. If you have side effects with the 10-mg dose, your doctor may prescribe a 5-mg dose. acetazolamide will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)drospirenone and fenoprofen both increase serum potassium. Use Caution/Monitor. Use Caution/Monitor. CYP3A4 substrates may require dosage adjustment. Monitor Closely (1)drospirenone and noni juice both increase serum potassium. ethinylestradiol decreases effects of insulin degludec/insulin aspart by pharmacodynamic antagonism. Use Caution/Monitor. To view formulary information first create a list of plans. Minor/Significance Unknown. Modify Therapy/Monitor Closely. Monitor Closely (1)drospirenone and tolvaptan both increase serum potassium. drospirenone and mefenamic acid both increase serum potassium. Modify Therapy/Monitor Closely. cenobamate will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. The effect of exenatide to slow gastric emptying may reduce the extent and rate of oral medications that require rapid GI absorption. Applies only to oral forms of hormone. Monitor Closely (1)ethinylestradiol will increase the level or effect of rasagiline by affecting hepatic enzyme CYP1A2 metabolism. ethinylestradiol, desipramine. Modify Therapy/Monitor Closely. Use Caution/Monitor. Monitor Closely (2)siltuximab, drospirenone. Elagolix is a weak-to-moderate CYP3A4 inducer. Applies only to oral forms of hormone. Monitor Closely (1)quinapril, drospirenone. Low risk of contraceptive failure. Risk of hyperkalemia. ethinylestradiol will increase the level or effect of alprazolam by Mechanism: decreasing metabolism. . Use Caution/Monitor. Minor/Significance Unknown. Monitor Closely (1)cephalexin will decrease the level or effect of ethinylestradiol by altering intestinal flora. The efficacy of hormonal contraceptives may be reduced. brigatinib will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Serious - Use Alternative (2)calaspargase pegol, drospirenone. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Risk of hyperkalemia. ethinylestradiol increases levels of tizanidine by unspecified interaction mechanism. Low risk of contraceptive failure. 3mg/0.02mg (Yaz, Gianvi, Loryna, Vestura), 3mg/0.03mg (Yasmin, Ocella, Syeda, Yaela, Zarah), 1 active tablet (3 mg drospirenone/0.03 mg EE) PO qDay for 21 days, THEN 1 inert tablet PO qDay for 7 days, 1 active tablet (3 mg drospirenone/0.02 mg EE) PO qDay for 24 days, THEN 1 inert tablet PO qDay for 4 days, Indicated for moderate acne in women, but only if oral contraceptive is chosen as method of birth control, Indicated for symptoms of premenstrual dysphoric disorder (PMDD), but only if oral contraceptive is chosen as method of birth control, ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC), elvitegravir/cobicistat/emtricitabine/tenofovir DF, Women >35 years who smoke should not use oral contraceptives, Cigarette smoking increases risk of serious cardiovascular adverse effects from combination oral contraceptive use, This risk increases with age (>35 yr) and with heavy smoking (15 or more cigarettes/day), Advise women taking oral contraceptives not to smoke, Epidemiology studies have not found a consistent association between use of combined oral contraceptives (COCs) and breast cancer risk; studies do not show an association between ever (current or past) use of COCs and risk of breast cancer, Some studies report a small increase in risk of breast cancer among current or recent users(<6 months since last use) and current users with longer duration of COC use, A woman's risk depends on conditions where naturally high hormone levels persist for long periods of time including early-onset menstruation before age 12, late-onset menopause, after age 55, first child after age 30, nulliparity, Discontinue immediately if thrombotic event occurs, Risk of VTE is highest during the first year of use; interim data from a large, prospective cohort safety study of various combined oral contraceptives (COCs) suggest that this increased risk, as compared with that in non-COC users, is greatest during the first 6 months of COC use, Women taking drospirenone-containing contraceptives may have up to a 3-fold increased risk for developing VTE compared with women taking other combined hormonal contraceptives, To decrease risk of VTE events, CDC guidelines recommend waiting at least 3 weeks following vaginal birth or 6 weeks after cesarean section before initiating use of combined hormonal contraceptives; women with additional risk factors for VTE (besides postpartum) should not use combined hormonal contraceptives, Ethinyl estradiol: >98% bound to serum albumin, Drospirenone: 97% bound to serum proteins (not SHBG or corticosteroid-binding globulin). Avoid or Use Alternate Drug. Most Modify Therapy/Monitor Closely. enasidenib, ethinylestradiol. drospirenone and ketoprofen both increase serum potassium. sotalol and drospirenone both increase serum potassium. Monitor when coadministered with weak CYP3A4 inhibitors . MaloneyMichaelMD@qwestoffice.net Monitor Closely (1)levofloxacin will decrease the level or effect of ethinylestradiol by altering intestinal flora. Use Caution/Monitor.Minor (2)drospirenone increases levels of sulfamethoxazole by unspecified interaction mechanism. The efficacy of hormonal contraceptives may be reduced. Monitor Closely (1)ethinylestradiol will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: Theoretically, shepherd's purse may interfere with BP control. Adjust finererone dosage as needed.drospirenone will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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