AccessPak for HIV PEP Expanded with Kaletra and Fallback Solo

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Ritonavir may reduce the blood levels and effects of levonorgestrel. If you are using birth control pills or another hormone-type contraceptive such as a patch, shot, vaginal ring or implant, you should talk to your doctor before taking ritonavir. You may need an alternative or additional method of birth control during and for at least two weeks after treatment with ritonavir in order to avoid an unintended pregnancy. Let your doctor know if you experience bleeding outside of your menstrual cycle, since it may indicate reduced effectiveness of levonorgestrel. 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.

ADDITIONAL CONTRACEPTION RECOMMENDED: Coadministration with ritonavir may decrease the plasma concentrations of contraceptive hormones. In a pharmacokinetic study, 22 of 23 healthy women who received single doses of an oral contraceptive containing ethinyl estradiol 50 mcg and ethynodiol 1 mg had reduced serum levels of ethinyl estradiol following the addition of ritonavir (500 mg twice a day) for 2 weeks. Specifically, the mean peak serum concentration (Cmax) decreased by 32%, the mean systemic exposure (AUC) decreased by 41%, and the mean terminal elimination rate constant increased by 31%. The exact mechanism of interaction is unknown but may involve ritonavir induction of glucuronosyltransferase and/or CYP450 hydroxylation. Since estrogens and progestins may share common routes of metabolism, the possibility of a similar interaction should be considered in patients receiving contraceptive hormones other than ethinyl estradiol.

MANAGEMENT: Women using hormonal contraceptives should be advised of the risk of breakthrough bleeding and unintended pregnancy during concomitant therapy with ritonavir. Alternative or additional methods of birth control should be used during and for at least 4 weeks after ritonavir therapy. If a combination oral contraceptive pill is used, a regimen containing at least 50 mcg of ethinyl estradiol per day or equivalent should be selected. Although breakthrough bleeding is not necessarily indicative of low ethinyl estradiol serum levels or increased risk of ovulation, some clinicians suggest that women who experience breakthrough bleeding during enzyme-inducing therapy may be prescribed an increased dose of ethinyl estradiol above 50 mcg daily by combining more than one formulation of contraceptive pill if necessary. For emergency contraception in patients who have used an hepatic enzyme inducer in the past 4 weeks, a non-hormonal emergency contraceptive (e.g., copper intrauterine device) is considered preferable. If this is not possible, some authorities recommend that the usual dose of levonorgestrel (1.5 mg) should be doubled to 3 mg and taken as a single dose as soon as possible (within 72 hours of unprotected sexual intercourse). However, there are no data on efficacy, compliance, or side effects of this regimen. No precautions or recommendations are available for women using hormone-releasing intrauterine systems, but a significant interaction with these systems is thought to be unlikely due to their local action. Injectable progestin-only contraceptives are also thought to be unaffected by enzyme-inducing drugs.

AccessPak for HIV PEP Expanded with Kaletra

Generic Name: emtricitabine / lopinavir / ritonavir / tenofovir

Brand name: AccessPak for HIV PEP Expanded with Kaletra

Synonyms: n.a.

What is AccessPak for HIV PEP Expanded with Kaletra?

Fallback Solo

Generic Name: levonorgestrel

Brand name: EContra EZ, Fallback Solo, My Way, Next Choice, Opcicon One-Step, Plan B One-Step, React, Aftera, EContra One-Step, My Choice, My Way, New Day, Next Choice One Dose, Take Action, Kyleena, Liletta, Mirena, Skyla

Synonyms: n.a.

What is Fallback Solo?