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Actos and Mili

Determining the interaction of Actos and Mili and the possibility of their joint administration.

Check result:

Actos <> Mili

Relevance: 12.08.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Coadministration with another thiazolidinedione, troglitazone, has been shown to decrease the plasma concentrations of contraceptive hormones. The proposed mechanism is induction of hormone metabolism via CYP450 3A4. In 15 healthy female subjects, troglitazone (60 mg once daily for 3 weeks) decreased the mean steady-state peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of ethinyl estradiol and norethindrone (35 mcg-1 mg) by approximately 30% each compared to administration of the contraceptive alone. Four subjects experienced breakthrough bleeding during the cycle with troglitazone. There are no data on the use of contraceptive hormones with pioglitazone. Because pioglitazone may be a weak inducer of CYP450 3A4, product labeling recommends additional caution in women requiring contraception. However, some studies have reported no significant effect of pioglitazone on CYP450 3A4. Rosiglitazone labeling states that the drug given in a dosage of 4 mg twice daily had no clinically relevant effect on the pharmacokinetics of oral contraceptives (ethinyl estradiol and norethindrone). Intrauterine systems are unlikely to be significantly affected because of their local action.

References

Loi CM, Stern R, Koup JR, Vassos AB, Knowlton P, Sedman AJ "Effect of troglitazone on the pharmacokinetics of an oral contraceptive agent." J Clin Pharmacol 39 (1999): 410-7
"Product Information. Avandia (rosiglitazone)" SmithKline Beecham, Philadelphia, PA.
Nowak SN, Edwards DJ, Clarke A, Anderson GD, Jaber LA "Pioglitazone: effect on CYP3A4 activity." J Clin Pharmacol 42 (2002): 1299-302
Glazer NB, Cheatham WW "Thiazolidinediones for type 2 diabetes - No evidence exists that pioglitazone induces hepatic cytochrome P450 isoform CYP3A4." Br Med J 322 (2001): 235-6
"Product Information. Actos (pioglitazone)" Takeda Pharmaceuticals America, Lincolnshire, IL.

Actos

Generic Name: pioglitazone

Brand name: Actos

Synonyms: n.a.

What is Actos?

Mili

Generic Name: ethinyl estradiol / norgestimate

Brand name: Estarylla, Femynor, Mili, Mono-Linyah, Mononessa, Ortho-Cyclen, Tri-Lo-Marzia>

Synonyms: Mili Tablets

What is Mili?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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