Azurette and Erythromycin Filmtabs
Determining the interaction of Azurette and Erythromycin Filmtabs and the possibility of their joint administration.
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:Antibiotics such as erythromycin may reduce the effects of ethinyl estradiol in some women. If you are using ethinyl estradiol for birth control, you may be at increased risk for pregnancy or breakthrough bleeding. Talk to your healthcare provider to determine if you should use an alternative or additional form of birth control during or after treatment with erythromycin. In addition, erythromycin may increase the blood levels and side effects of ethinyl estradiol. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects. 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.
Professional:ADDITIONAL CONTRACEPTION RECOMMENDED: The effectiveness of estrogen-containing oral contraceptives may be impaired by concomitant treatment with antimicrobial agents. However, the risk appears to be small, and supportive data are primarily limited to anecdotal evidence from case reports and findings from uncontrolled or poorly controlled studies. Most antimicrobials, with the exception of the rifamycins and possibly griseofulvin, do not induce hepatic enzymes and have not been shown to significantly increase the clearance of oral contraceptive estrogens. Some investigators believe that antimicrobials interfere with the enterohepatic recirculation of estrogens by decreasing bacterial hydrolytic enzymes in the gastrointestinal tract that are responsible for regenerating parent estrogen molecules following first-pass metabolism. It is possible that a small number of women may be more susceptible to contraceptive failure and, consequently, are more sensitive to the effects of antimicrobials on estrogen disposition in vivo, but risk factors or genetic predispositions have yet to be identified. Limited clinical data suggest that interactions are unlikely with clarithromycin.
MANAGEMENT: Until further data are available, women using oral contraceptives should be advised of the risk of breakthrough bleeding and unintended pregnancy during concomitant antimicrobial therapy. Alternative or additional methods of birth control should be considered during and for at least one week beyond the last dose of short-term antimicrobial therapy, and for at least the initial weeks of long-term antimicrobial therapy when risk may be the greatest. Intrauterine systems are unlikely to be significantly affected because of their local action. Input from a gynecologist or similar expert on adequate contraception, including emergency contraception, should be sought as needed.
MONITOR: Certain macrolide antibiotics (e.g., erythromycin, clarithromycin) may increase the plasma concentrations and the risk of adverse effects of estrogens and progestogens. The mechanism is decreased clearance of the hormones due to inhibition of CYP450 3A4 activity by the macrolide antibiotic. Concomitant administration with erythromycin may increase the estradiol exposure by approximately 50%.
MANAGEMENT: During concomitant therapy with erythromycin or clarithromycin, patients should be observed for increased or altered pharmacologic response to estrogens and progestogens, and dosage(s) adjusted accordingly as necessary.
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical, Raritan, NJ.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Faculty of Sexual & Reproductive Healthcare "FSRH Clinical Guidance: Drug Interactions with Hormonal Contraception. Available from: URL: file:///C:/Users/df033684/Downloads/ceuguidancedruginteractionshormonal.pdf." ([2012, Jan 1]):
- "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
- "Product Information. Yasmin (drospirenone-ethinyl estradiol)" Berlex Laboratories, Richmond, CA.
- "Product Information. Angeliq (drospirenone-estradiol)." Berlex Laboratories, Wayne, NJ.
Generic Name: desogestrel / ethinyl estradiol
Brand name: Azurette, Cyclessa, Desogen, Isibloom, Kariva, Mircette, Reclipsen, Apri, Bekyree, Caziant, Ortho-Cept, Solia, Cesia, Cyred
Synonyms: n.a.
Generic Name: erythromycin
Brand name: EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, E. E. S, EryPed, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV
Synonyms: Erythromycin, Erythromycin (Systemic)
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.