Esbriet and Microgestin Fe 1/20

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.

Ethinyl estradiol may increase the blood levels of pirfenidone. In some cases, this can increase the risk and/or severity of side effects such as liver problems, sensitivity to sunlight, rash, dizziness, diarrhea, nausea, vomiting, and upset stomach. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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.

MONITOR: Coadministration with inhibitors of CYP450 1A2 may increase the plasma concentrations of pirfenidone, which is primarily (70% to 80%) metabolized by the isoenzyme. Other CYP450 isoenzymes also contribute to a minor extent, including CYP450 2C9, 2C19, 2D6, and 2E1. Concomitant inhibition of one or more of these isoenzymes in addition to CYP450 1A2 is expected to further increase the magnitude of interaction. In 27 healthy study subjects, administration of a single 801 mg dose of pirfenidone on day 6 of treatment with the moderate CYP450 1A2 inhibitor ciprofloxacin (750 mg twice daily) increased pirfenidone peak plasma concentration (Cmax) and systemic exposure (AUC) by 23% and 81%, respectively. In 25 healthy nonsmokers and 25 smokers who were administered a single dose of pirfenidone with the potent CYP450 1A2 inhibitor fluvoxamine (50 mg at bedtime for 3 days; 50 mg twice a day for 3 days; then 50 mg in the morning and 100 mg at bedtime for 4 days), pirfenidone AUC increased approximately 4-fold in nonsmoking subjects and 7-fold in smoking subjects. Fluvoxamine also inhibits CYP450 2C9, 2C19 and 2D6, although the extent to which these effects contribute to the interaction has not been established.

MANAGEMENT: Caution is advised when pirfenidone is used concomitantly with CYP450 1A2 inhibitors. Patients should be closely monitored for adverse reactions such as hepatotoxicity, photosensitivity, rash, nausea, diarrhea, vomiting and dyspepsia, and consideration be given to dosage reduction, brief interruption, or permanent discontinuation of pirfenidone if clinically necessary in accordance with the product labeling. Coadministration of pirfenidone with CYP450 1A2 inhibitors in addition to inhibitors of other CYP450 isoenzymes involved in the metabolism of pirfenidone should be avoided, including significant inhibitors of CYP450 2C9 (e.g., amiodarone, fluconazole, imatinib, gemfibrozil, miconazole), 2C19 (e.g., chloramphenicol, cimetidine, esomeprazole, fluconazole, lansoprazole, omeprazole), and/or 2D6 (e.g., bupropion, cinacalcet, fluoxetine, paroxetine, quinidine, terbinafine).

Esbriet

Generic Name: pirfenidone

Brand name: Esbriet

Synonyms: n.a.

What is Esbriet?

Microgestin Fe 1/20

Generic Name: ethinyl estradiol / norethindrone

Brand name: Blisovi 24 Fe, Blisovi Fe 15/30, Blisovi Fe 1/20, Estrostep Fe, Gildess 24 Fe, Gildess Fe 15/30, Gildess Fe 1/20, Junel Fe 15/30, Junel Fe 1/20, Junel Fe 24, Larin 24 Fe, Larin Fe 15/30, Larin Fe 1/20, Lo Loestrin Fe, Loestrin 24 Fe, Loestrin Fe 15/30, Loestrin Fe 1/20, Lomedia 24 Fe, Microgestin 24 Fe, Microgestin Fe 15/30, Microgestin Fe 1/20, Tarina Fe 1/20, Taytulla, Tilia Fe, Tri-Legest Fe, Blisovi 24 Fe, Femcon Fe, Kaitlib FE, Lo Minastrin Fe, Microgestin 24 Fe, Norinyl 1+35, Ortho-Novum 7/7/7, Tri-Norinyl, Zenchent, femhrt 05 mg/25 mcg, Fyavolv, Jevantique Lo, Jinteli, Femcon Fe, Generess FE, Loestrin 1/20, Ovcon 35, Brevicon

Synonyms: n.a.

What is Microgestin Fe 1/20?