Estratest H.S. and Itraconazole
Determining the interaction of Estratest H.S. and Itraconazole 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:Using itraconazole and esterified estrogens together may alter the levels of esterified estrogens in your body. This combination may cause nausea, vomiting, or vaginal bleeding. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment if you take both medications. 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:MONITOR: Azole antifungal agents may increase the plasma concentrations of estrogens and progestins. The mechanism is decreased clearance of the hormones due to inhibition of CYP450 3A4 activity by azole antifungals. Coadministration of voriconazole (200 mg every 12 hours) and an oral contraceptive containing 35 mcg of ethinyl estradiol and 1 mg of norethindrone increased the steady-state peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of ethinyl estradiol by an average of 36% and 61%, respectively, and Cmax and AUC of norethindrone by 15% and 53%, respectively, in healthy volunteers. Fluconazole doses of 150 mg and 200 mg have also been shown to increase the serum concentrations of ethinyl estradiol and levonorgestrel in healthy women receiving low-dose oral contraceptives, while single and multiple doses of fluconazole 50 mg had no significant effect on the pharmacokinetics of a high-dose oral contraceptive containing 150 mcg ethinyl estradiol and norgestrel 300 mcg. Ironically, there have been isolated reports of breakthrough bleeding and unintended pregnancy during use of oral contraceptives with itraconazole, which would suggest decreased rather than increased effect of the contraceptives. However, the association to itraconazole is questionable.
MANAGEMENT: During concomitant therapy with azole antifungal agents, patients should be observed for increased or altered pharmacologic response to estrogens and progestins, and dosage(s) adjusted accordingly as necessary.
- Devenport MH, Crook D, Wynn V, Lees LJ "Metabolic effects of low-dose fluconazole in healthy female users and non-users of oral contraceptives." Br J Clin Pharmacol 27 (1989): 851-9
- Lazar JD, Wilner KD "Drug interactions with fluconazole." Rev Infect Dis 12 Suppl 3 (1990): s327-33
- Sinofsky FE, Pasquale SA "The effect of fluconazole on circulating ethinyl estradiol levels in women taking oral contraceptives." Am J Obstet Gynecol 178 (1998): 300-4
- Weisberg E "Interactions between oral contraceptives and antifungals antibacterials - Is contraceptive failure the result?." Clin Pharmacokinet 36 (1999): 309-13
- Pillans PI, Sparrow MJ "Pregnancy associated with a combined oral contraceptive and itraconazole." N Z Med J 106 (1993): 436
- "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals, New York, NY.
Generic Name: esterified estrogens / methyltestosterone
Brand name: Covaryx, Covaryx HS, EEMT, EEMT DS, EEMT HS, Essian, Essian HS, Estratest, Estratest HS, Menogen HS, Menogen, Syntest HS, Syntest DS
Synonyms: n.a.
Generic Name: itraconazole
Brand name: Onmel, Sporanox, Sporanox PulsePak, Tolsura
Synonyms: n.a.
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.
- Estratest H.S.-Itraconazole Capsules (Sporanox)
- Estratest H.S.-Itraconazole Capsules (Tolsura)
- Estratest H.S.-Itraconazole Oral Solution
- Estratest H.S.-Itraconazole Tablets
- Estratest H.S.-Ivabradine
- Estratest H.S.-Ivabradine Hydrochloride
- Itraconazole-Estring
- Itraconazole-Estring local
- Itraconazole-Estring Vaginal
- Itraconazole-Estring Vaginal Ring
- Itraconazole-Estrogel
- Itraconazole-EstroGel Pump for use on skin