Gengraf and Nordette
Determining the interaction of Gengraf and Nordette 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:Ethinyl estradiol may increase the blood levels and effects of cycloSPORINE. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects such as nausea, vomiting, diarrhea, abdominal pain, dizziness, fatigue, headache, tremors, seizures, fever, sore throat, unusual bruising or bleeding, and increased or decreased urination. 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: Coadministration with some estrogens or progestins may increase the plasma concentrations of cyclosporine. The risk of cyclosporine-induced nephrotoxicity, hepatotoxicity, and neurotoxicity may be increased. The proposed mechanism is competitive inhibition of cyclosporine metabolism via CYP450 3A4, of which estrogens and progestins are also substrates. One case report describes a patient treated with cyclosporine who developed severe hepatotoxicity following the addition of an oral contraceptive containing ethinyl estradiol 30 mcg and levonorgestrel 150 mcg. Increases in plasma trough concentrations of cyclosporine, serum creatinine, serum transaminases, serum bilirubin, and alkaline phosphatase were observed. In addition, the patient experienced nausea, vomiting, and hepatomegaly.
MANAGEMENT: Caution is advised during concomitant therapy with cyclosporine. Cyclosporine blood levels as well as renal and hepatic function should be checked frequently and the dosage adjusted accordingly, particularly following initiation or discontinuation of hormonal contraceptives in patients who are stabilized on their cyclosporine regimen. Patients should be advised to notify their physician if they experience signs and symptoms of hepatotoxicity (e.g., fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, jaundice) or neurotoxicity (e.g., tremor, convulsions).
- Maurer G "Metabolism of cyclosporine." Transplant Proc 17 (1985): 19-26
- Deray G, Le Hoang P, Cacoub P, et al "Oral contraceptive interaction with cyclosporin." Lancet 1 (1987): 158-9
Generic Name: cyclosporine
Brand name: Gengraf, Neoral, Sandimmune, Sandimmune
Synonyms: Gengraf (Capsules, Modified)
Generic Name: ethinyl estradiol / levonorgestrel
Brand name: Afirmelle, Altavera, Amethia, Amethia Lo, Amethyst, Ashlyna, Aubra, Aubra EQ, Aviane, Ayuna, Balcoltra, Camrese, Camrese Lo, Chateal, Chateal EQ, Daysee, Delyla, Enpresse-28, FaLessa, Falmina, Fayosim, Introvale, Jolessa, Kurvelo, Larissia, Lessina, Levonest, Levora 015/30, Lillow, LoSeasonique, Lutera, Marlissa, Myzilra, Orsythia, Portia-28, Quartette, Quasense, Rivelsa, Seasonique, Setlakin, Simpesse, Sronyx, Trivora, Vienva, Alesse, Enpresse, Levlen, Levora, Lybrel, Nordette, Portia, Tri-Levlen, Triphasil-21, Triphasil-28, Trivora-28, Seasonale, Preven EC, Triphasil
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.
- Gengraf-Norditropin
- Gengraf-Norditropin Flexpro
- Gengraf-Norditropin FlexPro Pen
- Gengraf-Norel AD
- Gengraf-Norel SR Tablets
- Gengraf-Norepinephrine
- Nordette-Gengraf (Cyclosporine Capsules, Modified)
- Nordette-Gengraf (Cyclosporine Oral Solution, Modified)
- Nordette-Gengraf Capsules
- Nordette-Gengraf Oral
- Nordette-Gengraf Oral Solution
- Nordette-Genicin