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TriNessa (28) and Zilretta

Determining the interaction of TriNessa (28) and Zilretta and the possibility of their joint administration.

Check result:
TriNessa (28) <> Zilretta
Relevance: 25.01.2023 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:

Ethinyl estradiol may increase the blood levels of triamcinolone. This may increase the risk and/or severity of side effects such as swelling, weight gain, electrolyte abnormalities, high blood pressure, high blood glucose, muscle weakness, depression, mood swings, acne, thinning skin, stretch marks, easy bruising, bone density loss, cataracts, glaucoma, menstrual irregularities, excessive growth of facial or body hair, and abnormal distribution of body fat, especially in the face, neck, back, and waist. Other side effects that may occur include decreased ability to fight infections, increased risk of developing infections, and inadequate response to stress such as infection, surgery, trauma, or a severe asthma attack. Children may experience a reduced growth rate during chronic use. 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 by your doctor to safely use 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: Estrogens may enhance the systemic effects of both endogenous and exogenous corticosteroids. The proposed mechanism is an increase in serum cortisol-binding globulin (transcortin) induced by estrogens, resulting in a decreased rate of corticosteroid metabolic clearance. The interaction has been reported with estrogens or estrogen-containing oral contraceptives (OCs) and hydrocortisone, prednisone, and prednisolone. In one pharmacokinetic study, the mean plasma clearance of total prednisolone (40 mg IV) in eight female OC users was less than half that of five healthy female non-OC users and eight healthy males, and the prednisolone half-life and mean residence time were longer. There was also a 2-fold increase in the area under the plasma concentration-time curve for unbound prednisolone compared to controls.

MANAGEMENT: Patients treated concomitantly with an estrogen-containing drug may require lower dosages of corticosteroids or adrenocorticotropic agents. Pharmacologic response to these agents should be monitored more closely whenever an estrogen is added to or withdrawn from therapy in patients stabilized on their existing corticosteroid or adrenocorticotropic regimen, and the dosage(s) adjusted as necessary.

References
  • Legler UF, Benet LZ "Marked alterations in dose-dependent prednisolone kinetics in women taking oral contraceptives." Clin Pharmacol Ther 39 (1986): 425-9
  • Meffin PJ, Wing LM, Sallustio BC, Brooks PM "Alterations in prednisolone as a result of oral contraceptive use and dose." Br J Clin Pharmacol 17 (1984): 655-64
  • Frey BM, Schaad HJ, Frey FJ "Pharmacokinetic interaction of contraceptive steroids with prednisone and prednisolone." Eur J Clin Pharmacol 26 (1984): 505-11
  • "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  • Olivesi A "Modified elimination of prednisolone in epileptic patients on carbamazepine monotherapy, and in women using low-dose oral contraceptives." Biomed Pharmacother 40 (1986): 301-8
  • "Product Information. Ortho-Novum (oral contraceptive combination pill)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  • Boekenoogen SJ, Szefler SJ, Jusko WJ "Prednisolone disposition and protein binding in oral contraceptive users." J Clin Endocrinol Metab 56 (1983): 702-8
TriNessa (28)

Generic Name: ethinyl estradiol / norgestimate

Brand name: Estarylla, Femynor, Mono-Linyah, Mononessa, Ortho Tri-Cyclen, Previfem, Sprintec, Tri-Lo-Marzia, TriNessa, Ortho Tri-Cyclen, Ortho-Cyclen, Sprintec 28, Tri-Lo-Marzia>

Synonyms: TriNessa

Zilretta

Generic Name: triamcinolone

Brand name: Kenalog-40, Zilretta, Aristocort, Azmacort

Synonyms: Zilretta (injection)

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.

Interaction with food and lifestyle
Disease interaction