Naslov
Interakcije estrogena i progestina s drugim lijekovima
(Interaction of estrogens and progestins with other drugs)

Autori
Zorc, Branka ; Martinac, Anita ; Zovko, Marijana

Izvornik
Farmaceutski glasnik (0014-8202) 63 (1999); 227-243

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
female hormones, estrogens, gestagens, interaction, drugs

Sažetak
Estrogens and progestins are given for replacement therapy indeficiency states, for menopausal and postmenopausal disorders, for contraception, for the treatment of malignant neoplasm, either alone or combined. Hormonal drugs can interact with a number of other medications, but not all interactions are clinically significant. One of the most important interactions is the interaction with anticonvulsants. Barbiturates, carbamazepine and hydantoins accelerate the biotransformation of both estrogens and progestins through enzyme induction and lower sex hormones blood level. Reduced contraceptive effectiveness and increased incidence of breakthrough bleeding and menstrual irregularities have been associated with concomitant use of birth control pills and rifampicin. A similar association, though less marked, has been suggested with other antibiotics (ampicillin and other penicillin-type antibiotics, tetracyclines, griseofulvin). The theory is that these broad- spectrum antibiotics kill bacteria in the digestive tract that play an important role in maintaining adequate blood levels of contraceptive hormones. Estrogens and progestins have been reported to increase blood levels of antidepressants, benzodiazepines, antiasthmic drugs and cyclosporine. Interactions with imipramine and theophylline can be very dangerous. They can also increase blood levels of β-adrenoceptor blockers (metoprolol and propranolol) and raise blood sugar so the dose of the diabetes drugs may need adjustment. Concurrent use of dantrolene with estrogens may increase the risk of hepatotoxicity. Women using oral contraceptives may need more vitamins (vitamin C, B6, E and folic acid). On the other hand vitamin C can boost estrogen levels. Grapefruit juice can increase circulating levels of oral estrogens by about one-third and alcohol even more. Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. And the last, but not the least, estrogens may increase calcium absorption. This can be used to therapeutic advantage.

Izvorni jezik
Hrvatski

Znanstvena područja
Farmacija

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