Interactions Between Antiretrovirals (Arvs) and Hormonal Contraceptives
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Everything You Need to Know About the Contraceptive Implant FDA Approval Means US Women Now Have a Progestin-Only Implant Among Their Birth Control Options
OBGM_0906_Darney.final 8/18/06 11:36 AM Page 50 OBGMANAGEMENT Everything you need to know about the contraceptive implant FDA approval means US women now have a progestin-only implant among their birth control options n July 17, the US Food and Drug or even monthly action on the part of the Administration (FDA) approved user, it is well-suited for: Philip D. Darney, MD, MSc what may be the most effective • Women who wish to or need Professor and Chief, Department O of Obstetrics, Gynecology, and hormonal contraceptive ever developed, a to avoid estrogen Reproductive Sciences, University single-rod implant that goes by the trade • Teens who find adherence to a of California-San Francisco, name Implanon. The implant contains 68 contraceptive regimen difficult San Francisco General Hospital ® Dowden Health Media mg of etonogestrel (ENG), the active • Healthy adult women who desire metabolite of desogestrel, in a membrane long-term protection ofCopyright ethylene vinylFor acetate. personal In clinical usetrials only• Women who are breastfeeding involving 20,648 cycles of exposure, only 6 pregnancies occurred, for a cumulative 1 Pearl Index of 0.38 per 100 woman-years. ❚ IN THIS ARTICLE This article reviews: Pros and cons • the 2 contraceptive mechanisms Advantages include: ❙ How the • indications and patient selection • Cost. A study2 of 15 contraceptive progestin-only • pharmacology, safety, adverse effects methods found the implant cost-effec- implant prevents • patient satisfaction and discontinua- tive compared to short-acting methods, tion rates provided it was used long-term. As of fertilization • insertion and removal press time, the manufacturer had not Page 52 • key points of patient counseling released the price. -
Package Leaflet: Information for the Patient Desogestrel Rowex
Package leaflet: Information for the patient Desogestrel Rowex 75 microgram Film-coated tablets desogestrel Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours. - If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet 1. What Desogestrel Rowex is and what it is used for 2. What you need to know before you take Desogestrel Rowex 4. Possible side effects 5. How to store Desogestrel Rowex 6. Contents of the pack and other information 1. What Desogestrel Rowex is and what it is used for Desogestrel Rowex used to prevent pregnancy. There are 2 main kinds of hormone contraceptive. - The combined pill, "The Pill", which contains 2 types of female sex hormone an oestrogen and a progestogen, - The progestogen-only pill, POP, which doesn't contain an oestrogen. Desogestrel Rowex is a progestogen-only-pill (POP). Desogestrel Rowex contains a small amount of one type of female sex hormone, the progestogen desogestrel. Most POPs work primarily by preventing the sperm cells from entering the womb but do not always prevent the egg cell from ripening, which is the main way that combined pills work. -
35 Cyproterone Acetate and Ethinyl Estradiol Tablets 2 Mg/0
PRODUCT MONOGRAPH INCLUDING PATIENT MEDICATION INFORMATION PrCYESTRA®-35 cyproterone acetate and ethinyl estradiol tablets 2 mg/0.035 mg THERAPEUTIC CLASSIFICATION Acne Therapy Paladin Labs Inc. Date of Preparation: 100 Alexis Nihon Blvd, Suite 600 January 17, 2019 St-Laurent, Quebec H4M 2P2 Version: 6.0 Control # 223341 _____________________________________________________________________________________________ CYESTRA-35 Product Monograph Page 1 of 48 Table of Contents PART I: HEALTH PROFESSIONAL INFORMATION ....................................................................... 3 SUMMARY PRODUCT INFORMATION ............................................................................................. 3 INDICATION AND CLINICAL USE ..................................................................................................... 3 CONTRAINDICATIONS ........................................................................................................................ 3 WARNINGS AND PRECAUTIONS ....................................................................................................... 4 ADVERSE REACTIONS ....................................................................................................................... 13 DRUG INTERACTIONS ....................................................................................................................... 16 DOSAGE AND ADMINISTRATION ................................................................................................ 20 OVERDOSAGE .................................................................................................................................... -
Revised 4/1/2021 GEORGIA MEDICAID FEE-FOR-SERVICE HIV
GEORGIA MEDICAID FEE-FOR-SERVICE HIV-AIDS PA SUMMARY Preferred (may not be all inclusive) Non-Preferred Abacavir generic Abacavir/lamivudine/zidovudine generic Abacavir/lamivudine generic Aptivus (tipranavir) Complera (emtricitabine/rilpivirine/tenofovir disoproxil Atazanavir capsules generic fumarate) Atripla (efavirenz/emtricitabine/tenofovir disoproxil Crixivan (indinavir) fumarate) Biktarvy (bictegravir/emtricitabine/tenofovir Delstrigo (doravirine/lamivudine/tenofovir disoproxil alafenamide) fumarate) Cimduo (lamivudine/tenofovir disoproxil fumarate) Fuzeon (enfuvirtide) Descovy (emtricitabine/tenofovir alafenamide) Intelence (etravirine) Dovato Invirase (saquinavir) Edurant (rilpivirine)* Lexiva (fosamprenavir) Efavirenz tablets generic Nevirapine extended-release generic Emtriva (emtricitabine) Norvir Powder (ritonavir) Epivir solution (lamivudine) Pifeltro (doravirine) Evotaz (atazanavir/cobicistat)* Reyataz Powder (atazanavir) Genvoya (elvitegravir/cobicistat/emtricitabine/ Ritonavir tablets generic tenofovir alafenamide) Isentress and Isentress HD (raltegravir)* Rukobia (fostemsavir) Juluca (dolutegravir/rilpivirine) Selzentry (maraviroc) Kaletra (lopinavir/ritonavir) Stavudine generic^ Stribild (elvitegravir/cobicistat/emtricitabine/ tenofovir Lamivudine generic disoproxil fumarate) Symfi (efavirenz 600 mg/lamivudine/tenofovir Lamivudine/zidovudine generic disoproxil fumarate) Symfi Lo (efavirenz 400 mg/lamivudine/tenofovir Nevirapine immediate-release tablets generic disoproxil fumarate) Norvir (ritonavir) Temixys (lamivudine/tenofovir -
Ocps) Used in the NM Family Planning Program (FPP
The following slides are intended to familiarize nurses and clinicians with oral contraceptive pills (OCPs) used in the NM Family Planning Program (FPP). The FPP does not intend for this information to supersede the Family Planning Protocol particularly on the requirement for Public Health Nurses in the Public Health Offices to consult a clinician as stated in the Protocol when in doubt or if it is necessary to switch the client’s OCP type. 1 2 Combined oral contraceptives (COCs) contain two hormones; estrogen and progestin. In general, any combined OCP is good for most women who are eligible to take estrogen according to the CDC U.S. Medical Eligibility Criteria (MEC). Once again, refer to the US MEC chart to find out if OCP is a suitable choice for clients with specific health conditions. To learn a little bit about what each hormone does, the FPP is providing the following summary: Estrogen: provides endometrial stability = menstrual cycle control. A higher estrogen dose increases the venous thromboembolism (VTE) or clot risk but OCP clot risk is still less harmful than the clot risk related to pregnancy and giving birth. Progestin: provides most of the contraceptive effect by ‐Preventing luteinizing hormone (LH) surge /ovulation ‐Thickening the cervical mucus to prevent sperm entry. Two major OCP formations are available. Monophasic: There is only one dose of estrogen and progestin in each active pill in the packet; and Multiphasic: There are varying doses of hormones, particularly progestin in the active pills. 3 Section 3 of the FPP Protocol contains the OCP Substitute Table, which groups OCPs into 6 classes according to the estrogen dosage, the type of progestin and the formulations. -
Pharmacokinetic Interactions Between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance
life Review Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance Laura Rombolà 1 , Damiana Scuteri 1,2 , Straface Marilisa 1, Chizuko Watanabe 3, Luigi Antonio Morrone 1, Giacinto Bagetta 1,2,* and Maria Tiziana Corasaniti 4 1 Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, 87036 Rende, Italy; [email protected] (L.R.); [email protected] (D.S.); [email protected] (S.M.); [email protected] (L.A.M.) 2 Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy 3 Department of Physiology and Anatomy, Tohoku Pharmaceutical University, 981-8558 Sendai, Japan; [email protected] 4 School of Hospital Pharmacy, University “Magna Graecia” of Catanzaro and Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-0984-493462 Received: 28 May 2020; Accepted: 30 June 2020; Published: 4 July 2020 Abstract: The therapeutic efficacy of a drug or its unexpected unwanted side effects may depend on the concurrent use of a medicinal plant. In particular, constituents in the medicinal plant extracts may influence drug bioavailability, metabolism and half-life, leading to drug toxicity or failure to obtain a therapeutic response. This narrative review focuses on clinical studies improving knowledge on the ability of selected herbal medicines to influence the pharmacokinetics of co-administered drugs. Moreover, in vitro studies are useful to anticipate potential herbal medicine-drug interactions. -
Truvada (Emtricitabine / Tenofovir Disoproxil)
Pre-exposure Prophylaxis (2.3) HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use Recommended dose in HIV-1 uninfected adults: One tablet TRUVADA safely and effectively. See full prescribing information (containing 200 mg/300 mg of emtricitabine and tenofovir for TRUVADA. disoproxil fumarate) once daily taken orally with or without food. (2.3) TRUVADA® (emtricitabine/tenofovir disoproxil fumarate) tablets, for oral use Recommended dose in renally impaired HIV-uninfected Initial U.S. Approval: 2004 individuals: Do not use TRUVADA in HIV-uninfected individuals if CrCl is below 60 mL/min. If a decrease in CrCl is observed in WARNING: LACTIC ACIDOSIS/SEVERE HEPATOMEGALY WITH uninfected individuals while using TRUVADA for PrEP, evaluate STEATOSIS, POST-TREATMENT ACUTE EXACERBATION OF potential causes and re-assess potential risks and benefits of HEPATITIS B, and RISK OF DRUG RESISTANCE WITH USE OF continued use. (2.4) TRUVADA FOR PrEP IN UNDIAGNOSED HIV-1 INFECTION -----------------------DOSAGE FORMS AND STRENGTHS------------------- See full prescribing information for complete boxed warning. Tablets: 200 mg/300 mg, 167 mg/250 mg, 133 mg/200 mg, and 100 Lactic acidosis and severe hepatomegaly with steatosis, mg/150 mg of emtricitabine and tenofovir disoproxil fumarate . (3) including fatal cases, have been reported with the use of nucleoside analogs, including VIREAD, a component of TRUVADA. (5.1) --------------------------------CONTRAINDICATIONS----------------------------- TRUVADA is not approved for the treatment of chronic Do not use TRUVADA for pre-exposure prophylaxis in individuals with hepatitis B virus (HBV) infection. Severe acute unknown or positive HIV-1 status. TRUVADA should be used in exacerbations of hepatitis B have been reported in patients HIV-infected patients only in combination with other antiretroviral coinfected with HIV-1 and HBV who have discontinued agents. -
Comparing the Effects of Combined Oral Contraceptives Containing Progestins with Low Androgenic and Antiandrogenic Activities on the Hypothalamic-Pituitary-Gonadal Axis In
JMIR RESEARCH PROTOCOLS Amiri et al Review Comparing the Effects of Combined Oral Contraceptives Containing Progestins With Low Androgenic and Antiandrogenic Activities on the Hypothalamic-Pituitary-Gonadal Axis in Patients With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis Mina Amiri1,2, PhD, Postdoc; Fahimeh Ramezani Tehrani2, MD; Fatemeh Nahidi3, PhD; Ali Kabir4, MD, MPH, PhD; Fereidoun Azizi5, MD 1Students Research Committee, School of Nursing and Midwifery, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran 2Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran 3School of Nursing and Midwifery, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran 4Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran 5Endocrine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran Corresponding Author: Fahimeh Ramezani Tehrani, MD Reproductive Endocrinology Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences 24 Parvaneh Yaman Street, Velenjak, PO Box 19395-4763 Tehran, 1985717413 Islamic Republic Of Iran Phone: 98 21 22432500 Email: [email protected] Abstract Background: Different products of combined oral contraceptives (COCs) can improve clinical and biochemical findings in patients with polycystic ovary syndrome (PCOS) through suppression of the hypothalamic-pituitary-gonadal (HPG) axis. Objective: This systematic review and meta-analysis aimed to compare the effects of COCs containing progestins with low androgenic and antiandrogenic activities on the HPG axis in patients with PCOS. -
Indinavir Sulfate Capsule Merck & Co., Inc
CRIXIVAN - indinavir sulfate capsule Merck & Co., Inc. ---------- CRIXIVAN® (INDINAVIR SULFATE) CAPSULES DESCRIPTION CRIXIVAN1 (indinavir sulfate) is an inhibitor of the human immunodeficiency virus (HIV) protease. CRIXIVAN Capsules are formulated as a sulfate salt and are available for oral administration in strengths of 100, 200, 333, and 400 mg of indinavir (corresponding to 125, 250, 416.3, and 500 mg indinavir sulfate, respectively). Each capsule also contains the inactive ingredients anhydrous lactose and magnesium stearate. The capsule shell has the following inactive ingredients and dyes: gelatin, titanium dioxide, silicon dioxide and sodium lauryl sulfate. The chemical name for indinavir sulfate is [1(1S,2R),5(S)]-2,3,5-trideoxy-N-(2,3-dihydro-2-hydroxy-1H-inden-1-yl)-5-[2-[[(1,1 dimethylethyl)amino]carbonyl]-4-(3-pyridinylmethyl)-1-piperazinyl]-2-(phenylmethyl)-D-erythro-pentonamide sulfate (1:1) salt. Indinavir sulfate has the following structural formula: Indinavir sulfate is a white to off-white, hygroscopic, crystalline powder with the molecular formula C36H47N5O4• H2SO4 and a molecular weight of 711.88. It is very soluble in water and in methanol. 1 Registered trademark of MERCK & CO., Inc. COPYRIGHT © 1996, 1997, 1998, 1999, 2004 MERCK & CO., Inc. All rights reserved MICROBIOLOGY Mechanism of Action HIV-1 protease is an enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the individual functional proteins found in infectious HIV-1. Indinavir binds to the protease active site and inhibits the activity of the enzyme. This inhibition prevents cleavage of the viral polyproteins resulting in the formation of immature non-infectious viral particles. -
Pharmacokinetic Interactions of Drugs with St John's Wort
http://www.paper.edu.cn Pharmacokinetic interactions of Journal of Psychopharmacology 18(2) (2004) 262–276 © 2004 British Association drugs with St John’s wort for Psychopharmacology ISSN 0269-8811 SAGE Publications Ltd, London, Thousand Oaks, CA and New Delhi 10.1177/0269881104042632 Shufeng Zhou Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore. Eli Chan Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore. Shen-Quan Pan Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore. Min Huang Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510089, PR China. Edmund Jon Deoon Lee Department of Pharmacology, Faculty of Medicine, National University of Singapore, Singapore. Abstract There is a worldwide increasing use of herbs which are often cancer patients receiving irinotecan treatment. St John’s wort did not administered in combination with therapeutic drugs, raising the alter the pharmacokinetics of tolbutamide, but increased the incidence potential for herb–drug interactions. St John’s wort (Hypericum of hypoglycaemia. Several cases have been reported that St John’s wort perforatum) is one of the most commonly used herbal antidepressants. A decreased cyclosporine blood concentration leading to organ rejection. literature search was performed using Medline (via Pubmed), Biological St John’s wort caused breakthrough bleeding and unplanned pregnancies Abstracts, Cochrane Library, AMED, PsycINFO and Embase (all from their when used concomitantly with oral contraceptives. It also caused inception to September 2003) to identify known drug interaction with serotonin syndrome when coadministered with selective serotonin- St John’s wort. The available data indicate that St John’s wort is a reuptake inhibitors (e.g. -
CYP3A4 Mediated Pharmacokinetics Drug Interaction Potential of Maha
www.nature.com/scientificreports OPEN CYP3A4 mediated pharmacokinetics drug interaction potential of Maha‑Yogaraj Gugglu and E, Z guggulsterone Sarvesh Sabarathinam1, Satish Kumar Rajappan Chandra2 & Vijayakumar Thangavel Mahalingam1* Maha yogaraja guggulu (MYG) is a classical herbomineral polyherbal formulation being widely used since centuries. The aim of this study was to investigate the efect of MYG formulation and its major constituents E & Z guggulsterone on CYP3A4 mediated metabolism. In vitro inhibition of MYG and Guggulsterone isomers on CYP3A4 was evaluated by high throughput fuorometric assay. Eighteen Adult male Sprague–Dawley rats (200 ± 25 g body weight) were randomly divided into three groups. Group A, Group B and Group C were treated with placebo, MYG and Standard E & Z guggulsterone for 14 days respectively by oral route. On 15th day, midazolam (5 mg/kg) was administered orally to all rats in each group. Blood samples (0.3 mL) were collected from the retro orbital vein at 0.25, 0.5, 0.75, 1, 2, 4, 6, 12 and 24 h of each rat were collected. The fndings from the in vitro & in vivo study proposed that the MYG tablets and its guggulsterone isomers have drug interaction potential when consumed along with conventional drugs which are CYP3A4 substrates. In vivo pharmacokinetic drug interaction study of midazolam pointed out that the MYG tablets and guggulsterone isomers showed an inhibitory activity towards CYP3A4 which may have leads to clinically signifcant interactions. Te use of alternative medicine such as herbal medicines, phytonutrients, ayurvedic products and nutraceuticals used widely by the majority of the patients for their primary healthcare needs. -
ORTHO TRI-CYCLEN® TABLETS ORTHO-CYCLEN® TABLETS (Norgestimate/Ethinyl Estradiol)
PHYSICIANS' PACKAGE INSERT ORTHO TRI-CYCLEN® TABLETS ORTHO-CYCLEN® TABLETS (norgestimate/ethinyl estradiol) Patients should be counseled that this product does not protect against HIV infection (AIDS) and other sexually transmitted diseases. DESCRIPTION Each of the following products is a combination oral contraceptive containing the progestational compound norgestimate and the estrogenic compound ethinyl estradiol. ORTHO TRI-CYCLEN 21 Tablets and ORTHO TRI-CYCLEN 28 Tablets. Each white tablet contains 0.180 mg of the progestational compound, norgestimate (18,19-Dinor- 17-pregn-4-en-20-yn-3-one,17-(acetyloxy)-13-ethyl-, oxime,(17α)-(+)-) and 0.035 mg of the estrogenic compound, ethinyl estradiol (19-nor-17α-pregna,1,3,5(10)-trien-20-yne-3,17-diol). Inactive ingredients include lactose, magnesium stearate, and pregelatinized starch. Each light blue tablet contains 0.215 mg of the progestational compound norgestimate (18,19- Dinor-17-pregn-4-en-20-yn-3-one,17-(acetyloxy)-13-ethyl-,oxime,(17α)-(+)-) and 0.035 mg of the estrogenic compound, ethinyl estradiol (19-nor-17α-pregna,1,3,5(10)-trien-20-yne-3,17-diol). Inactive ingredients include FD & C Blue No. 2 Aluminum Lake, lactose, magnesium stearate, and pregelatinized starch. Each blue tablet contains 0.250 mg of the progestational compound norgestimate (18,19-Dinor-17- pregn-4-en-20-yn-3-one, 17-(acetyloxy)-13-ethyl-,oxime,(17α)-(+)-) and 0.035 mg of the estrogenic compound, ethinyl estradiol (19-nor-17α-pregna,1,3,5(10)-trien-20-yne-3,17-diol). Inactive ingredients include FD & C Blue No. 2 Aluminum Lake, lactose, magnesium stearate, and pregelatinized starch.