There are 22 disease interactions with Tri-Estarylla (ethinyl estradiol / norgestimate).
- Smoking
- Abnormal vagin*l bleeding
- Carcinomas (estrogenic)
- Hypercalcemia in breast cancer
- Hypertension
- Thromboembolism/cardiovascular
- Hepatic neoplasms
- Liver disease
- Thromboembolism
- Angioedema
- Gallbladder disease
- Hypercalcemia
- Hyperlipidemia
- Liver disease
- Melasma
- Depression
- Fluid retention
- Glucose intolerance
- Retinal thrombosis
- Thyroid function tests
- Hyperlipidemia
- Weight gain
Major
Combined oral contraceptives (applies to Tri-Estarylla) smoking
Major Potential Hazard, Moderate plausibility.
Cigarette smoking increases the risk of serious cardiovascular events from estrogen-containing combination oral contraceptives (COC). This risk increases with age, particularly in females over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs are contraindicated in females who are over 35 years of age and smoke.
References
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2017) "Product Information. Gianvi (drospirenone-ethinyl estradiol)." Teva Pharmaceuticals USA
- (2017) "Product Information. Alesse-28 (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Canada Inc
- (2017) "Product Information. Lo Loestrin Fe (ethinyl estradiol-norethindrone)." Warner Chilcott Laboratories
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 5 references
Major
Estrogens (applies to Tri-Estarylla) abnormal vagin*l bleeding
Major Potential Hazard, High plausibility. Applicable conditions: Abnormal Uterine Bleeding
The use of estrogens is contraindicated in patients with undiagnosed, abnormal vagin*l bleeding. Prolonged (> 1 year), unopposed estrogen use (i.e. estrogen without concomitant progestin therapy) has been associated with a significant, dose-related risk of endometrial carcinoma. The risk may be offset substantially by the addition of a progestin but may not be completely abolished. Prior to initiating estrogen therapy, appropriate diagnostic tests should be performed in patients with abnormal vagin*l bleeding to rule out endometrial malignancy. The same applies if recurrent or persistent bleeding develops during estrogen therapy.
References
- Obrink A, Bunne G, Collen J, Tjernberg B (1979) "Endometrial cancer and exogenous estrogens." Acta Obstet Gynecol Scand, 58, p.123
- Spengler RF, Clarke EA, Woolever CA, Newman AM, Osborn RW (1981) "Exogenous estrogens and endometrial cancer: a case-control study and assessment of potential biases." Am J Epidemiol, 114, p.497-506
- Buring JE, Bain CJ, Ehrmann RL (1986) "Conjugated estrogen use and risk of endometrial cancer." Am J Epidemiol, 124, p.434-41
- Persson I, Adami HO, Bergkvist L, Lindgren A, Pettersson B, Hoover R, Schairer C (1989) "Risk of endometrial cancer after treatment with oestrogens alone or in conjunction with progestogens: results of a prospective study." BMJ, 298, p.147-51
- Antunes CM, Strolley PD, Rosenshein NB, Davies JL, Tonascia JA, Brown C, Burnett L, Rutledge A, Pokempner M, Garcia R (1979) "Endometrial cancer and estrogen use. Report of a large case-control study." N Engl J Med, 300, p.9-13
- Gordon J, Reagan JW, Finkle WD, Ziel HK (1977) "Estrogen and endometrial carcinoma. An independent pathology review supporting original risk estimate." N Engl J Med, 297, p.570-1
- Shapiro S, Kelly JP, Rosenberg L, Kaufman DW, Helmrich SP, Rosenshein NB, Lewis JL Jr, Knapp RC, Stolley PD, Schottenfeld D (1985) "Risk of localized and widespread endometrial cancer in relation to recent and discontinued use of conjugated estrogens." N Engl J Med, 313, p.969-72
- Gray LA Sr, Christopherson WM, Hoover RN (1977) "Estrogens and endometrial carcinoma." Obstet Gynecol, 49, p.385-9
- Woodruff JD, Pickar JH (1994) "Incidence of endometrial hyperplasia in postmenopausal women taking conjugated estrogens (Premarin) with medroxyprogesterone acetate or conjugated estrogens alone." Am J Obstet Gynecol, 170, p.1213-23
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- The Writing Group for the PEPI Trial (1996) "Effects of hormone replacement therapy on endometrial histology in postmenopausal women." JAMA, 275, p.370-5
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
- (2023) "Product Information. Intrarosa (prasterone)." Theramex Australia Pty Ltd, 1
View all 30 references
Major
Estrogens (applies to Tri-Estarylla) carcinomas (estrogenic)
Major Potential Hazard, High plausibility. Applicable conditions: Neoplasia -- Estrogen Dependent
The use of estrogens is generally contraindicated in patients with known or suspected estrogen-dependent neoplasia such as breast and endometrial cancer, since it may stimulate tumor proliferation. High dosages of estrogens may be used for the palliative treatment of inoperable, metastatic breast cancer, but only in appropriately selected men and postmenopausal women.
References
- Ewertz M (1992) "Oral contraceptives and breast cancer risk in Denmark." Eur J Cancer, 28A, p.1176-81
- Obrink A, Bunne G, Collen J, Tjernberg B (1979) "Endometrial cancer and exogenous estrogens." Acta Obstet Gynecol Scand, 58, p.123
- Palmer JR, Rosenberg L, Clarke EA, Miller DR, Shapiro S (1991) "Breast cancer risk after estrogen replacement therapy: results from the Toronto Breast Cancer Study." Am J Epidemiol, 134, p.1386-95
- Kaufman DW, Palmer JR, de Mouzon J, Rosenberg L, Stolley PD, Warshauer ME, Zauber AG, Shapiro S (1991) "Estrogen replacement therapy and the risk of breast cancer: results from the case-control surveillance study." Am J Epidemiol, 134, p.1375-85
- Spengler RF, Clarke EA, Woolever CA, Newman AM, Osborn RW (1981) "Exogenous estrogens and endometrial cancer: a case-control study and assessment of potential biases." Am J Epidemiol, 114, p.497-506
- Buring JE, Bain CJ, Ehrmann RL (1986) "Conjugated estrogen use and risk of endometrial cancer." Am J Epidemiol, 124, p.434-41
- Persson I, Adami HO, Bergkvist L, Lindgren A, Pettersson B, Hoover R, Schairer C (1989) "Risk of endometrial cancer after treatment with oestrogens alone or in conjunction with progestogens: results of a prospective study." BMJ, 298, p.147-51
- Hoover R, Glass A, Finkle WD, Azevedo D, Milne K (1981) "Conjugated estrogens and breast cancer risk in women." J Natl Cancer Inst, 67, p.815-20
- Thomas DB, Persing JP, Hutchinson WB (1982) "Exogenous estrogens and other risk factors for breast cancer in women with benign breast diseases." J Natl Cancer Inst, 69, p.1017-25
- Antunes CM, Strolley PD, Rosenshein NB, Davies JL, Tonascia JA, Brown C, Burnett L, Rutledge A, Pokempner M, Garcia R (1979) "Endometrial cancer and estrogen use. Report of a large case-control study." N Engl J Med, 300, p.9-13
- Gordon J, Reagan JW, Finkle WD, Ziel HK (1977) "Estrogen and endometrial carcinoma. An independent pathology review supporting original risk estimate." N Engl J Med, 297, p.570-1
- Bergkvist L, Adami HO, Persson I, Hoover R, Schairer C (1989) "The risk of breast cancer after estrogen and estrogen-progestin replacement." N Engl J Med, 321, p.293-7
- Shapiro S, Kelly JP, Rosenberg L, Kaufman DW, Helmrich SP, Rosenshein NB, Lewis JL Jr, Knapp RC, Stolley PD, Schottenfeld D (1985) "Risk of localized and widespread endometrial cancer in relation to recent and discontinued use of conjugated estrogens." N Engl J Med, 313, p.969-72
- Gray LA Sr, Christopherson WM, Hoover RN (1977) "Estrogens and endometrial carcinoma." Obstet Gynecol, 49, p.385-9
- Delgado-Rodriguez M, Sillero-Arenas M, Martin-Moreno JM, Galvez-Vargas R (1992) "Oral contraceptives and cancer of the cervix uteri. A meta-analysis." Acta Obstet Gynecol Scand, 71, p.368-76
- Sillero-Arenas M, Rodriguez-Contreras R, Delgado-Rodriguez M, Bueno-Cavanillas A, Galvez-Vargas R (1991) "Patterns of research. Oral contraceptives and cervical cancer." Acta Obstet Gynecol Scand, 70, p.143-8
- Lund E (1992) "Oral contraceptives and breast cancer. A review with some comments on mathematical models." Acta Oncol, 31, p.183-6
- Miller DR, Rosenberg L, Kaufman DW, Stolley P, Warshauer ME, Shapiro S (1989) "Breast cancer before age 45 and oral contraceptive use: new findings." Am J Epidemiol, 129, p.269-80
- Rosenberg L, Palmer JR, Clarke EA, Shapiro S (1992) "A case-control study of the risk of breast cancer in relation to oral contraceptive use." Am J Epidemiol, 136, p.1437-44
- Schlesselman JJ (1990) "Oral contraceptives and breast cancer." Am J Obstet Gynecol, 163, p.1379-87
- Turnquest MA (1993) "Oral contraceptive use and incidence of cervical intraepithelial neoplasia." Am J Obstet Gynecol, 168, p.1895-6
- Kaunitz AM (1992) "Oral contraceptives and gynecologic cancer: an update for the 1990s." Am J Obstet Gynecol, 167, p.1171-6
- Romieu I, Willett WC, Colditz GA, Stampfer MJ, Rosner B, Hennekens CH, Speizer FE (1989) "Prospective study of oral contraceptive use and risk of breast cancer in women." J Natl Cancer Inst, 81, p.1313-21
- Olsson H, Moller TR, Ranstam J (1989) "Early oral contraceptive use and breast cancer among premenopausal women: final report from a study in southern Sweden." J Natl Cancer Inst, 81, p.1000-4
- Jones MW, Silverberg SG (1989) "Cervical adenocarcinoma in young women: possible relationship to microglandular hyperplasia and use of oral contraceptives." Obstet Gynecol, 73, p.984-9
- Murray PP, Stadel BV, Schlesselman JJ (1989) "Oral contraceptive use in women with a family history of breast cancer." Obstet Gynecol, 73, p.977-83
- Thomas DB (1991) "Oral contraceptives and breast cancer: review of the epidemiologic literature." Contraception, 43, p.597-642
- Brinton LA (1991) "Oral contraceptives and cervical neoplasia." Contraception, 43, p.581-95
- (1992) "Oral contraceptives and neoplasia. WHO Scientific Group." World Health Organ Tech Rep Ser, 817, p.1-46
- Woodruff JD, Pickar JH (1994) "Incidence of endometrial hyperplasia in postmenopausal women taking conjugated estrogens (Premarin) with medroxyprogesterone acetate or conjugated estrogens alone." Am J Obstet Gynecol, 170, p.1213-23
- Mishell DR (1989) "Contraception." N Engl J Med, 320, p.777-85
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- Lavecchia C, Negri E, Franceschi S, Talamini R, Amadori D, Filiberti R, Conti E, Montella M, Veronesi A, Parazzini F, Ferraroni M (1995) "Oral contraceptives and breast cancer: a cooperative italian study." Int J Cancer, 60, p.163-7
- Colditz GA, Hankinson SE, Hunter DJ, et al. (1995) "The use of estrogens and progestins and the risk of breast cancer in postmenopausal women." N Engl J Med, 332, p.1589-93
- Stanford JL, Weiss NS, Voigt LF, Daling JR, Habel LA, Rossing MA (1995) "Combined estrogen and progestin hormone replacement therapy in relation to risk of breast cancer in middle-aged women." JAMA, 274, p.137-42
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- The Writing Group for the PEPI Trial (1996) "Effects of hormone replacement therapy on endometrial histology in postmenopausal women." JAMA, 275, p.370-5
- Zondervan KT, Carpenter LM, Painter R, Vessey MP (1996) "Oral contraceptives and cervical cancer - further findings from the oxford family planning association contraceptive study." Br J Cancer, 73, p.1291-7
- Calle EE, Heath CW, Miraclemcmahill HL, Coates RJ, Liff JM, Franceschi S, Talamini R, Chantarakul N, Koetsawang S, Rachawat D (1996) "Breast cancer and hormonal contraceptives: further results." Contraception, 54 (suppl, s1-106
- Rettig BA, Lemon HM (1996) "Cancers related to contraceptive use." Br J Cancer, 74, p.1509-10
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- Greendale GA, Reboussin BA, Sie A, et al. (1999) "Effects of estrogen and estrogen-progestin on mammographic parenchymal density." Ann Intern Med, 130, p.262-9
- Gapstur SM, Morrow M, Sellers TA (1999) "Hormone replacement therapy and risk of breast cancer with a favorable histology: results of the Iowa women's health study." JAMA, 281, p.2091-7
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
- (2023) "Product Information. Intrarosa (prasterone)." Theramex Australia Pty Ltd, 1
View all 59 references
Major
Estrogens (applies to Tri-Estarylla) hypercalcemia in breast cancer
Major Potential Hazard, Moderate plausibility.
When treated with an estrogen, patients with breast cancer and bone metastases may develop severe hypercalcemia, in which case the drug should be stopped and measures be taken to reduce serum calcium levels.
References
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
View all 11 references
Major
Estrogens (applies to Tri-Estarylla) hypertension
Major Potential Hazard, High plausibility.
The risk of myocardial infarction and strokes, including those associated with oral contraceptive use and some estrogen use, is increased in patients with hypertension. Moreover, estrogens (and progestogens) may elevate blood pressure and worsen the hypertension, thus compounding the risk. Clinically significant blood pressure increases have been reported during estrogen therapy, particularly in patients receiving high dosages or treated with oral contraceptive combinations having high progestational activity. These effects also increase with duration of therapy and patient age. Therapy with estrogens should be administered cautiously in patients with preexisting hypertension. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary. In patients requiring contraception, alternative methods should be considered for those who are hypertensive, over age 35, and smoke.
References
- Leiman G (1972) "Depo-medroxyprogesterone acetate as a contraceptive agent: its effect on weight and blood pressure." Am J Obstet Gynecol, 114, p.97-102
- Williams RS (1992) "Benefits and risks of oral contraceptive use." Postgrad Med, 92, p.155-7
- Crane MG, Harris JJ (1978) "Estrogens and hypertension: effect of discontinuing estrogens on blood pressure, exchangeable sodium, and the renin-aldosterone system." Am J Med Sci, 276, p.33-55
- Crane MG, Harris JJ, Winsor W 3d (1971) "Hypertension, oral contraceptive agents, and conjugated estrogens." Ann Intern Med, 74, p.13-21
- Rosenberg L, Slone D, Shapiro S, Kaufman D, Stolley PD, Miettinen OS (1980) "Noncontraceptive estrogens and myocardial infarction in young women." JAMA, 244, p.339-42
- Jick H, Dinan B, Rothman KJ (1978) "Noncontraceptive estrogens and nonfatal myocardial infarction." JAMA, 239, p.1407-8
- Wren BG, Routledge DA (1981) "Blood pressure changes: oestrogens in climacteric women." Med J Aust, 2, p.528-31
- Rosenberg L, Palmer JR, Lesko SM, Shapiro S (1990) "Oral contraceptive use and the risk of myocardial infarction." Am J Epidemiol, 131, p.1009-16
- Thorogood M, Mann J, Murphy M, Vessey M (1992) "Fatal stroke and use of oral contraceptives: findings from a case- control study." Am J Epidemiol, 136, p.35-45
- Leaf DA, Bland D, Schaad D, Neighbor WE, Scott CS (1991) "Oral contraceptive use and coronary risk factors in women." Am J Med Sci, 301, p.365-8
- Thorneycroft IH (1990) "Oral contraceptives and myocardial infarction." Am J Obstet Gynecol, 163, p.1393-7
- Lidegaard O (1993) "Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study." BMJ, 306, p.956-63
- Derman RJ (1990) "Oral contraceptives and cardiovascular risk. Taking a safe course of action." Postgrad Med, 88, p.119-22
- Hannaford PC, Croft PR, Kay CR (1994) "Oral contraception and stroke. Evidence from the Royal College of General Practitioners' Oral Contraception Study." Stroke, 25, p.935-42
- Steinberg WM (1989) "Oral contraception: risks and benefits." Adv Contracept, 5, p.219-28
- Peterson HB, Lee NC (1990) "Long-term health risks and benefits of oral contraceptive use." Obstet Gynecol Clin North Am, 17, p.775-88
- Derman R (1989) "Oral contraceptives: a reassessment." Obstet Gynecol Surv, 44, p.662-8
- Belchetz PE (1994) "Hormonal treatment of postmenopausal women." N Engl J Med, 330, p.1062-71
- Stampfer MJ, Colditz GA, Willett WC, et al. (1991) "Postmenopausal estrogen and cardiovascular disease. Ten-year follow-up from the Nurses' Health Study." N Engl J Med, 325, p.756-62
- Barrett-Connor E, Bush TL (1991) "Estrogen and coronary heart disease in women." JAMA, 265, p.1861-7
- Barrett-Connor E, Wingard DL, Criqui MH (1989) "Postmenopausal estrogen use and heart disease risk factors in the 1980s. Rancho Bernardo, Calif, revisited." JAMA, 261, p.1095-2100
- Mishell DR (1989) "Contraception." N Engl J Med, 320, p.777-85
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- Schwartz J, Freeman R, Frishman W (1995) "Clinical pharmacology of estrogens: cardiovascular actions and cardioprotective benefits of replacement therapy in postmenopausal women." J Clin Pharmacol, 35, p.1-16
- The Writing Group for the PEPI Trial (1995) "Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial." JAMA, 273, p.199-208
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- Norris LA, Bonnar J (1996) "The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives." Br J Obstet Gynaecol, 103, p.261-7
- Levine AB, Teppa J, Mcgough B, Cowchock FS (1996) "Evaluation of the prethrombotic state in pregnancy and in women using oral contraceptives." Contraception, 53, p.255-7
- Petitti DB, Sidney S, Bernstein A, Wolf S, Quesenberry C, Ziel HK (1996) "Stroke in users of low-dose oral contraceptives." N Engl J Med, 335, p.8-15
- Speroff L (1996) "Oral contraceptives and venous thromboembolism." Int J Gynaecol Obstet, 54, p.45-50
- Poulter NR, Chang CL, Farley TMM, Meirik O, Marmot MG, Debertribeiro M, Medina E, Artigas J, Shen H, Zhong YH, Zhang DW, (1996) "Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study." Lancet, 348, p.498-505
- Poulter NR, Chang CL, Farley TMM, Meirik O, Marmot MG (1996) "Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case-control study." Lancet, 348, p.505-10
- Piegsa K, Guillebaud J (1996) "Oral contraceptives and the risk of DVT." Practitioner, 240, p.544
- Martinelli I, Rosendaal FR, Vandenbroucke JP, Mannucci PM (1996) "Oral contraceptives are a risk factor for cerebral vein thrombosis." Thromb Haemost, 76, p.477-8
- Farley TMM, Meirik O, Poulter NR, Chang CL, Marmot MG (1996) "Oral contraceptives and thrombotic diseases: impact of new epidemiological studies." Contraception, 54, p.193-5
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- Sidney S, Petitti DB, Quesenberry CP (1997) "Myocardial infarction and the use of estrogen and estrogen-progestogen in postmenopausal women." Ann Intern Med, 127, p.501-8
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- Thorogood M (1999) "Risk of stroke in users of oral contraceptives." JAMA, 281, p.1255-6
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 53 references
Major
Estrogens (applies to Tri-Estarylla) thromboembolism/cardiovascular
Major Potential Hazard, Moderate plausibility. Applicable conditions: Migraine, History - Thrombotic/Thromboembolic Disorder, Cerebral Vascular Disorder, Thrombotic/Thromboembolic Disorder, Ischemic Heart Disease
The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic or thromboembolic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Although the clinical significance of these effects is unknown, epidemiological data suggest it may be dose-dependent. The risk is probably slight with the use of newer, low-dose oral contraceptives in the absence of known risk factors (e.g., smoker, particularly over the age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40). However, a much more significant risk has been reported with higher dosages, such as those used to treat prostate or metastatic breast cancer or those used in older formulations of birth control pills. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of breast or prostatic malignancy.
References
- Notelovitz M (1985) "Oral contraception and coagulation." Clin Obstet Gynecol, 28, p.73-83
- Meade TW (1982) "Oral contraceptives, clotting factors, and thrombosis." Am J Obstet Gynecol, 142, p.758-61
- Williams RS (1992) "Benefits and risks of oral contraceptive use." Postgrad Med, 92, p.155-7
- Rosenberg L, Slone D, Shapiro S, Kaufman D, Stolley PD, Miettinen OS (1980) "Noncontraceptive estrogens and myocardial infarction in young women." JAMA, 244, p.339-42
- Jick H, Dinan B, Rothman KJ (1978) "Noncontraceptive estrogens and nonfatal myocardial infarction." JAMA, 239, p.1407-8
- Boschetti C, Cortellaro M, Nencioni T, Bertolli V, Della Volpe A, Zanussi C (1991) "Short- and long-term effects of hormone replacement therapy (transdermal estradiol vs oral conjugated equine estrogens, combined with medroxyprogesterone acetate) on blood coagulation factors in postmenopausal women." Thromb Res, 62, p.1-8
- Rosenberg L, Palmer JR, Lesko SM, Shapiro S (1990) "Oral contraceptive use and the risk of myocardial infarction." Am J Epidemiol, 131, p.1009-16
- Thorogood M, Mann J, Murphy M, Vessey M (1992) "Fatal stroke and use of oral contraceptives: findings from a case- control study." Am J Epidemiol, 136, p.35-45
- Leaf DA, Bland D, Schaad D, Neighbor WE, Scott CS (1991) "Oral contraceptive use and coronary risk factors in women." Am J Med Sci, 301, p.365-8
- Thorneycroft IH (1990) "Oral contraceptives and myocardial infarction." Am J Obstet Gynecol, 163, p.1393-7
- Lidegaard O (1993) "Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study." BMJ, 306, p.956-63
- Derman RJ (1990) "Oral contraceptives and cardiovascular risk. Taking a safe course of action." Postgrad Med, 88, p.119-22
- Hannaford PC, Croft PR, Kay CR (1994) "Oral contraception and stroke. Evidence from the Royal College of General Practitioners' Oral Contraception Study." Stroke, 25, p.935-42
- Steinberg WM (1989) "Oral contraception: risks and benefits." Adv Contracept, 5, p.219-28
- Miwa LJ, Edmunds AL, Shaefer MS, Raynor SC (1989) "Idiopathic thromboembolism associated with triphasic oral contraceptives." DICP, 23, p.773-5
- Beaumont V, Lemort N, Beaumont JL (1991) "Oral contraceptives, sex steroid-induced antibodies and vascular thrombosis: results from 1318 cases." Eur Heart J, 12, p.1219-24
- Key JD, Hammill WW, Everett L (1992) "Pulmonary embolus in an adolescent on oral contraceptives." J Adolesc Health, 13, p.713-5
- Burkman RT Jr (1991) "Benefits and risk of oral contraceptives. A reassessment." J Reprod Med, 36, p.217-8
- Peterson HB, Lee NC (1990) "Long-term health risks and benefits of oral contraceptive use." Obstet Gynecol Clin North Am, 17, p.775-88
- Boston Collaborative Drug Surveilance Program (1974) "Surgically confirmed gallbladder disease, venous thromboembolism, and breast tumors in relation to postmenopausal estrogen therapy." N Engl J Med, 290, p.15-9
- Belchetz PE (1994) "Hormonal treatment of postmenopausal women." N Engl J Med, 330, p.1062-71
- Devor M, Barrett-Connor E, Renvall M, Feigal D, Ramsdell J (1992) "Estrogen replacement therapy and the risk of venous thrombosis." Am J Med, 92, p.275-81
- Barrett-Connor E, Bush TL (1991) "Estrogen and coronary heart disease in women." JAMA, 265, p.1861-7
- Grady D, Rubin SM, Petiti DB, et al. (1992) "Hormone therapy to prevent disease and prolong life in postmenopausal women." Ann Intern Med, 117, p.1016-36
- Barrett-Connor E, Wingard DL, Criqui MH (1989) "Postmenopausal estrogen use and heart disease risk factors in the 1980s. Rancho Bernardo, Calif, revisited." JAMA, 261, p.1095-2100
- Mishell DR (1989) "Contraception." N Engl J Med, 320, p.777-85
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- Schwartz J, Freeman R, Frishman W (1995) "Clinical pharmacology of estrogens: cardiovascular actions and cardioprotective benefits of replacement therapy in postmenopausal women." J Clin Pharmacol, 35, p.1-16
- Lidegaard O (1995) "Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease." Br J Obstet Gynaecol, 102, p.153-9
- The Writing Group for the PEPI Trial (1995) "Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial." JAMA, 273, p.199-208
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- Norris LA, Bonnar J (1996) "The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives." Br J Obstet Gynaecol, 103, p.261-7
- Levine AB, Teppa J, Mcgough B, Cowchock FS (1996) "Evaluation of the prethrombotic state in pregnancy and in women using oral contraceptives." Contraception, 53, p.255-7
- Petitti DB, Sidney S, Bernstein A, Wolf S, Quesenberry C, Ziel HK (1996) "Stroke in users of low-dose oral contraceptives." N Engl J Med, 335, p.8-15
- Speroff L (1996) "Oral contraceptives and venous thromboembolism." Int J Gynaecol Obstet, 54, p.45-50
- Poulter NR, Chang CL, Farley TMM, Meirik O, Marmot MG, Debertribeiro M, Medina E, Artigas J, Shen H, Zhong YH, Zhang DW, (1996) "Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study." Lancet, 348, p.498-505
- Poulter NR, Chang CL, Farley TMM, Meirik O, Marmot MG (1996) "Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case-control study." Lancet, 348, p.505-10
- Piegsa K, Guillebaud J (1996) "Oral contraceptives and the risk of DVT." Practitioner, 240, p.544
- Martinelli I, Rosendaal FR, Vandenbroucke JP, Mannucci PM (1996) "Oral contraceptives are a risk factor for cerebral vein thrombosis." Thromb Haemost, 76, p.477-8
- Farley TMM, Meirik O, Poulter NR, Chang CL, Marmot MG (1996) "Oral contraceptives and thrombotic diseases: impact of new epidemiological studies." Contraception, 54, p.193-5
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- Sidney S, Petitti DB, Quesenberry CP (1997) "Myocardial infarction and the use of estrogen and estrogen-progestogen in postmenopausal women." Ann Intern Med, 127, p.501-8
- Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E (1998) "Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women." JAMA, 280, p.605-13
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- Petitti DB (1998) "Hormone replacement therapy and heart disease prevention: experimentation trumps observation." JAMA, 280, p.650-2
- Thorogood M (1999) "Risk of stroke in users of oral contraceptives." JAMA, 281, p.1255-6
- Mendelsohn ME, Karas RH (1999) "The protective effects of estrogen on the cardiovascular system." N Engl J Med, 340, p.1801-11
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
- (2023) "Product Information. Intrarosa (prasterone)." Theramex Australia Pty Ltd, 1
View all 62 references
Major
Estrogens/progestogens (applies to Tri-Estarylla) hepatic neoplasms
Major Potential Hazard, High plausibility. Applicable conditions: Hepatic Tumor, Hepatic Tumor
The use of oral contraceptives is contraindicated in patients with liver tumors. An increased risk of benign hepatic adenomas and hepatocellular carcinomas has been associated with long-term, oral estrogen- progestin contraceptive use of at least 4 years and 8 years, respectively. Although these tumors are rare and have not been reported with other types of estrogen or progestogen therapies, any preparation containing estrogens and/or progestogens should probably be avoided in patients with existing tumors of the liver. Hepatic hemangiomas and nodular hyperplasia of the liver have been reported with isolated estrogen therapy.
References
- Tao LC (1991) "Oral contraceptive-associated liver cell adenoma and hepatocellular carcinoma." Cancer, 68, p.341-7
- (1991) "Depot-medroxyprogesterone acetate (DMPA) and risk of liver cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives." Int J Cancer, 49, p.182-5
- Conter RL, Longmire WP Jr (1988) "Recurrent hepatic hemangiomas. Possible association with estrogen therapy." Ann Surg, 207, p.115-9
- Aldinger K, Ben-Menachem Y, Whalen G (1977) "Focal nodular hyperplasia of the liver associated with high-dosage estrogens." Arch Intern Med, 137, p.357-9
- Palmer JR, Rosenberg L, Kaufman DW, Warshauer ME, Stolley P, Shapiro S (1989) "Oral contraceptive use and liver cancer." Am J Epidemiol, 130, p.878-82
- Mooney MJ, Nyreen MR, Hall RA, Carter PL (1993) "Hepatic adenoma presenting as a right lower quadrant mass." Am Surg, 59, p.229-31
- Gyorffy EJ, Bredfeldt JE, Black WC (1989) "Transformation of hepatic cell adenoma to hepatocellular carcinoma due to oral contraceptive use." Ann Intern Med, 110, p.489-90
- Tavani A, Negri E, Parazzini F, Franceschi S, La Vecchia C (1993) "Female hormone utilisation and risk of hepatocellular carcinoma." Br J Cancer, 67, p.635-7
- Mathieu D, Zafrani ES, Anglade MC, Dhumeaux D (1989) "Association of focal nodular hyperplasia and hepatic hemangioma." Gastroenterology, 97, p.154-7
- Le Bail B, Jouhanole H, Deugnier Y, Salame G, Pellegrin JL, Saric J, Balabaud C, Bioulac-Sage P (1992) "Liver adenomatosis with granulomas in two patients on long-term oral contraceptives." Am J Surg Pathol, 16, p.982-7
- (1992) "Oral contraceptives and neoplasia. WHO Scientific Group." World Health Organ Tech Rep Ser, 817, p.1-46
- Mishell DR (1989) "Contraception." N Engl J Med, 320, p.777-85
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2006) "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 34 references
Major
Progestogens (applies to Tri-Estarylla) liver disease
Major Potential Hazard, High plausibility.
The use of progestogens, in general, is contraindicated in patients with impaired hepatic function or liver disease. There are little or no data concerning the pharmaco*kinetic disposition of the different progestogens in patients with hepatic disease. However, most hormones, including progestational hormones, are known to be extensively metabolized by the liver. Medroxyprogesterone should not be used by women with significant liver disease and should be discontinued if jaundice or disturbances of liver function occur.
References
- Utaaker E, Lundgren S, Kvinnsland S, Aakvaag A (1988) "Pharmaco*kinetics and metabolism of medroxyprogesterone acetate in patients with advanced breast cancer." J Steroid Biochem, 31, p.437-41
- Castegnaro E, Sala G (1971) "Pharmaco*kinetics and metabolism of medroxyprogesterone acetate. Influence of the route of administration and of its physical state." Steroidologia, 2, p.13-26
- Riippa P, Kauppila A, Sundstrom H, Vihko R (1984) "Hepatic impairment during simultaneous administration of medroxyprogesterone acetate and tamoxifen in the treatment of endometrial and ovarian carcinoma." Anticancer Res, 4, p.109-12
- Meyer WJ, 3d Wiener I, Emory LE, Cole CM, Isenberg N, fa*gan CJ, Thompson JC (1992) "Cholelithiasis associated with medroxyprogesterone acetate therapy in men." Res Commun Chem Pathol Pharmacol, 75, p.69-84
- Hendeles SM, Galand N, Schwers J (1972) "Metabolism of orally administered D-norgestrel in women." Acta Endocrinol (Copenh), 71, p.557-68
- (2001) "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC
- (2006) "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals
View all 12 references
Major
Progestogens (applies to Tri-Estarylla) thromboembolism
Major Potential Hazard, Moderate plausibility. Applicable conditions: Cerebral Vascular Disorder, History - Thrombotic/Thromboembolic Disorder, Thrombotic/Thromboembolic Disorder
The use of progestogens, in general, is considered by manufacturers to be contraindicated in patients with active thrombophlebitis, cerebrovascular disease, or a current or past history of thromboembolic disorders. While the role of progestogens in the development of thromboembolic events associated with hormonal therapy is often unclear and thought to be secondary to that of estrogens, it may not be insignificant. Medroxyprogesterone, a common progestational agent, has been shown to produce a hypercoagulable state in high dosages. Whether or not this effect contributes to the development of thrombotic events is unknown. However, thrombophlebitis and pulmonary embolism have been reported with megestrol, an antineoplastic and progestational agent. In addition, an increased risk of nonfatal venous thrombosis has been associated with oral contraceptive combinations containing desogestrel or gestodene relative to those that contain other progestins (e.g., levonorgestrel, norethindrone), suggesting some degree of hemostatic effect by progestogens.
References
- Astedt B, Jeppsson S, Pandolfi M (1972) "Fibrinolytic activity of veins during use of depot medroxyprogesterone acetate as a contraceptive." Fertil Steril, 23, p.489-92
- Yamamoto H, Noguchi S, Miyauchi K, Inaji H, Imaoka S, Koyama H, Iwanaga T (1991) "Changes in hematologic parameters during treatment with medroxyprogesterone acetate for breast cancer." Jpn J Cancer Res, 82, p.420-5
- f*ckutomi T, Nanasawa T, Yamamoto H, Adachi I, Watanabe T (1990) "The induction of a hypercoagulable state by medroxyprogesterone acetate in breast cancer patients." Jpn J Surg, 20, p.665-70
- (2001) "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Megace (megestrol)." Bristol-Myers Squibb
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC
- (2006) "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals
View all 17 references
Moderate
Estrogens (applies to Tri-Estarylla) angioedema
Moderate Potential Hazard, Moderate plausibility.
The use of exogenous estrogens may induce or exacerbate symptoms of angioedema, particularly in women with hereditary angioedema. Close monitoring is recommended when prescribing these agents to patients predisposed to angioedema.
References
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 7 references
Moderate
Estrogens (applies to Tri-Estarylla) gallbladder disease
Moderate Potential Hazard, Moderate plausibility.
A two- to four-fold increase in risk of gallbladder disease has been noted in women receiving postmenopausal estrogen therapy. The risk for gallbladder disease may be less for premenopausal women using oral contraceptives containing low-dose estrogens and/or progestins. Therapy with estrogens should be administered cautiously in patients with preexisting gallbladder disease.
References
- Boston Collaborative Drug Surveilance Program (1974) "Surgically confirmed gallbladder disease, venous thromboembolism, and breast tumors in relation to postmenopausal estrogen therapy." N Engl J Med, 290, p.15-9
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 19 references
Moderate
Estrogens (applies to Tri-Estarylla) hypercalcemia
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperparathyroidism, Renal Dysfunction
Estrogens influence the metabolism of calcium and phosphorus. Intestinal absorption and retention of calcium are increased, which may occasionally result in hypercalcemia. Therapy with estrogens should be administered cautiously in patients with preexisting hypercalcemia, renal dysfunction, or metabolic bone diseases that are associated with hypercalcemia.
References
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn
- (2013) "Product Information. Duavee (bazedoxifene-conjugated estrogens)." Pfizer U.S. Pharmaceuticals Group
View all 7 references
Moderate
Estrogens (applies to Tri-Estarylla) hyperlipidemia
Moderate Potential Hazard, Moderate plausibility.
Although estrogens have generally favorable effects on plasma lipids, including increases in HDL and decreases in total cholesterol and LDL, they have also been associated with significant elevations in triglyceride levels, particularly when high dosages are used. Severe hyperlipidemia is known to sometimes cause pancreatitis. Patients with preexisting hyperlipidemia may require closer monitoring during estrogen therapy, and adjustments made accordingly in their lipid-lowering regimen.
References
- Molitch ME, Oill P, Odell WD (1974) "Massive hyperlipemia during estrogen therapy." JAMA, 227, p.522-5
- Janaud A, Rouffy J, Upmalis D, Dain MP (1992) "A comparison study of lipid and androgen metabolism with triphasic oral contraceptive formulations containing norgestimate or levonorgestrel." Acta Obstet Gynecol Scand Suppl, 156, p.33-8
- Steinberg WM (1989) "Oral contraception: risks and benefits." Adv Contracept, 5, p.219-28
- Burkman RT, Zacur HA, Kimball AW, Kwiterovich P, Bell WR (1989) "Oral contraceptives and lipids and lipoproteins: Part I--Variations in mean levels by oral contraceptive type." Contraception, 40, p.553-61
- Derman R (1989) "Oral contraceptives: a reassessment." Obstet Gynecol Surv, 44, p.662-8
- Godsland IF, Crook D (1994) "Update on the metabolic effects of steroidal contraceptives and their relationship to cardiovascular disease risk." Am J Obstet Gynecol, 170, p.1528-36
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E (1998) "Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women." JAMA, 280, p.605-13
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 25 references
Moderate
Estrogens (applies to Tri-Estarylla) liver disease
Moderate Potential Hazard, High plausibility.
Estrogens are primarily metabolized by the liver. Patients with impaired hepatic function may be at increased risk for adverse effects associated with estrogen administration due to decreased drug clearance. Therapy with estrogens should be administered cautiously in patients with liver disease. In addition, clinicians should be aware that estrogen therapy may affect liver function tests. Increased sulfobromophthalein retention has been reported with the use of estrogen-containing oral contraceptives and may be expected with larger doses of estrogens.
References
- Bhavnani BR, Cecutti A (1994) "Pharmaco*kinetics of 17 beta-dihydroequilin sulfate and 17 beta- dihydroequilin in normal postmenopausal women." J Clin Endocrinol Metab, 78, p.197-204
- Adlercrueuta H (1974) "Hepatic metabolism of estrogens in health and disease." N Engl J Med, 290, p.1081-3
- Goldzieher JW (1989) "Pharmacology of contraceptive steroids: a brief review." Am J Obstet Gynecol, 160, p.1260-4
- Kuhnz W, al-Yacoub G, Fuhrmeister A (1992) "Pharmaco*kinetics of levonorgestrel and ethinylestradiol in 9 women who received a low-dose oral contraceptive over a treatment period of 3 months and the same contraceptive formulation." Contraception, 46, p.455-69
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 23 references
Moderate
Estrogens (applies to Tri-Estarylla) melasma
Moderate Potential Hazard, Moderate plausibility.
The use of exogenous estrogens may occasionally cause chloasma, especially in women with a history of chloasma gravidarum. Women with a tendency to chloasma should avoid exposure to the sun or ultraviolet radiation while taking combination oral contraceptives.
References
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 7 references
Moderate
Estrogens/progestogens (applies to Tri-Estarylla) depression
Moderate Potential Hazard, Moderate plausibility.
The use of oral contraceptives has been associated with an increased incidence of depression. It is uncertain whether this effect is related to the estrogenic or the progestogenic component of the contraceptive, although excess progesterone activity is associated with depression. Patients with a history of depression receiving estrogen and/or progestogen therapy should be followed closely. The manufacturer of medroxyprogesterone recommends monitoring patients who have a history of depression and to not re- administer medroxyprogesterone if depression recurs.
References
- (2001) "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2006) "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 24 references
Moderate
Estrogens/progestogens (applies to Tri-Estarylla) fluid retention
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Migraine, Asthma, Seizures, Congestive Heart Failure, Renal Dysfunction, Renal Dysfunction, Asthma, Congestive Heart Failure, Seizures, Migraine
Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.
References
- Leiman G (1972) "Depo-medroxyprogesterone acetate as a contraceptive agent: its effect on weight and blood pressure." Am J Obstet Gynecol, 114, p.97-102
- (2001) "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn
- (2001) "Product Information. Megace (megestrol)." Bristol-Myers Squibb
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC
- (2006) "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals
View all 27 references
Moderate
Estrogens/progestogens (applies to Tri-Estarylla) glucose intolerance
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus, Diabetes Mellitus
Impaired glucose tolerance has been observed in some patients administered oral contraceptives and appears to be related primarily to the estrogen dose. However, progestogens can increase insulin secretion and produce insulin resistance to varying degrees, depending on the agent. Patients with diabetes mellitus should be monitored more closely during therapy with estrogens and/or progestogens, and adjustments made accordingly in their antidiabetic regimen.
References
- Haiba NA, el-Habashy MA, Said SA, Darwish EA, Abdel-Sayed WS, Nayel SE (1989) "Clinical evaluation of two monthly injectable contraceptives and their effects on some metabolic parameters." Contraception, 39, p.619-32
- Virutamasen P, Wongsrichanalai C, Tangkeo P, Nitichai Y, Rienprayoon D (1986) "Metabolic effects of depot-medroxyprogesterone acetate in long-term users: a cross-sectional study." Int J Gynaecol Obstet, 24, p.291-6
- Who Task Force on Long-acting Agents for Fertility Regulation (1986) "Metabolic side-effects of injectable depot-medroxyprogesterone acetate, 150 mg three-monthly, in undernourished lactating women." Bull World Health Organ, 64, p.587-94
- Garg SK, Chase HP, Marshall G, Hoops SL, Holmes DL, Jackson WE (1994) "Oral contraceptives and renal and retinal complications in young women with insulin-dependent diabetes mellitus." JAMA, 271, p.1099-102
- Hannaford PC, Kay CR (1989) "Oral contraceptives and diabetes mellitus." BMJ, 299, p.1315-6
- Stubblefield PG (1989) "Choosing the best oral contraceptive." Clin Obstet Gynecol, 32, p.316-28
- Spellacy WN, Ellingson AB, Tsibris JC (1989) "The effects of two triphasic oral contraceptives on carbohydrate metabolism in women during 1 year of use." Fertil Steril, 51, p.71-4
- Steinberg WM (1989) "Oral contraception: risks and benefits." Adv Contracept, 5, p.219-28
- Derman R (1989) "Oral contraceptives: a reassessment." Obstet Gynecol Surv, 44, p.662-8
- Belchetz PE (1994) "Hormonal treatment of postmenopausal women." N Engl J Med, 330, p.1062-71
- Luciano AA, De Souza MJ, Roy MP, Schoenfeld MJ, Nulsen JC, Halvorson CV (1993) "Evaluation of low-dose estrogen and progestin therapy in postmenopausal women." J Reprod Med, 38, p.207-14
- Kaunitz AM (1994) "Long-acting injectable contraception with depot medroxyprogesterone acetate." Am J Obstet Gynecol, 170, p.1543-9
- "Product Information. Ortho-Novum 1/35 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 24 references
Moderate
Estrogens/progestogens (applies to Tri-Estarylla) retinal thrombosis
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Visual Defect/Disturbance, Visual Defect/Disturbance
Estrogens and progestogens may cause retinal thrombosis. Oral contraceptives should be discontinued if there is unexplained partial or complete loss of vision; onset of proptosis or diplopia; papilledema; or retinal vascular lesions. Therapy with these agents should be administered cautiously in patients who have preexisting ocular problems and appropriate diagnostic and therapeutic measures should be instituted. Contact lens wearers who develop visual changes or changes in lens tolerance should be assessed by an ophthalmologist.
References
- "Product Information. Ortho-Novum 1/35 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 13 references
Moderate
Estrogens/progestogens (applies to Tri-Estarylla) thyroid function tests
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Thyroid Disease, Thyroid Disease
When administering estrogen and/or progestogen therapy in patients with thyroid disorders, clinicians should be aware that these hormones may affect thyroid function tests. Changes have mostly been reported with the use of combination oral contraceptives. Specifically, thyroid-binding globulin (TBG) may be increased, resulting in elevated circulating total thyroid hormone, as measured by PBI (protein-bound iodine), T4 by column or radioimmunoassay, or T3 by radioimmunoassay. Free T3 resin uptake may be decreased. On the contrary, a decrease in TBG and, consequently, thyroxine concentration, has been reported by the manufacturers of the progestin-only (norethindrone) oral contraceptives.
References
- (2001) "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn
- (2001) "Product Information. Climara (estradiol)." Berlex Laboratories
- (2001) "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories
- (2001) "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals
- (2001) "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- "Product Information. Ortho-Novum 1/50 (mestranol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn
- (2001) "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical
- "Product Information. Ortho Dienestrol (dienestrol topical)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn
- "Product Information. Estinyl (ethinyl estradiol)." Schering Corporation
- (2001) "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
View all 25 references
Moderate
Progestogens (applies to Tri-Estarylla) hyperlipidemia
Moderate Potential Hazard, Moderate plausibility.
Some progestogenic agents may elevate plasma LDL levels and/or lower HDL levels, although data have been inconsistent. Patients with preexisting hyperlipidemia may require closer monitoring during progestogen therapy, and adjustments made accordingly in their lipid-lowering regimen.
References
- Barnes RB, Roy S, Lobo RA (1985) "Comparison of lipid and androgen levels after conjugated estrogen or depo-medroxyprogesterone acetate treatment in postmenopausal women." Obstet Gynecol, 66, p.216-9
- Haiba NA, el-Habashy MA, Said SA, Darwish EA, Abdel-Sayed WS, Nayel SE (1989) "Clinical evaluation of two monthly injectable contraceptives and their effects on some metabolic parameters." Contraception, 39, p.619-32
- Virutamasen P, Wongsrichanalai C, Tangkeo P, Nitichai Y, Rienprayoon D (1986) "Metabolic effects of depot-medroxyprogesterone acetate in long-term users: a cross-sectional study." Int J Gynaecol Obstet, 24, p.291-6
- Teichmann AT, Wander HE, Cremer P, et al. (1987) "Medroxyprogesterone acetate and lipid metabolic changes." Arzneimittelforschung, 37, p.573-77
- Who Task Force on Long-acting Agents for Fertility Regulation (1986) "Metabolic side-effects of injectable depot-medroxyprogesterone acetate, 150 mg three-monthly, in undernourished lactating women." Bull World Health Organ, 64, p.587-94
- Luciano AA, De Souza MJ, Roy MP, Schoenfeld MJ, Nulsen JC, Halvorson CV (1993) "Evaluation of low-dose estrogen and progestin therapy in postmenopausal women." J Reprod Med, 38, p.207-14
- (2001) "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
View all 17 references
Minor
Progestogens (applies to Tri-Estarylla) weight gain
Minor Potential Hazard, Low plausibility. Applicable conditions: Obesity
Progestogens can cause weight gain, which may be significant (as is the case with parenteral medroxyprogesterone) and undesirable in obese patients attempting to lose weight.
References
- Leiman G (1972) "Depo-medroxyprogesterone acetate as a contraceptive agent: its effect on weight and blood pressure." Am J Obstet Gynecol, 114, p.97-102
- Amatayakul K, Sivasomboon B, Thanangkul O (1980) "A study of the mechanism of weight gain in medroxyprogesterone acetate users." Contraception, 22, p.605-22
- (2001) "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn
- "Product Information. Ortho-Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical
- "Product Information. Demulen 1/50 (ethinyl estradiol-ethynodiol)." Searle
- (2001) "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories
View all 13 references
Tri-Estarylla drug interactions
There are 464 drug interactions with Tri-Estarylla (ethinyl estradiol / norgestimate).
Tri-Estarylla alcohol/food interactions
There are 7 alcohol/food interactions with Tri-Estarylla (ethinyl estradiol / norgestimate).
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Drug Interaction Classification
Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
---|---|
Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circ*mstances. |
Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Unknown | No interaction information available. |
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