Ethinyl Estradiol; Norethindrone with Prednisolone Interaction Details
Brand Names Associated with Prednisolone
- Flo-Pred®
- Orapred®
- Pediapred®
- Prednisolone
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 12, 2023
Interaction Effect
Increased prednisoLONE exposure and an increased risk of corticosteroid side effects (neuropsychiatric reactions, fluid and electrolyte disturbances, hypertension, hyperglycemia)
Interaction Summary
COCs containing ethinyl estradiol may inhibit the metabolism of prednisoLONE and may increase the plasma concentrations of prednisoLONE. Combination contraceptives may decrease prednisoLONE clearance significantly .
Severity
Major
Onset
Delayed
Evidence
Established
How To Manage Interaction
Combination oral contraceptives (COCs) containing ethinyl estradiol may inhibit the metabolism of prednisoLONE and may increase the plasma concentrations of prednisoLONE.
Mechanism Of Interaction
Inhibition of prednisoLONE metabolism
Literature Reports
A) Chronic contraceptive and steroid use results in a marked decrease in prednisoLONE clearance. Six females using chronic oral contraceptives received prednisoLONE 0.53 (high dose) and 0.14 mg/kg (low dose) intravenously. Six females (controls) received only prednisoLONE. A significant decrease in clearance occurred for each of the prednisoLONE doses in women receiving oral contraceptives as compared with the control values (p less than 0.01). There is a significant decrease in unbound prednisoLONE clearance for women taking oral contraceptives compared with 0 control subjects at both doses (p less than 0.01). The results presented in this study demonstrate that an approximate 3.5-fold increase in prednisoLONE dose resulted in an increase, observed in each subject, in clearance by a factor of 1.96 +/- 0.52 for the control subjects and by a factor of 1.44 +/- 0.33 for the oral contraceptives group. Dose-dependent prednisoLONE kinetics and marked decreases in prednisoLONE clearance in women taking oral contraceptives results from concomitant synthetic estrogen dosing. Women taking oral contraceptives who are currently undergoing prednisoLONE therapy should be monitored carefully. The author expects lower doses of prednisoLONE to yield clinical efficacy in these patients .
B) The clearance of free prednisoLONE is reduced in women taking oral contraceptives compared to women who do not. The study evaluated eight female subjects who used oral combination contraceptives and eight female control subjects who did not. Each subject received prednisoLONE phosphate equivalent to 0.1 mg/kg intravenous of prednisoLONE and 1.0 mg/kg of prednisoLONE. Free prednisoLONE clearance was reduced approximately 30% in oral contraceptive users compared with control subjects (p less than 0.001). Pre-dose plasma cortisol concentrations were elevated two-fold (p less than 0.001) in oral contraceptive users compared with control subjects. The authors conclude that inhibition of prednisoLONE clearance by cortisol may be the mechanism for circadian variations in free prednisoLONE clearance. This mechanism could contribute the inhibition of prednisoLONE clearance by oral contraceptives. This study demonstrated that there is a reduction in the dose dependency of free prednisoLONE clearance in oral contraceptive users compared to control subjects .
Prednisolone Overview
-
Prednisolone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisolone is also used to treat certain conditions that affect the blood, skin, eyes, central nervous system, kidneys, lungs, stomach, and intestines. It is also used to treat allergic reactions; and certain types of arthritis; multiple sclerosis (a disease in which the nerves do not function properly); and to help prevent transplant rejection (attack of the transplanted organ by the body) in certain adults who have received a transplant. Prednisolone is also sometimes used to treat symptoms from certain types of cancer. Prednisolone is in a class of medications called corticosteroids. It works by reducing swelling and redness and by changing the way the immune system works.
Return To Our Drug Interaction Homepage
Feedback, Question Or Comment About This Information?
Ask Dr. Brian Staiger, PharmD, our medical editor, directly! He's always more than happy to assist.
Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.