Before Using

Drug information provided by: Merative, Micromedex®

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Geriatric

This medicine has been tested and has not been shown to cause different side effects or problems in older women than it does in younger females.

Pregnancy

Estrogens (contained in this combination medicine) are not recommended for use during pregnancy, since some estrogens have been shown to cause serious birth defects in humans. Some daughters of women who took diethylstilbestrol (DES) during pregnancy have developed reproductive (genital) tract problems and, rarely, cancer of the vagina and/or uterine cervix when they reached childbearing age. Some sons of women who took DES during pregnancy have developed urinary-genital tract problems.

Androgens (contained in this combination medicine) should not be used during pregnancy because they may cause male-like changes in a female baby.

Breastfeeding

Use of this medicine is not recommended in nursing mothers. Estrogens pass into the breast milk and their possible effect on the baby is not known. It is not known if androgens pass into breast milk. However, androgens may cause unwanted effects in nursing babies such as too early sexual development in males or male-like changes in females.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

  • Tranexamic Acid

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abametapir
  • Amifampridine
  • Amoxicillin
  • Ampicillin
  • Amprenavir
  • Anisindione
  • Apalutamide
  • Apixaban
  • Aprepitant
  • Armodafinil
  • Artemether
  • Bacampicillin
  • Belzutifan
  • Betamethasone
  • Bexarotene
  • Bosentan
  • Bupropion
  • Carbamazepine
  • Carbenicillin
  • Cefaclor
  • Cefadroxil
  • Cefdinir
  • Cefditoren
  • Cefixime
  • Cefpodoxime
  • Cefprozil
  • Ceftazidime
  • Ceftibuten
  • Cefuroxime
  • Cenobamate
  • Ceritinib
  • Clarithromycin
  • Clobazam
  • Cloxacillin
  • Colesevelam
  • Conivaptan
  • Cosyntropin
  • Cyclacillin
  • Cyclosporine
  • Dabigatran Etexilate
  • Dabrafenib
  • Darunavir
  • Dexamethasone
  • Dicloxacillin
  • Dicumarol
  • Donepezil
  • Doxycycline
  • Edoxaban
  • Efavirenz
  • Elagolix
  • Elvitegravir
  • Enasidenib
  • Encorafenib
  • Enzalutamide
  • Eslicarbazepine Acetate
  • Etravirine
  • Fedratinib
  • Fexinidazole
  • Fosamprenavir
  • Fosaprepitant
  • Fosnetupitant
  • Fosphenytoin
  • Griseofulvin
  • Guar Gum
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Bovine
  • Insulin Degludec
  • Insulin Detemir
  • Insulin Glulisine
  • Insulin Lispro, Recombinant
  • Isotretinoin
  • Itraconazole
  • Ivosidenib
  • Lesinurad
  • Levoketoconazole
  • Lixisenatide
  • Lorlatinib
  • Lumacaftor
  • Mavacamten
  • Meropenem
  • Methotrexate
  • Minocycline
  • Mitapivat
  • Mitotane
  • Mobocertinib
  • Modafinil
  • Mycophenolate Mofetil
  • Mycophenolic Acid
  • Nafcillin
  • Nelfinavir
  • Netupitant
  • Nevirapine
  • Octreotide
  • Oxacillin
  • Oxcarbazepine
  • Oxytetracycline
  • Paclitaxel
  • Paclitaxel Protein-Bound
  • Penicillin G
  • Penicillin G Procaine
  • Penicillin V
  • Phenobarbital
  • Phenprocoumon
  • Phenylbutazone
  • Phenytoin
  • Pitolisant
  • Pixantrone
  • Prednisolone
  • Prednisone
  • Primidone
  • Repotrectinib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Rivaroxaban
  • Rufinamide
  • Secobarbital
  • Somatrogon-ghla
  • St John's Wort
  • Sugammadex
  • Sultamicillin
  • Tazemetostat
  • Telaprevir
  • Tetracycline
  • Theophylline
  • Ticarcillin
  • Tigecycline
  • Tirzepatide
  • Tizanidine
  • Topiramate
  • Ulipristal
  • Valproic Acid
  • Warfarin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood clots (or history of during previous estrogen therapy)—Estrogens may worsen blood clots or cause new clots to form
  • Breast cancer (active or suspected)—Estrogens may cause growth of the tumor
  • Changes in vaginal bleeding of unknown causes—Some irregular vaginal bleeding is a sign that the lining of the uterus is growing too much or is a sign of cancer of the uterus lining; estrogens may make these conditions worse.
  • Type 2 diabetes mellitus—Androgens can decrease blood sugar levels.
  • Edema (swelling of feet or lower legs caused by retaining [keeping] too much body water) or
  • Heart or circulation disease or
  • Kidney disease or
  • Liver disease—Androgens can worsen these conditions because androgens cause the body to retain extra fluid (keep too much body water). Also, heart or circulation disease can be worsened by androgens because androgens may increase blood cholesterol levels.
  • Endometriosis—Estrogens may worsen endometriosis by causing growth of endometriosis implants.
  • Fibroid tumors of the uterus—Estrogens may cause fibroid tumors to increase in size.
  • Gallbladder disease or gallstones (or history of)—There is no clear evidence as to whether estrogens increase the risk of gallbladder disease or gallstones
  • Jaundice (or history of during pregnancy)—Estrogens use may worsen or cause jaundice in these patients.
  • Liver disease—Toxic drug effects may occur in patients with liver disease because the body is not able to get this medicine out of the bloodstream as it normally would.
  • Porphyria—Estrogens can worsen porphyria.

Portions of this document last updated: May 01, 2024

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