An alternate or additional form of birth control may be advisable during concomitant use. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Use Caution/Monitor. Monitor Closely (1)nilotinib will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Use Caution/Monitor. Monitor Closely (1)hydrocortisone will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. . If you miss more than one pill, this medicine may not be as effective and you may need to use another form of birth control. Low risk of contraceptive failure. [14] Dienogest produces no androgenic side effects and has little effect on metabolic and lipid hemostatic parameters. An alternate or additional form of birth control may be advisable during concomitant use. erythromycin base will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Applies only to oral forms of hormone. dienogest/estradiol valerate decreases effects of insulin degludec by pharmacodynamic antagonism. Low risk of contraceptive failure. Use Caution/Monitor. deferasirox will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Advise women to use alternative method of contraception or back-up method when moderate or weak enzyme inducer is used with combination contraceptives. Monitor Closely (1)aprepitant will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nafcillin will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ertapenem will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. dasatinib will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Women should not choose estradiol valerate/dienogest as their contraceptive while using strong CYP3A4 inducers due to potential decrease in contraceptive efficacy. They can't legally call it a birth control as it wasn't tested to be one. [7][1] Because of this, it may have a lower propensity for drug interactions. Use Caution/Monitor. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Low risk of contraceptive failure. Low risk of contraceptive failure. Monitor sensitive CYP3A4 substrates for reduced effectiveness if coadministered. erythromycin base will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Low risk of contraceptive failure. A small amount passes into breast milk and may have undesirable effects on a nursing infant. Monitor Closely (1)cenobamate will decrease the level or effect of dienogest/estradiol valerate by unspecified interaction mechanism. Estradiol valerate/dienogest should not be used for at least 28 days after discontinuation of the inducer due to possibility of decreased contraceptive efficacy. This website also contains material copyrighted by 3rd parties. Use Caution/Monitor. [2][3] The metabolites of dienogest are quickly excreted and are said to be mostly inactive. Effects of progestin-only contraceptives on the efficacy of elagolix is unknown. Using a condom is the only way to protect yourself from these diseases. This drug is available at a higher level co-pay. eslicarbazepine acetate will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. [8] The combination of estradiol valerate and dienogest is in pre-registration in Europe for the treatment of acne. ticarcillin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. This drug is available at a middle level co-pay. Potential for increased toxicity. An alternate or additional form of birth control may be advisable during concomitant use. Avoid or Use Alternate Drug. Advise women to use alternative method of contraception or back-up method when moderate or weak enzyme inducer is used with combination contraceptives. This effect can result in pregnancy. Significant changes (increase or decrease) in plasma levels of estrogen and progestin have been seen when HIV protease inhibitors are administered. It works by suppressing oestradiol production and preventing the growth of the endometrium. 1 tablet orally at the same time every day-Tablets must be taken in the order directed on the blister pack.Comments:-Efficacy in women with a body mass index over 30 kg/m2 has not been evaluated.-To start: Take the first pill on the first day of the menstrual cycle; non-hormonal back-up contraceptives should be used for the first 9 days.-Starting postpartum: Start no earlier than 4 weeks postpartum due to increased thromboembolism risk; if no period has occurred, rule out pregnancy; non-hormonal back-up contraceptives should be used for the first 9 days.-Switching from another combination hormonal method: Take the first pill on the first day of withdrawal bleeding; if no withdrawal bleeding occurred, rule out pregnancy.-Switching from vaginal ring or transdermal patch: Take the first pill on the day the ring/patch is removed; non-hormonal back-up contraceptives should be used for the first 9 days.-Switching from a progestin-only method: Take the first pill on the day the next progestin-only pill would have been taken, the day of removal of an implant, or the day the next injection would have occurred; non-hormonal back-up contraceptives should be used for the first 9 days.Uses:-Pregnancy prevention-Treatment of heavy menstrual bleeding without organic pathology in women who choose oral contraceptives for contraception. Low risk of contraceptive failure. Use Caution/Monitor. [24] [7] [25] It is also available in a quadriphasic birth control pill combined with estradiol valerate, marketed as Natazia in the United States and Qlaira in some European countries and Russia. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Use Caution/Monitor. Serious - Use Alternative (1)belzutifan will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. [2][3] Metabolic pathways of dienogest include reduction of its 4-3-keto group, hydroxylation mainly via CYP3A4, removal of its C17 cyanomethyl group, and conjugation. . It contains 2 hormones: dienogest (a progestin) and estradiol valerate (an estrogen). Low risk of contraceptive failure. An alternate or additional form of birth control may be advisable during concomitant use. mifepristone will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: CYP450 activity in the liver is down regulated by infection and inflammation stimuli including cytokines (eg, IL-6); inhibition of IL-6 by siltuximab may restore CYP450 enzymatic activity; caution if coadministered with CYP substrates that have a narrow therapeutic index. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Applies only to oral forms of hormone. [2] The high endometrial activity of dienogest underlies its ability to stabilize the menstrual cycle when combined with either ethinylestradiol or estradiol valerate (which has lower relative effects on the uterus compared to ethinylestradiol) in birth control pills, and also its use in the treatment of endometriosis. Use Caution/Monitor. dienogest/estradiol valerate, pretomanid. This information does not assure that this product is safe, effective, or appropriate for you. Copyright(c) 2023 First Databank, Inc. To view formulary information first create a list of plans. cefazolin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. amiodarone will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. STORAGE: Store at room temperature away from light and moisture. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Monitor Closely (1)quinupristin/dalfopristin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Tell your doctor if you just had or will be having surgery or if you will be confined to a bed or chair for a long time (such as on a long plane flight). Use Caution/Monitor. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Store at room temperature away from moisture and heat. Low risk of contraceptive failure. Smoking raises your risk of stroke, heart attack, blood clots, and high blood pressure from hormonal birth control (such as the pill, patch, ring). Then take one pill per day in the order directed on the pack. For the first cycle of use only, use an additional form of non-hormonal birth control (such as condoms, spermicide) for the first 9 days to prevent pregnancy until the medication has enough time to work. [37][38] The suppression of testosterone levels with 10mg/day dienogest was comparable to that with 10mg/day cyproterone acetate. Low risk of contraceptive failure. Use Caution/Monitor. Individual plans may vary Dienogest and estradiol is a combination drug that contains female hormones that prevent ovulation (the release of an egg from an ovary). Estradiol valerate/dienogest should not be used for at least 28 days after discontinuation of the inducer due to possibility of decreased contraceptive efficacy. tablet Contains 4 phases of doses for estrogen or combined estrogen/progestin throughout the 28-day cycle Days 1-2: estradiol valerate 3 mg Days 3-7: estradiol valerate 2 mg and dienogest 2. Low risk of contraceptive failure. Use Caution/Monitor. Follow the arrows shown on each row of pills in the pack. danazol will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. meropenem/vaborbactam will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Patients receiving oral estrogen replacement may require higher lonapegsomatropin dosages. Women should not choose estradiol valerate/dienogest as their contraceptive while using strong CYP3A4 inducers due to potential decrease in contraceptive efficacy. Use Caution/Monitor. Use Caution/Monitor. Pick a time of day that is easy for you to remember, and take your pill at the same time each day.It is very important to continue taking this medication exactly as prescribed by your doctor. Contraindicated (1)pentobarbital will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: Mechanism: likely due to induction of lamotrigine glucuronidation; dosage adjustments may be necessary for proper seizure control.dienogest/estradiol valerate will decrease the level or effect of lamotrigine by increasing hepatic clearance. Use Caution/Monitor. cefixime will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Estradiol valerate/dienogest should not be used for at least 28 days after discontinuation of the inducer due to possibility of decreased contraceptive efficacy. Use Caution/Monitor. Applies only to oral forms of hormone. dienogest/estradiol valerate decreases levels of lamotrigine by Other (see comment). Estradiol valerate/dienogest should not be used for at least 28 days after discontinuation of the inducer due to possibility of decreased contraceptive efficacy. [12], Dienogest is used in combination with estradiol valerate in the treatment of menopausal symptoms in certain countries such as Germany and the Netherlands. Use Caution/Monitor. Use Caution/Monitor. [2][7] In relation to its endometrial activity, dienogest is said to be one of the strongest progestogens available. Use Caution/Monitor. Contraindicated. This medication may raise your blood pressure. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. An alternate or additional form of birth control may be advisable during concomitant use. Use Caution/Monitor. Talk to your pharmacist for more details.Before using this product, tell your doctor or pharmacist your medical history, especially of: blood clots (for example, in the legs, eyes, lungs), blood clotting disorders (such as protein C or protein S deficiency), high blood pressure, abnormal breast exam, cancer (especially endometrial or breast cancer), high cholesterol or triglyceride (blood fat) levels, depression, diabetes, family or personal history of a certain swelling disorder (angioedema), gallbladder problems, severe headaches/migraine, heart problems (such as heart valve disease, irregular heartbeat, previous heart attack), history of yellowing eyes/skin (jaundice) during pregnancy or while using hormonal birth control (such as pills, patch), kidney disease, liver disease (including tumors), stroke, swelling (edema), thyroid problems, unexplained vaginal bleeding.If you have diabetes, this medication may affect your blood sugar. mobocertinib will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. [2][7][1][3] The medication does not interact with the estrogen receptor, the glucocorticoid receptor, or the mineralocorticoid receptor, and hence has no estrogenic, glucocorticoid, or antimineralocorticoid activity. Taking this medication after your evening meal or at bedtime may help if you have stomach upset or nausea with the medication. Applies only to oral forms of hormone. Use Caution/Monitor. Use Caution/Monitor. Get medical help right away if you have: shortness of breath/rapid breathing, chest/jaw/left arm pain, unusual sweating, confusion, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, sudden/severe headaches, trouble speaking, weakness on one side of the body, sudden vision changes.A very serious allergic reaction to this drug is rare. These conditions increase your risk of getting blood clots, especially if you are using hormonal birth control. Read this sheet carefully each time. [7][3] The plasma protein binding of dienogest is 90%, with a relatively high free fraction of 10%. Contraindicated (1)rifabutin will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Significant changes (increase or decrease) in plasma levels of estrogen and progestin have been seen when HIV protease inhibitors are administered. Low risk of contraceptive failure. Applies only to oral forms of hormone. Atazanavir may increase or decrease levels of dienogest/estradiol valerate. fosamprenavir will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Applies only to oral forms of hormone. ceftazidime will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Women should not choose estradiol valerate/dienogest as their contraceptive while using strong CYP3A4 inducers due to potential decrease in contraceptive efficacy. Monitor Closely (1)clindamycin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Low risk of contraceptive failure. antibiotics or medicines for infections, especially rifampin, rifabutin, rifapentine, griseofulvin, and possibly penicillins, tetracyclines, or macrolides like erythromycin, barbiturate medicines, such as phenobarbital, certain medicines for blood pressure like diltiazem, verapamil, certain medicines for fungal infections like ketoconazole and itraconazole, ritonavir or other medicines for HIV infection or AIDS. [2], Dienogest does not inhibit or induce CYP3A4, unlike many other related progestins. Women should not choose estradiol valerate/dienogest as their contraceptive while using strong CYP3A4 inducers due to potential decrease in contraceptive efficacy. Significant changes (increase or decrease) in plasma levels of estrogen and progestin have been seen when HIV protease inhibitors are administered. cefpodoxime will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. An alternate or additional form of birth control may be advisable during concomitant use. Before using this product, tell your doctor or pharmacist your medical history, especially of: blood clots (for example, in the legs, eyes, lungs), blood clotting disorders (such as protein C or protein S deficiency), high blood pressure, abnormal breast exam, cancer (especially endometrial or breast cancer), high cholesterol or triglyceride (blood fat) levels, depression, diabetes, family or personal history of a certain swelling disorder (angioedema), gallbladder problems, severe headaches/migraine, heart problems (such as heart valve disease, irregular heartbeat, previous heart attack), history of yellowing eyes/skin (jaundice) during pregnancy or while using hormonal birth control (such as pills, patch), kidney disease, liver disease (including tumors), stroke, swelling (edema), thyroid problems, unexplained vaginal bleeding. Use Caution/Monitor. Monitor Closely (1)lapatinib will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. [13], Contraindications of dienogest include active venous thromboembolism, previous or current cardiovascular disease, diabetes with cardiovascular complications, previous or current severe liver disease or tumors, hormone-dependent cancers such as breast cancer, and undiagnosed vaginal bleeding. You may choose to take this medication at another time of day that is easier for you to remember. Low risk of contraceptive failure. This information is not individual medical advice and does not substitute for the advice of your health care professional. unknown mechanism. Drug interactions may change how your medications work or increase your risk for serious side effects. Advise women to use alternative method of contraception or back-up method when moderate or weak enzyme inducer is used with combination contraceptives. Use Caution/Monitor. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Do not share this medication with others. tamoxifen will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. aprepitant will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Contraindicated (1)nevirapine will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. An alternate or additional form of birth control may be advisable during concomitant use. 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