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Hormone replacement therapy (estrogen mixture)

Conjugated Estrogens with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Conjugated Estrogens (Conjugated Estrogens). Most antibiotics do not interfere meaningfully with Conjugated Estrogens at 0.3mg, 0.625mg, 1.25mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Hormone replacement therapy (estrogen mixture) agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Conjugated Estrogens at 0.3mg, 0.625mg, 1.25mg.

Practical guidance

According to the prescribing information for Conjugated Estrogens, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Conjugated Estrogens is co-administered. Adjusted 0.3mg, 0.625mg, 1.25mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Conjugated Estrogens during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Conjugated Estrogens is metabolised and may need a temporary 0.3mg, 0.625mg, 1.25mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Conjugated Estrogens regimen.

Will antibiotics make Conjugated Estrogens stop working?

Most antibiotics do not affect Conjugated Estrogens efficacy. Rifampicin and a few others can lower Conjugated Estrogens levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

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