Norcolut Drug Interactions

Potential for other medicinal products to affect norethisterone: Antibacterials: Rifampicin, rifabutin and rifamycin derivatives may enhance the metabolism of progestins and decrease the serum concentration of norethisterone by liver enzymes inductions.
Antiepileptics: Antiepileptic drugs increase the clearance of progestins by enzyme induction, so diminishing their effect. Oxcarbazepine, carbamazepine, eslicabazepin, clobazam, perampanel, primidone, topiramate, rufinamide, felbamate, lamotrigine, phenytoin and phosphenytoin reduce the serum concentrations of norethisterone.
Antivirals: Antiretroviral drugs such as protease inhibitors (e.g. lopinavir) and non-nucleoside reverse transcriptase inhibitors (e.g. nevirapine) may decrease the serum concentration of progestins. A number of antivirals (ribavirin, darunavir, efavirenz, fosamprenavir, lopinavir, nelfinavir, saquinavir, telaprevir) are likely to accelerate the metabolism of progestogens, therefore they reduce the efficacy of norethisterone. In contrast to the previously mentioned antiretroviral drugs, the following drugs may increase the serum concentration of progestins: atazanavir, cobicistat, boceprevir or tripranavir.
Antifungal: However, griseofulvin may reduce the efficacy of progestogens, voriconazole may increase the serum concentration of progestins.
Other: There are some antidiabetic, retinoid, antiemetic, antimalarial and anticancer drugs which may reduce the effect of progestins (e.g. lixisenatide, exenatide, metreleptin, acitretin, fosaprepitant, aprepitant, artemether, bexarotene, brigatininb, ixazomib). Bile acid sequestrant, colesevelam, prucalopride, sugammadex, lumacaftor, mifepristone, ulipristal, mycophenolate and lesinurad may decrease the serum concentration of progestins also.
5-alpha-reductase inhibitors such as finasteride and dutasteride can inhibit the metabolism of norethisterone.
St John's Wort (Hypericum perforatum), bosentan, deferasirox, mitotane, sarilumab, siltuximab and tocilizumab may decrease the serum concentration of CYP3A4 substrates which may alter circulating levels of norethisterone.
Concomitant lamotrigine and progestins use may result in reduced plasma concentrations of lamotrigine, possibly resulting in reduced seizure control.
Potential for norethisterone to affect other medicinal products: Progestins may diminish the therapeutic effect of anticoagulants. More specifically, the potential prothrombotic effects of some progestins and progestin-oestrogen combinations may counteract anticoagulant effects of warfarin and phenindione.
Progestins may enhance the thrombogenic effect of C1 inhibitors, tranexamic acid, thalidomide and pomalidomide.
Norethisterone may diminish the therapeutic effect of antidiabetic agents.
Norethisterone may increase the serum concentration of voriconazole.
Progestins may enhance the hepatotoxic effect of cyclosporine.
Concomitant use with the medicinal products containing ombitasvir/paritaprevir/ritonavir and dasabuvir, with or without ribavirin may increase the risk of ALT elevations. Concomitant use with the medicinal products containing glecaprevir/pibrentasvir may also increase the risk of ALT elevations (see Contraindications and Precautions).
Laboratory tests: The use of sex steroids may influence the results of certain laboratory tests, including biochemical parameters of liver, thyroid, adrenal and renal function, plasma levels of (carrier) proteins, e.g. corticosteroid-binding globulin and lipid/lipoprotein fractions, parameters of carbohydrate metabolism and parameters of coagulation and fibrinolysis. Changes generally remain within the normal laboratory range.