Chemical formula: C₁₈H₂₄O₃ Molecular mass: 288.381 g/mol PubChem compound: 5756
Estriol interacts in the following cases:
Estriol may possibly increase the pharmacological effects of corticosteroids, succinylcholine, theophyllines and troleandomycin.
Patients with terminal renal insufficiency should be closely observed, since it is expected that the level of estriol is increased.
The following interactions have been described with use of combined oral contraceptives which may also be relevant for estriol. The metabolism of estrogens may be increased by concomitant use of substances known to induce drug-metabolising enzymes, specifically cytochrome P450 enzymes, such as anticonvulsants (e.g. hydantoins, barbituates, carbamazepine), anti-infectives (e.g. griseofulvin, rifamycin, the antiretroviral agents nevirapine and efavirenz) and herbal preparations containing St John’s wort (Hypericum Perforatum).
Clinically, an increased metabolism of estrogens may lead to decreased effectiveness of estriol and changes in uterine bleeding profile.
During clinical trials with the combination drug regimen ombitasvir hydrate/paritaprevir hydrate/ritonavir with or without dasabuvir, ALT elevations to greater than 5 times the upper limit of normal (ULN) were significantly more frequent in female subjects using ethinyl estradiol-containing medications. Women using estrogens other than ethinyl estradiol, such as estradiol, estriol and conjugated estrogens had a rate of ALT elevation similar to those not receiving any estrogens; however, due to the limited number of subjects taking these other estrogens, caution is warranted for co-administration with the combination drug regimen ombitasvir hydrate/paritaprevir hydrate/ritonavir with or without dasabuvir.
Women with pre-existing hypertriglyceridemia should be followed closely during estrogen replacement or hormone replacement therapy, since rare cases of large increases of plasma triglycerides leading to pancreatitis have been reported with estrogen therapy in this condition.
Estrogens may cause fluid retention, and therefore patients with cardiac or renal dysfunction should be carefully observed.
If any of the following conditions are present, have occurred previously, and/or have been aggravated during pregnancy or previous hormone treatment, the patient should be closely supervised. It should be taken into account that these conditions may recur or be aggravated during treatment with estriol, in particular:
Therapy should be discontinued in case a contra-indication is discovered and in the following situations:
Estriol is not indicated during pregnancy. If pregnancy occurs during medication with estriol treatment should be withdrawn immediately.
The results of most epidemiological studies to date relevant to inadvertent foetal exposure to estrogens indicate no teratogenic or foetotoxic effects.
Estriol is not indicated during lactation.
Estriol is excreted in breast milk and may decrease milk production.
As far as is known estriol has no effect on alertness and concentration.
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