Dienille Drug Interactions

Several medicines leading to an increased clearance of sexual steroids might elicit break-through bleeding or lead to the loss of contraceptive potential. These effects have been shown in the case of hydantoine, barbiturates, primidon, carbamazepin and rifampicin. This applies possibly to rifabutin, efavirenz, nevirapin, oxcarbazepin, topiramat, felbamat, ritonavir, nelvinafir, griseofulvin and herbal remedies containing St John's wort (Hypericum perforatum). These medicines increase liver enzyme induction.
Some antibiotics (such as ampicillin or tetracycline) have been suspected to reduce efficacy of combined oral contraceptives. The reason for this side effect is not known yet.
Women receiving short courses (maximum one week) of the products above should take additional, contraceptive precautions (e. g. barrier method) during the time of concurrent medication and for 7 days afterwards.
With rifampicin additional contraceptive precautions (e. g. barrier method) should be taken during the time of concurrent medication and continued for 4 weeks after treatment stops. If the end of a pack overruns while taking other medicines, the next pack should be started without the usual tablet-free interval.
The dose of contraceptive steroids should be increased during long-term treatment with medicines inducing the enzyme system of the liver. If it leads to undesirable side effects (e. g. irregular bleeding), or if it seems ineffective, other non-hormonal contraceptive method should be applied.
Oral contraceptives may affect the metabolism of certain other active substances. Accordingly, plasma and tissue concentrations may either increase (e.g. cyclosporin) or decrease (e.g. lamotrigine).
The progestin compound may interact with ACE inhibitors, angiotensin II receptor antagonists, potassium-sparing diuretics, aldosterone antagonists, and nonsteroidal anti-inflammatory drugs.
In in vitro studies dienogest did not inhibit function of cytochrome P450 enzyme system in the dose applied, thus no interaction with other medicinal products can be expected from this site.
Laboratory tests: The use of steroids may influence the results of certain laboratory tests. Among these are: biochemical parameters of the liver, thyroid, adrenal and renal function, plasma levels of proteins (such as corticosteroid binding globulins) and lipid/lipoprotein fractions, carbohydrate metabolism, and parameters of coagulation and fibrinolysis. However, these changes remain within the normal range.
Note: The prescribing information of concomitant medications should be consulted to identify potential interactions.
Concomitant use with the medicinal products containing ombitasvir / paritaprevir / ritonavir and dasabuvir, with or without ribavirin may increase the risk of ALT elevations (See Contraindications and Precautions). Therefore, users must switch to an alternative method of contraception (e.g., progestogen-only contraception or non-hormonal methods) prior to starting therapy with this combination drug regimen. Dienille can be restarted 2 weeks following completion of treatment with this combination drug regimen.