Concomitant use w/ skin medication which alters skin barrier or function (e.g., sodium lauryl sulphate,
benzalkonium or benzothonium chloride, astringents, sunscreens salicylic acid, lactic acid) should be avoided.
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., phenobarbital, phenytoin, carbamazepine) and anti-infectives (e.g., rifampicin, rifabutin, nevirapine, efavirenz). Ritonavir and nelfinavir, although known as strong enzyme inhibitors, by contrast exhibit inducing properties when used concomitantly with steroid hormones. Herbal medicine preparations containing St. John's wort (Hypericum perforatum) may induce the metabolism of estrogens.