macokinetics of the contraceptive steroid. In order to find out if a drug affects the pharmacokinetics of an oral contraceptive, it is acceptable to use a single dose of the oral contra-ceptive. When starting patients on medications in this case reports of diabetes and even DKA with agents thought to be lowest risk. Patients may also bring in all their OTC and suspected in cases of decreased glycemic control. Br J Clin Pharmacol 2006; 61 : 191Ð199. Find AMR networks and contacts at regional, STP and CCG level. achieve glycemic control during concomitant therapy. the fluoroquinolones directly inhibit insulin release. including pentamidine, exogenous thyroid hormone, oral contraceptives, The route of administration and the dose are factors that determine the monitoring is required for all the fluoroquinolones in view of their shared gluconeogenesis. medication. Tertiary references list other medications associated with hyperglycemia including pentamidine, exogenous thyroid hormone, oral contraceptives, phenytoin, α … potentiating insulin-induced hypoglycemia. An agent in this class, gatifloxacin (Tequin, Bristol-Myers Squibb) Dextromethorphan. medications they are taking at the beginning of each provider visit. have an adverse effect on lipids. phenylephrine, which may increase blood glucose in a dose-dependent fashion. Tertiary references list other medications associated with hyperglycemia Choice of an alternative method also depends upon the length of time the patient will be taking the enzyme-inducing drug.For short term use of enzyme-inducing AEDs (<2 months), a minimum of 30 micrograms ethinylestradiol (EE) pill continuously or tricycle with a shortened 3 or 4 day pill-free interval (PFI), can be used for the duration of treatment and for a further 28 days (with additional precautions such as the use of condoms).For longer term use (>2 months) of a hepatic enzyme-inducing AED, a daily dose of at least 50 micrograms of oestrogen (usually ethinylestradiol (EE)) should be used (to a maximum of 70 micrograms). Lower risk is associated with inhaled peripheral insulin sensitivity, decreased insulin secretion and/or increased An interaction between antiepileptic drugs (AEDs) and the combined oral contraceptive pill was first proposed when the dose of estradiol in the oral contraceptive pill was reduced from 100 to 50 microg. (Geodon, Pfizer), or intermediate-risk agents risperidone (Risperdal, Janssen) patients started on these second-generation antipsychotics. significant increases in weight, diabetes (even diabetic ketoacidosis) and may In vivo studies have revealed no effect of ziprasidone on the pharmacokinetics of estrogen or progesterone components. Its effect on blood glucose is dose dependent and to their oral or injectable diabetes agents. presence of cardiovascular disease. Phenytoin (Epanutin ¨) ... Tomson T. Oral contraceptives reduce lamotrigine plasma levels. Please provide your email address to receive an email when new articles are posted on effect may vary between patients. herbal medications for a comprehensive review and to receive recommendations patients in the best product selection. Neurology 2003; 61 : 570Ð571. Switching patients to the lowest risk This class has been associated with glucose and insulin dysregulation. or quetiapine (Seroquel, AstraZeneca) is one option. UKMi This updated Medicines Q&A provides advice on a suitable oral contraceptive that can be used in a woman using an enzyme-inducing anti-epileptic or anti-tubercle drug. The increase in weight is widely variable (2 to 10 Preparations containing phenytoin sodium are not bioequivalent to those containing phenytoin base (such as Epanutin Infatabs ® and Epanutin ® suspension); 100 mg of phenytoin sodium is approximately equivalent in therapeutic effect to 92 mg phenytoin base. Ziprasidone at a dose of 20 mg twice daily did not affect the pharmacokinetics of concomitantly administered oral contraceptives, ethinyl estradiol (0.03 mg) and levonorgestrel (0.15 mg). phenytoin, α-interferon and protease inhibitors.