Drug General Information (ID: DDI2X8YAL5)
Drug Name			Norgestrel		Drug Info		Neratinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Contraceptive Agents				Antineoplastics
Structure

Mechanism of Norgestrel-Neratinib Interaction (Severity Level: Moderate)
Attenuated pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Norgestrel				Neratinib
Mechanism		Hormonal contraceptives				Reduce the therapeutic efficacy of hormonal contraceptives
Key Mechanism Factor 1
		Factor Name		Pharmacodynamics
		Factor Description		Reduced pharmacological effects leading to insufficient efficacy and/or treatment failure.
Mechanism Description		Attenuated pharmacological effects of  Norgestrel when combined with Neratinib

Recommended Action
Management		Although the clinical significance of this interaction is unknown, caution is advised when neratinib is prescribed concomitantly with hormonal contraceptives because of the potential to cause fetal harm. Women should avoid becoming pregnant during treatment with neratinib and for up to 1 month after discontinuing treatment. Women using hormonal contraceptives should add a barrier method. In addition, men receiving neratinib should use a barrier method of contraception during treatment and for 3 months after discontinuing treatment.

References
1	Abbas R, Hug BA, Leister C, Burns J, Sonnichsen D "Pharmacokinetics of oral neratinib during co-administration of ketoconazole in healthy subjects." Br J Clin Pharmacol 71 (2011): 522-7. [PMID: 21395644]
2	Cerner Multum, Inc. "Australian Product Information.".