Drug General Information (ID: DDI83EDW0T)
Drug Name			Norethisterone		Drug Info		Miltefosine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Contraceptive Agents				Antifungal Agents
Structure

Mechanism of Norethisterone-Miltefosine Interaction (Severity Level: Moderate)
Altered absorption (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Norethisterone				Miltefosine
Mechanism		Absorption decreased by vomiting/diarrhea-causing agents				Vomiting/diarrhea-causing agent
Key Mechanism Factor 1
		Factor Name		Pharmacokinetic
		Factor Description		Alters the absorption of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Altered absorption of Norethisterone caused by Miltefosine

Recommended Action
Management		Female patients receiving oral contraceptives should be advised to use additional non-hormonal or alternative method(s) of effective contraception if vomiting or diarrhea occurs during miltefosine therapy. This is particularly important because miltefosine may cause fetal harm. Teratogenicity and fetal death were observed in animals administered miltefosine at dosages lower than the recommended human dosage. Females of reproductive potential should use effective contraception during miltefosine therapy and for 5 months after completion of therapy.

References
1	Bailey DG, Arnold JMO, Spence JD "Grapefruit juice and drugs - how significant is the interaction." Clin Pharmacokinet 26 (1994): 91-8. [PMID: 8162660]
2	Gunston GD, Mehta U "Potentially serious drug interactions with grapefruit juice." S Afr Med J 90 (2000): 41. [PMID: 10721388]
3	Product Information. Impavido (miltefosine). Paladin Therapeutics Inc, Wilmington, DE.