Drug General Information (ID: DDIAIMWV5D)
Drug Name			Conjugated estrogens (topical)		Drug Info		Corticotropin		Drug Info
Drug Type		Small molecule				Hormones
Therapeutic Class		Estrogens				Corticosteroids
Structure

Mechanism of Conjugated estrogens (topical)-Corticotropin Interaction (Severity Level: Moderate)
Increase globulin concentration Click to Show/Hide Mechanism Graph
Drug Name		Conjugated estrogens (topical)				Corticotropin
Mechanism		Increase serum cortisol-binding globulin concentration				Corticosteroid
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the distribution of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Decreased plasma concentration of Corticotropin caused by Conjugated estrogens (topical) mediated increased concentration of serum thyroid-binding globulin

Recommended Action
Management		Patients treated concomitantly with an estrogen-containing drug may require lower dosages of corticosteroids or adrenocorticotropic agents. Pharmacologic response to these agents should be monitored more closely whenever an estrogen is added to or withdrawn from therapy in patients stabilized on their existing corticosteroid or adrenocorticotropic regimen, and the dosage(s) adjusted as necessary.

References
1	Legler UF, Benet LZ "Marked alterations in dose-dependent prednisolone kinetics in women taking oral contraceptives." Clin Pharmacol Ther 39 (1986): 425-9
2	Meffin PJ, Wing LM, Sallustio BC, Brooks PM "Alterations in prednisolone as a result of oral contraceptive use and dose." Br J Clin Pharmacol 17 (1984): 655-64
3	Frey BM, Schaad HJ, Frey FJ "Pharmacokinetic interaction of contraceptive steroids with prednisone and prednisolone." Eur J Clin Pharmacol 26 (1984): 505-11