Drug General Information (ID: DDII50D29O)
Drug Name			Medroxyprogesterone acetate		Drug Info		Tivozanib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Contraceptives/Hormones/Antineoplastics				Antineoplastics
Structure

Mechanism of Medroxyprogesterone acetate-Tivozanib Interaction (Severity Level: Moderate)
Attenuated pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Medroxyprogesterone acetate				Tivozanib
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  Medroxyprogesterone acetate when combined with Tivozanib

Recommended Action
Management		Until more information is known, caution is advised when tivozanib is prescribed concomitantly with hormonal contraceptives. Some authorities recommend that female patients of childbearing potential use an additional method of contraception. An acceptable barrier method (e.g., diaphragm with spermicide, cervical cap with spermicide, contraceptive sponge, male condom, female condom) in addition to the hormonal contraceptive of choice may be advisable during the duration of tivozanib therapy and for at least one month after completing therapy.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Fotivda (tivozanib). Aveo Pharmaceuticals, Inc., Boston, MA.
3	Schubert W, Eriksson U, Edgar B, Cullberg G, Hedner T "Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17B-estradiol." Eur J Drug Metab Pharmacokinet 20 (1995): 219-24. [PMID: 8751044]