Drug General Information (ID: DDIZ27EQC1)
Drug Name			Mestranol		Drug Info		Romidepsin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Estrogens				Histone Deacetylase Inhibitors
Structure

Mechanism of Mestranol-Romidepsin Interaction (Severity Level: Moderate)
Antagonize the effect of estrogen Click to Show/Hide Mechanism Graph
Drug Name		Mestranol				Romidepsin
Mechanism 1		Estrogen agent				Anti-estrogen receptor effects
Key Mechanism Factor 1
		Factor Name		Estrogen
		Factor Description		The efficacy of estrogenic medications may be reduced, such as contraceptive failure due to reduced efficacy of estrogen-containing contraceptives.
Mechanism Description		Antagonize the effect of Mestranol when combined with Romidepsin
Mechanism 2		Estrogen agent				Anti-estrogen receptor effects
Key Mechanism Factor 2
		Factor Name		Estrogen
		Factor Description		The efficacy of estrogenic medications may be reduced, such as contraceptive failure due to reduced efficacy of estrogen-containing contraceptives.
Mechanism Description		Antagonize the effect of Mestranol when combined with Romidepsin

Recommended Action
Management		Estrogen-containing contraceptives, including oral, injectable, transdermal, and implantable forms, may not be reliable during concomitant therapy with romidepsin. Female patients of childbearing potential should consider using an additional method of contraception if possible. Input from a gynecologist or similar expert on adequate contraception should be sought as needed.

References
1	Fuhr U, Maier-Bruggemann A, Blume H, et al. "Grapefruit juice increases oral nimodipine bioavailability." Int J Clin Pharmacol Ther 36 (1998): 126-32. [PMID: 9562227]
2	Gunston GD, Mehta U "Potentially serious drug interactions with grapefruit juice." S Afr Med J 90 (2000): 41. [PMID: 10721388]
3	Product Information. Istodax (romidepsin). Gloucester Pharmaceuticals, Cambridge, MA.