effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.cyanocobalaminmestranol decreases levels of cyanocobalamin by altering metabolism. Minor/Significance Unknown.cyclophosphamidecyclophosphamide will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.desipraminemestranol, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.dosulepinmestranol, dosulepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.doxepinmestranol, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.felbamatefelbamate decreases levels of mestranol by unknown mechanism. Minor/Significance Unknown.fluconazolefluconazole decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.folic acidmestranol decreases levels of folic acid by altering metabolism. Minor/Significance Unknown.fosaprepitantfosaprepitant decreases levels of mestranol by increasing metabolism. Minor/Significance Unknown.green teamestranol increases levels of green tea by decreasing elimination. Minor/Significance Unknown. (Caffeine).griseofulvingriseofulvin decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.imipraminemestranol, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.isoniazidisoniazid will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ketoconazoleketoconazole decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.L-methylfolatemestranol decreases levels of L-methylfolate by altering metabolism. Minor/Significance Unknown.larotrectiniblarotrectinib will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.levoketoconazolelevoketoconazole decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.lofepraminemestranol, lofepramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.magnesium chloridemestranol decreases levels of magnesium chloride by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.magnesium citratemestranol decreases levels of magnesium citrate by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.magnesium hydroxidemestranol decreases levels of magnesium hydroxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.magnesium oxidemestranol decreases levels of magnesium oxide by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.magnesium sulfatemestranol decreases levels of magnesium sulfate by Other (see comment). Minor/Significance Unknown. Comment: Magnesium shifted from blood to tissue storage.maprotilinemestranol, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.metyraponemestranol decreases effects of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.miconazole vaginalmiconazole vaginal decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.mineral oilmineral oil decreases levels of mestranol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.mycophenolatemycophenolate decreases effects of mestranol by unknown mechanism. Minor/Significance Unknown. Clinical significance unclear.naratriptanmestranol increases effects of naratriptan by unspecified interaction mechanism. Minor/Significance Unknown.nortriptylinemestranol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.phytoestrogensphytoestrogens decreases effects of mestranol by pharmacodynamic antagonism. Minor/Significance Unknown.pioglitazonepioglitazone decreases levels of mestranol by unknown mechanism. Minor/Significance Unknown.pleurisy rootpleurisy root decreases effects of mestranol by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.posaconazoleposaconazole decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.protriptylinemestranol, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.pyridoxinemestranol decreases levels of pyridoxine by altering metabolism. Minor/Significance Unknown.pyridoxine (Antidote)mestranol decreases levels of pyridoxine (Antidote) by altering metabolism. Minor/Significance Unknown.ropinirolemestranol increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.rose hipsmestranol decreases levels of rose hips by increasing elimination. Minor/Significance Unknown.rosuvastatinrosuvastatin increases levels of mestranol by unspecified interaction mechanism. Minor/Significance Unknown.ruxolitinibmestranol will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalmestranol will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.sodium tetradecyl sulfatesodium tetradecyl sulfate increases toxicity of mestranol by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of thromboembolic disorder.tizanidinemestranol increases levels of tizanidine by unspecified interaction mechanism. Minor/Significance Unknown.trazodonemestranol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.trimipraminemestranol, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.ursodiolmestranol decreases effects of ursodiol by pharmacodynamic antagonism. Minor/Significance Unknown.abametapirSerious - Use Alternative (1)abametapir will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.acetazolamideMinor (1)acetazolamide will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.albiglutideMonitor Closely (1)mestranol decreases effects of albiglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.alfalfaMinor (1)alfalfa decreases effects of mestranol by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).alpelisibMonitor Closely (1)alpelisib will decrease the level or effect of mestranol by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.amikacinMonitor Closely (1)amikacin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.aminocaproic acidMonitor Closely (1)mestranol decreases effects of aminocaproic acid by pharmacodynamic antagonism. Use Caution/Monitor. Risk of thromboembolic disorder.amiodaroneMonitor Closely (1)amiodarone will increase the level or effect of mestranol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.amitriptylineMinor (1)mestranol, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.amobarbitalMonitor Closely (1)amobarbital will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)amobarbital decreases levels of mestranol by increasing metabolism. Avoid or Use Alternate Drug. May result in contraceptive failure.amoxapineMinor (1)mestranol, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.amoxicillinMonitor Closely (1)amoxicillin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.amphotericin B deoxycholateMinor (1)amphotericin B deoxycholate decreases effects of mestranol by increasing metabolism. Minor/Significance Unknown. May also cause menstrual irregularities.ampicillinMonitor Closely (1)ampicillin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.anastrozoleMinor (1)anastrozole will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.androstenedioneMinor (1)androstenedione increases effects of mestranol by pharmacodynamic synergism. Minor/Significance Unknown.antithrombin alfaSerious - Use Alternative (1)mestranol decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.antithrombin IIISerious - Use Alternative (1)mestranol decreases effects of antithrombin III by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.apalutamideMonitor Closely (1)apalutamide will decrease the level or effect of mestranol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.Serious - Use Alternative (1)apalutamide will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.aprepitantMonitor Closely (1)aprepitant will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)aprepitant decreases levels of mestranol by increasing metabolism. Minor/Significance Unknown.argatrobanSerious - Use Alternative (1)mestranol decreases effects of argatroban by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.armodafinilMonitor Closely (1)armodafinil will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.artemether/lumefantrineMonitor Closely (1)artemether/lumefantrine will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atazanavirMonitor Closely (1)atazanavir will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atogepantMonitor Closely (1)mestranol will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atorvastatinMonitor Closely (1)atorvastatin will increase the level or effect of mestranol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.avapritinibMonitor Closely (1)mestranol will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.axitinibMonitor Closely (1)mestranol increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.azithromycinMonitor Closely (1)azithromycin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Modify Therapy/Monitor Closely.aztreonamMonitor Closely (1)aztreonam will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.bemiparinSerious - Use Alternative (1)mestranol decreases effects of bemiparin by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.bivalirudinSerious - Use Alternative (1)mestranol decreases effects of bivalirudin by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.boronMinor (1)boron increases levels of mestranol by altering metabolism. Minor/Significance Unknown.bosentanMonitor Closely (1)bosentan will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.brigatinibSerious - Use Alternative (1)brigatinib will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Brigatinib induces CYP3A4 in vitro. Coadministration of hormonal contraceptives with brigatinib can result in decreased concentrations and loss of efficacy. Brigatinib can cause fetal harm. Women should use an effective nonhormonal method of contraception during treatment and for at least 4 months after the last brigatinib dose.budesonideMonitor Closely (1)budesonide will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.butabarbitalMonitor Closely (1)butabarbital will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)butabarbital decreases levels of mestranol by increasing metabolism. Avoid or Use Alternate Drug. May result in contraceptive failure.butalbitalMonitor Closely (1)butalbital will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)butalbital decreases levels of mestranol by increasing metabolism. Avoid or Use Alternate Drug. May result in contraceptive failure.cannabidiolMonitor Closely (1)cannabidiol will decrease the level or effect of mestranol by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.carbamazepineSerious - Use Alternative (2)carbamazepine will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. carbamazepine decreases levels of mestranol by increasing metabolism. Avoid or Use Alternate Drug. May result in loss of contraceptive efficacy.cefaclorMonitor Closely (1)cefaclor will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.cefadroxilMonitor Closely (1)cefadroxil will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.cefamandoleMonitor Closely (1)cefamandole will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.cefpiromeMonitor Closely (1)cefpirome will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.cefprozilMonitor Closely (1)cefprozil will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.ceftibutenMonitor Closely (1)ceftibuten will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.cenobamateMonitor Closely (1)cenobamate will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.cephalexinMonitor Closely (1)cephalexin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.ceritinibMonitor Closely (1)ceritinib will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.chlorhexidine oralMonitor Closely (1)chlorhexidine oral will decrease the level