Hormones and hormone antagonists

ANTICANCER AND IMMUNOMODULATING DRUGS HORMONES AND HORMONE ANTAGONISTS Lanreotide 

Primary drug Secondary drug Effect HORMONES AND HORMONE ANTAGONISTS Mechanism Precautions 

ANASTRAZOLE ANTICOAGULANTS -WARFARIN t anticoagulant effect Uncertain possibly inhibition of hepatic enzymes. Anastrazole is a known inhibitor of CYP1A2, CYP2C9 and CYP3A4 Monitor INR at least weekly until stable at initiation and discontinuation of concurrent therapy 

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Flototto, T. Djahansouzi, S. Glaser, M. Hanstein, B. Niederacher, D. Brumm, C. Beckmann, M. W. Hormones and hormone antagonists mechanisms of action in carcinogenesis of endometrial and breast cancer. Horm. Metab. Res. 2001, 33, 451 -57. 

THIAZIDES HORMONES AND HORMONE ANTAGONISTS -TOREMIFENE Risk of hypercalcaemia Additive effect Monitor calcium levels closely. Warn patients about the symptoms of hypercalcaemia... 

MITOMYCIN HORMONES AND HORMONE ANTAGONISTS -TAMOXIFEN t incidence of anaemia and thrombocytopenia and risk of haemolytic-uraemic syndrome Mitomycin causes subdinical endothelial damage in addition to the thrombotic effect on platelets caused by tamoxifen, which leads to haemolytic-uraemic syndrome Monitor renal function at least twice weekly during concurrent therapy and watch clinically for bleeding episodes, e.g. nose bleeds, bleeding from the gums, skin bruising... 

TAMOXIFEN HORMONES AND HORMONE ANTAGONISTS - LETROZOLE i plasma concentrations of letrozole (by approximately 40%) and l efficacy of letrozole Attributed to induction of enzymes metabolizing letrozole by tamoxifen Avoid concurrent use outside clinical trials... 

CANNABIS HORMONES AND HORMONE ANTAGONISTS -TAMOXIFEN Unpredictable changes in plasma concentration. Risk of toxicity or therapeutic failure, particularly of drugs with a narrow therapeutic index Induction or inhibition of CYP3A4-mediated metabolism by cannabis. It is not yet known whether the effects are dependent on the degree of cannabis consumption Be aware. Watch for signs of toxicity, especially when cannabis use abruptly changes... 

Sex hormones and hormone antagonists. Oestrogens increase the synthesis of some vitamin K dependent clotting factors and progestogen-only contraceptives are preferred. The hormone antagonists danazol, flutamide and tamoxifen enhance the effect of warfarin. 

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