Significantly decreased plasma concentrations and efficacy of allylestrenol, leading to treatment failure and potential for breakthrough bleeding.
Avoid concomitant use. If rifampicin is essential, consider an alternative progestin not metabolized by CYP3A4 or use a non-hormonal method. If allylestrenol must be used, significantly increase the dose and monitor closely, but efficacy may still be compromised.
Barbiturates (e.g., Phenobarbital)Moderate
Database
Reduced plasma levels and efficacy of allylestrenol, increasing risk of breakthrough bleeding or treatment failure.
Consider alternative progestin or increase allylestrenol dose. Monitor for signs of reduced allylestrenol efficacy.
Decreased plasma concentrations and efficacy of allylestrenol, potentially leading to breakthrough bleeding or treatment failure.
Consider alternative progestin or increase allylestrenol dose with careful monitoring. Monitor for signs of reduced allylestrenol efficacy.
CarbamazepineModerate
Database
Decreased plasma concentrations and efficacy of allylestrenol, potentially leading to breakthrough bleeding or treatment failure.
Consider alternative progestin or increase allylestrenol dose with careful monitoring. Monitor for signs of reduced allylestrenol efficacy.
GriseofulvinModerate
Database
Decreased plasma concentrations and efficacy of allylestrenol, potentially leading to breakthrough bleeding or treatment failure.
Consider alternative progestin or increase allylestrenol dose with careful monitoring. Monitor for signs of reduced allylestrenol efficacy.
ModafinilModerate
Database
Reduced plasma levels and efficacy of allylestrenol, increasing risk of breakthrough bleeding or treatment failure.
Consider alternative progestin or increase allylestrenol dose. Monitor for signs of reduced allylestrenol efficacy.
PhenytoinModerate
Database
Reduced plasma levels and efficacy of allylestrenol, increasing risk of breakthrough bleeding or treatment failure.
Consider alternative progestin or increase allylestrenol dose. Monitor for signs of reduced allylestrenol efficacy.
RitonavirModerate
Database
Variable effects on allylestrenol levels, potentially leading to decreased efficacy or increased side effects. Primarily, induction is a concern with chronic use.
Monitor closely for changes in allylestrenol efficacy or side effects. Dose adjustment of allylestrenol may be necessary. Consider alternative progestin if possible.
St. John's WortModerate
Database
Decreased plasma concentrations and efficacy of allylestrenol, potentially leading to breakthrough bleeding or treatment failure.
Avoid concomitant use. If St. John's Wort is essential, consider an alternative progestin or use a non-hormonal method. If allylestrenol must be used, significantly increase the dose and monitor closely, but efficacy may still be compromised.
Grapefruit JuiceMild
Database
Potentially increased plasma concentrations of allylestrenol, leading to increased risk of progestin-related side effects (e.g., nausea, breast tenderness).
Advise patients to avoid consuming large amounts of grapefruit juice while on allylestrenol. Monitor for increased side effects.