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[口服避孕药与其他药物之间的相互作用]

[Interactions between oral contraceptives and other drugs].

作者信息

Hansen T H, Jensen S B

机构信息

Gynaekologisk/obstetrisk afdeling, Hvidovre Hospital, København.

出版信息

Ugeskr Laeger. 1991 Oct 28;153(44):3073-6.

PMID:1949335
Abstract

Failures of oral contraceptives are possible when combined with rifampicin or antiepileptics, especially phenobarbitone and phenytoin. The mode of action is shown by clinical trials to be due to induction of hepatic enzymes thus increasing the steroid metabolism. Failure or oral contraceptives has occurred with the concomitant use of antibiotics, i.e. ampicillin and sulfonamides. Clinical trials have focused upon the changes in the intestinal flora induced by antibiotics. This might influence the enterohepatic circulation of estrogen and thereby decrease reabsorption of estrogen, but this has not been definitely proved. The failures may be caused by individual pharmacokinetics of oral contraceptives. Oral contraceptives are able to influence the pharmacodynamics of various other drugs metabolized by oxidation or conjugation but besides an increased pharmacological effect of prednisolone and increased toxicity of imipramine the clinical importance is uncertain.

摘要

口服避孕药与利福平或抗癫痫药(尤其是苯巴比妥和苯妥英)合用时可能会失效。临床试验表明,其作用方式是由于肝酶诱导,从而增加了类固醇代谢。口服避孕药与抗生素(如氨苄青霉素和磺胺类药物)同时使用时也会出现失效情况。临床试验集中在抗生素引起的肠道菌群变化上。这可能会影响雌激素的肠肝循环,从而减少雌激素的重吸收,但这尚未得到明确证实。失效可能是由口服避孕药的个体药代动力学引起的。口服避孕药能够影响通过氧化或结合代谢的各种其他药物的药效学,但除了泼尼松龙的药理作用增强和丙咪嗪的毒性增加外,其临床重要性尚不确定。

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