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Drug Interactions With Conjugated Estrogens Vaginal Cream

Grapefruit Juice
Grapefruit juice may decrease the ability of your body to metabolize the hormones in conjugated estrogens vaginal cream, possibly leading to high levels of these hormones in the body. This may increase the risk of side effects of conjugated estrogens vaginal cream.
Protease Inhibitors
Protease inhibitors may decrease the ability of your body to metabolize the hormones in conjugated estrogens vaginal cream, possibly leading to high levels of these hormones in the body. This may increase the risk of conjugated estrogens vaginal cream side effects. Check with your healthcare provider before combining the cream with a protease inhibitor.
Rifamycin Antibiotics
Rifamycin antibiotics may cause your body to metabolize the hormones in conjugated estrogens vaginal cream too quickly, possibly leading to low levels of these hormones in the body. Because the cream acts directly on the vaginal tissues and is absorbed into the bloodstream without passing through the liver first (as happens with oral medications), this interaction is probably not significant.
St. John's Wort
St. John's wort (a commonly used herbal supplement) may cause your body to metabolize the hormones in conjugated estrogens vaginal cream too quickly, possibly leading to low levels of these hormones in the body. Because the cream acts directly on the vaginal tissues and is absorbed directly into the bloodstream without passing through the liver first (as happens with oral medications), this interaction is probably not significant.
Thyroid Medications
If you take medications for an underactive thyroid (hypothyroidism) with conjugated estrogens vaginal cream, your healthcare provider may need to increase the dose of your thyroid medication. Your healthcare provider should monitor you and make any necessary adjustments.
Last reviewed by: Kristi Monson, PharmD
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