Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction

Oral anticoagulants
Changes in anticoagulant activity (the increased effect of the oral anticoagulant by modification of coagulation factor hepatic synthesis and competitive inhibition of plasma protein binding): 
Increased monitoring of the prothrombin time and INR determinations are recommended. Patients receiving oral anticoagulants require close monitoring especially when androgens are started or stopped.

Corticosteroids
Concomitant administration of testosterone with ACTH or corticosteroids may increase the risk of developing oedema. As a result, these medicinal products should be administered cautiously, particularly in patients suffering from cardiac, renal or hepatic disease.

Laboratory tests
Interaction with laboratory tests: androgens may decrease levels of thyroxin binding globulin, resulting in decreased T4 serum concentrations and in increased resin uptake of T3 and T4. Free thyroid hormone levels, however, remain unchanged, and there is no clinical evidence of thyroid insufficiency.

Diabetic medication
Improved insulin sensitivity, glucose tolerance, glycaemic control, blood glucose and glycosylated haemoglobin levelshave been reported with androgens. In diabetic patients, the dose of antidiabetic medications may need reduction (seesection 4.4).