Drug interactions
Estradiol + Hemin
Severity: Moderate
Estradiol and Hemin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Estrogens can provoke attacks in patients with acute porphyria by inducing hepatic delta-aminolevulinic acid synthase. This opposes the therapeutic effect of hemin, which is given to suppress that pathway during acute attacks.
What this interaction means in plain words
Estradiol and Hemin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Estradiol belongs to Endocrine; Hemin belongs to Miscellaneous.
Why it happens
Estrogen-induced upregulation of hepatic ALA synthase counteracts hemin's feedback repression of porphyrin synthesis.
What to do
Avoid starting or continuing estradiol during an acute porphyria attack unless clearly needed. Monitor clinical response and porphyrin precursors, and consider non-hormonal alternatives.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Estradiol
- Anastrozole + Estradiol Contraindicated
- Estradiol + Fezolinetant Contraindicated
- Estradiol + Ospemifene Contraindicated
- Antithrombin alfa + Estradiol Major
- Antithrombin iii + Estradiol Major
- Estradiol + Exemestane Major
Other interactions of Hemin
- Hemin + Secobarbital Major
- Argatroban + Hemin Moderate
- Bazedoxifene-conjugated estrogens + Hemin Moderate
- Dabigatran etexilate + Hemin Moderate
- Dalteparin + Hemin Moderate
- Desogestrel-ethinyl estradiol + Hemin Moderate
Frequently asked questions
Can I take Estradiol with Hemin?
MediHelp rates the interaction as moderate. Estradiol and Hemin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Estrogens can provoke attacks in patients with acute porphyria by inducing hepatic delta-aminolevulinic acid synthase. This opposes the therapeutic effect of hemin, which is given to suppress that pathway during acute attacks.
How serious is the interaction between Estradiol and Hemin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid starting or continuing estradiol during an acute porphyria attack unless clearly needed. Monitor clinical response and porphyrin precursors, and consider non-hormonal alternatives.
What other medicines interact with Estradiol?
MediHelp also lists interactions of Estradiol with, for example, Anastrozole, Fezolinetant, Ospemifene. The full list is on the Estradiol page.
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