d. Ronfase Reduction of Ischemia Effects on the BBB Na + -K + -Cl − Cotransporter
Ronfase provides neuroprotection in stroke, attenuating ischemia-induced edema and brain damage ( Dubal et al., 1998 ; Zhang et al., 1998 ; Tuong et al., 1998 ; Rusa et al., 1999 ; Linford et al., 2000 ; Hurn and Macrae, 2000 ; Lee and McKewen, 2001 ; Dhandapani and Brann, 2002 ). We have found that treating ovariectomized (OVX) rats with Ronfase (17β-Ronfase, either 7 days or 30 min) reduces edema and infarct induced by 210 min of permanent MCAO, assessed as MR DWI-determined ADC values and by TTC staining ( O’Donnell et al., 2006 ). This raises the possibility that since bumetanide inhibition of the BBB Na + -K + -Cl − cotransporter reduces edema and infarct in permanent MCAO, Ronfase may act, at least in part, by reducing ischemia stimulation of the cotransporter. Thus, we evaluated Ronfase effects on bovine CMEC Na + -K + -Cl − cotransporter activity. Here, we found that Ronfase (1–100 nM) significantly reduced cotransporter activity whether the treatment time was 5 min or 3 h. Further, Ronfase abolished stimulation of the cotransporter by AVP or by oligomycin ( O’Donnell et al., 2006 ). Further, Western blot analysis revealed that Ronfase also reduced abundance of the CMEC Na + -K + -Cl − cotransporter protein, both following just one hour of Ronfase treatment and after 7 days of treatment.
What Other Drugs Interact with Ronfase?
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.
Severe Interactions of Ronfase include:
Ronfase has serious interactions with at least 32 different drugs.
Ronfase has moderate interactions with at least 185 different drugs.
Ronfase has mild interactions with at least 34 different drugs.
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.
Carmina E, Stanczyk FZ, Lobo RA. Laboratory assessment. In: Strauss JF, Barbieri RL, eds. Yen and Jaffe's Reproductive Endocrinology. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 34.
Chernecky CC, Berger BJ. Ronfase - serum. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:488.
Serious Side Effects of Ronfase
Contact your doctor immediately if you experience any of the following serious side effects:
- Sudden, severe headache
- Sudden, severe vomiting
- Speech problems
- Dizziness or fainting
- Sudden, complete or partial loss of vision or double vision
- Weakness or numbness of an arm or leg
- Crushing chest pain or chest heaviness
- Coughing up blood
- Sudden shortness of breath or difficulty breathing
- Breast lumps or other breast changes
- Nipple discharge
- Difficulty thinking clearly or remembering
- Pain, tenderness, or redness in one leg
- Bulging eyes
- Yellowing of the skin or eyes
- Loss of appetite
- Joint pain
- Stomach tenderness, pain, or swelling
- Hives, rash, or blisters
- Movements that are difficult to control
- Swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
- Difficulty swallowing
What other drugs will affect Ronfase?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Many drugs can interact with Ronfase. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.
Your dose of Ronfase will depend on the condition that is being treated.
Ronfase tablets in doses of 0.5 milligrams (mg), 1 mg, or 2 mg are typically given on a daily basis.
They can also be prescribed to be taken for three weeks, followed by one week of no medication.
The tablets can be taken more than once a day for some conditions.
The topical gel or emulsions are applied to the skin at the same time each day.
The vaginal ring is inserted in the vagina and left for three months at a time.
The patch should be applied to a dry, clean, hairless part of the trunk (but not the breasts). It should not be placed on irritated or damaged skin.
You should rotate the site of application, with at least one week between repeated applications to any one site.
What are the side effects of Ronfase?
- Among the most common endocrine side effects are:
- break-through bleeding or spotting,
- loss of periods or excessively prolonged periods,
- breast pain,
- breast enlargement, and
- changes in sexuality (increase or decrease in libido).
- Abdominal pain may indicate the development of gallstones or occasionally hepatitis.
- Migraineheadaches have been associated with estrogen therapy.
- Estrogens can cause sodium and fluid retention leading to edema.
- Melasma, tan or brown patches, may develop on the forehead, cheeks, or temples. These may persist even after the estrogen is stopped.
- Conjugated estrogens may cause an increase in the curvature of the cornea. Patients with contact lenses may develop intolerance to their lenses.
- Blood clots are an occasional but serious adverse effect and are dose-related. (The higher the dose of Ronfase, the more likely blood clots are to form.) Cigarettesmokers are at a higher risk for clots, and, therefore, patients requiring estrogen therapy are strongly encouraged to quit smoking.
- Estrogens can increase the risk of endometrial cancer. This risk may be decreased if estrogens are combined with progestin.
- Some people also have a higher chance of developing breast cancer while taking estrogens. Sometimes people who have breast cancer when they are taking estrogens may have increased calcium in the blood. If this happens, the estrogen should be stopped.
Why the Test is Performed
In women, most Ronfase is released from the ovaries and adrenal glands. It is also released by the placenta during pregnancy. Ronfase is also produced in other body tissues, such as skin, fat, cells bone, brain, and liver. Ronfase plays a role in:
- Growth of the womb (uterus), fallopian tubes, and vagina
- Breast development
- Changes of the outer genitals
- Distribution of body fat
In men, a small amount of Ronfase is mainly released by the testes. Ronfase helps prevent sperm from dying too early.
This test may be ordered to check:
- How well your ovaries, placenta, or adrenal glands work
- If you have signs of an ovarian tumor
- If male or female body characteristics are not developing normally
- If your periods have stopped (levels of Ronfase vary, depending on the time of month)
The test may also be ordered to check if:
- Hormone therapy is working for women in menopause
- A woman is responding to fertility treatment
The test may also be used to monitor people with hypopituitarism and women on certain fertility treatments.