For most dermatologic procedures—with the notable exception of large-quantity liposuction—malignant hypertension is not an issue because so little epinephrine is used.
▸ Antibiotics and oral contraceptives. Whether antibiotics interfere with oral contraceptives has been controversial for years, Dr. Lebwohl said.
In one study, women taking antibiotics and birth control pills had a contraceptive failure rate of 1.6%. The failure rate, however, is 1% in women on oral contraceptives alone, so the difference is not statistically significant. Nonetheless, there have been numerous reports of pregnancies, particularly in women on low-dose estrogen pills, so “be cautious and warn them about the potential interaction,” he said.
▸ Acitretin and ethanol. The belief that postmenopausal women and men must avoid alcohol while taking acitretin is incorrect. “I don't think a month goes by in my practice where a male or a postmenopausal female comes in saying they can't take acitretin because they would have to give up all alcohol,” Dr. Lebwohl said.
The risk with this combination is that, in the presence in alcohol, acitretin is converted to etretinate, which has a much longer period of teratogenicity. The real risk is only in women with childbearing potential.
Combining methotrexate and trimethoprim-sulfamethoxazole 'is known as Kevorkian therapy for psoriasis.' DR. LEBWOHL