Drug interactions
Atazanavir + Ethinyl estradiol-drospirenone
Severity: Major
Atazanavir and Ethinyl estradiol-drospirenone: major 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
Atazanavir can alter ethinyl estradiol and progestin exposure, and boosted regimens may reduce ethinyl estradiol while atazanavir raises some progestin levels. This may compromise contraceptive efficacy or increase progestin-related effects such as hyperkalemia with drospirenone.
What this interaction means in plain words
Atazanavir and Ethinyl estradiol-drospirenone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Ethinyl estradiol-drospirenone belongs to Endocrine.
Why it happens
Atazanavir inhibits CYP3A4 and UGT1A1, altering metabolism of the hormones, and ritonavir boosting may induce glucuronidation of ethinyl estradiol.
What to do
Use a non-hormonal or alternative contraceptive method, or follow labeling for the combined product dose. If drospirenone is continued, monitor serum potassium.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone Major
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Ethinyl estradiol-drospirenone?
MediHelp rates the interaction as major. Atazanavir and Ethinyl estradiol-drospirenone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir can alter ethinyl estradiol and progestin exposure, and boosted regimens may reduce ethinyl estradiol while atazanavir raises some progestin levels. This may compromise contraceptive efficacy or increase progestin-related effects such as hyperkalemia with drospirenone.
How serious is the interaction between Atazanavir and Ethinyl estradiol-drospirenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a non-hormonal or alternative contraceptive method, or follow labeling for the combined product dose. If drospirenone is continued, monitor serum potassium.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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