Drug interactions
Drospirenone + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Moderate
Drospirenone and Elvitegravir / cobicistat / emtricitabine / tenofovir df: moderate interaction.
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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
Cobicistat is a strong CYP3A inhibitor and raises drospirenone exposure. Drospirenone is a potassium-sparing progestin, so higher levels raise the risk of hyperkalemia, especially with renal impairment or other potassium-raising drugs. The label advises caution with this combination.
What this interaction means in plain words
Drospirenone and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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.
Why it happens
Cobicistat inhibits CYP3A4, reducing drospirenone clearance and increasing its exposure.
What to do
Check serum potassium during the first treatment cycle and avoid the combination in patients with renal, adrenal or hepatic impairment. Consider an alternative contraceptive that does not depend on drospirenone if potassium rises.
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 Drospirenone
Frequently asked questions
Can I take Drospirenone with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as moderate. Drospirenone and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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. Cobicistat is a strong CYP3A inhibitor and raises drospirenone exposure. Drospirenone is a potassium-sparing progestin, so higher levels raise the risk of hyperkalemia, especially with renal impairment or other potassium-raising drugs. The label advises caution with this combination.
How serious is the interaction between Drospirenone and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium during the first treatment cycle and avoid the combination in patients with renal, adrenal or hepatic impairment. Consider an alternative contraceptive that does not depend on drospirenone if potassium rises.
What other medicines interact with Drospirenone?
MediHelp also lists interactions of Drospirenone with, for example, Belzutifan, Bosentan, Carbamazepine. The full list is on the Drospirenone page.
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