Drug interactions
Drospirenone + Rifabutin
Severity: Moderate
Drospirenone and Rifabutin: 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
Rifabutin is an inducer of CYP3A4 and can lower exposure to the progestin in drospirenone-containing contraceptives, risking reduced contraceptive efficacy and breakthrough bleeding. The legacy direction (drospirenone raising rifabutin) is not clinically relevant.
What this interaction means in plain words
Drospirenone and Rifabutin 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.
Drospirenone belongs to Endocrine; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces hepatic CYP3A4, increasing drospirenone metabolism and lowering its plasma concentrations.
What to do
Advise an additional non-hormonal contraceptive method during rifabutin therapy and for a period after stopping it, or choose a non-hormonal or long-acting alternative method.
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
Other interactions of Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Drospirenone with Rifabutin?
MediHelp rates the interaction as moderate. Drospirenone and Rifabutin 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. Rifabutin is an inducer of CYP3A4 and can lower exposure to the progestin in drospirenone-containing contraceptives, risking reduced contraceptive efficacy and breakthrough bleeding. The legacy direction (drospirenone raising rifabutin) is not clinically relevant.
How serious is the interaction between Drospirenone and Rifabutin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise an additional non-hormonal contraceptive method during rifabutin therapy and for a period after stopping it, or choose a non-hormonal or long-acting alternative method.
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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