Drug interactions
Drospirenone + Ritonavir
Severity: Moderate
Drospirenone and Ritonavir: 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
Ritonavir is a strong CYP3A4 inhibitor and can raise drospirenone exposure, which is partly cleared by CYP3A4. Higher drospirenone levels increase its potassium-sparing (anti-mineralocorticoid) effect and the risk of hyperkalemia, particularly in patients with renal impairment or on other potassium-raising drugs. Ritonavir-boosted regimens may also alter contraceptive hormone exposure more broadly.
What this interaction means in plain words
Drospirenone and Ritonavir 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; Ritonavir belongs to Anti Virals.
Why it happens
Ritonavir inhibits CYP3A4-mediated metabolism of drospirenone, increasing its plasma concentrations.
What to do
Monitor serum potassium during the first weeks of combined use, especially with renal impairment or other hyperkalemia-causing drugs. Consider an alternative contraceptive method, such as a non-drospirenone option, if potassium rises or the patient is at risk.
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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Drospirenone with Ritonavir?
MediHelp rates the interaction as moderate. Drospirenone and Ritonavir 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. Ritonavir is a strong CYP3A4 inhibitor and can raise drospirenone exposure, which is partly cleared by CYP3A4. Higher drospirenone levels increase its potassium-sparing (anti-mineralocorticoid) effect and the risk of hyperkalemia, particularly in patients with renal impairment or on other potassium-raising drugs. Ritonavir-boosted regimens may also alter contraceptive hormone exposure more broadly.
How serious is the interaction between Drospirenone and Ritonavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium during the first weeks of combined use, especially with renal impairment or other hyperkalemia-causing drugs. Consider an alternative contraceptive method, such as a non-drospirenone option, if potassium rises or the patient is at risk.
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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