Drug interactions
Drospirenone + Sacubitril / valsartan
Severity: Major
Drospirenone and Sacubitril / valsartan: major interaction.
Last updated Sources: US FDA label
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
Valsartan blocks angiotensin II receptors, reducing aldosterone-driven potassium excretion, and drospirenone adds antimineralocorticoid activity. The combination can cause clinically important hyperkalemia, particularly in heart failure or renal impairment.
What this interaction means in plain words
Drospirenone and Sacubitril / valsartan 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.
Why it happens
Additive hyperkalemia from angiotensin receptor blockade and aldosterone receptor antagonism.
What to do
Prefer a non-drospirenone contraceptive in patients on sacubitril/valsartan; if used, check serum potassium during the first cycle and periodically thereafter.
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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References
Other interactions of Drospirenone
Frequently asked questions
Can I take Drospirenone with Sacubitril / valsartan?
MediHelp rates the interaction as major. Drospirenone and Sacubitril / valsartan 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. Valsartan blocks angiotensin II receptors, reducing aldosterone-driven potassium excretion, and drospirenone adds antimineralocorticoid activity. The combination can cause clinically important hyperkalemia, particularly in heart failure or renal impairment.
How serious is the interaction between Drospirenone and Sacubitril / valsartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-drospirenone contraceptive in patients on sacubitril/valsartan; if used, check serum potassium during the first cycle and periodically thereafter.
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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