Drug interactions
Drospirenone + Sulfamethoxazole
Severity: Moderate
Drospirenone and Sulfamethoxazole: 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
Sulfamethoxazole is usually combined with trimethoprim, which blocks epithelial sodium channels and can cause hyperkalemia, and drospirenone adds anti-mineralocorticoid potassium-sparing activity. The combination can raise serum potassium, particularly with renal impairment, diabetes or other potassium-raising drugs.
What this interaction means in plain words
Drospirenone and Sulfamethoxazole 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
Additive potassium retention from drospirenone's aldosterone antagonism and trimethoprim's sodium-channel blockade in the distal nephron.
What to do
Measure serum potassium and renal function at baseline and within the first week of co-trimoxazole therapy in at-risk patients. Consider an alternative antibiotic if potassium rises or renal function is impaired.
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 Sulfamethoxazole?
MediHelp rates the interaction as moderate. Drospirenone and Sulfamethoxazole 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. Sulfamethoxazole is usually combined with trimethoprim, which blocks epithelial sodium channels and can cause hyperkalemia, and drospirenone adds anti-mineralocorticoid potassium-sparing activity. The combination can raise serum potassium, particularly with renal impairment, diabetes or other potassium-raising drugs.
How serious is the interaction between Drospirenone and Sulfamethoxazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure serum potassium and renal function at baseline and within the first week of co-trimoxazole therapy in at-risk patients. Consider an alternative antibiotic if potassium rises or renal function is impaired.
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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