Drug interactions
Enalapril + Ethinyl estradiol-drospirenone
Severity: Moderate
Enalapril and Ethinyl estradiol-drospirenone: 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
Drospirenone has antimineralocorticoid activity and retains potassium. Together with an ACE inhibitor, which also reduces potassium excretion, serum potassium can rise and occasionally cause clinically significant hyperkalemia, particularly in patients with renal impairment.
What this interaction means in plain words
Enalapril and Ethinyl estradiol-drospirenone 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.
Enalapril belongs to Cardiovascular; Ethinyl estradiol-drospirenone belongs to Endocrine.
Why it happens
Additive potassium retention from aldosterone antagonism by drospirenone and reduced aldosterone secretion from ACE inhibition.
What to do
Check serum potassium during the first treatment cycle in patients on long-term ACE inhibitors. Avoid the combination in renal impairment or if potassium is already elevated.
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 Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone Major
Other interactions of Enalapril
- Aliskiren + Enalapril Contraindicated
- Enalapril + Protein a column Contraindicated
- Enalapril + Sacubitril / valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Amifostine + Enalapril Major
- Amiloride + Enalapril Major
Frequently asked questions
Can I take Enalapril with Ethinyl estradiol-drospirenone?
MediHelp rates the interaction as moderate. Enalapril and Ethinyl estradiol-drospirenone 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 has antimineralocorticoid activity and retains potassium. Together with an ACE inhibitor, which also reduces potassium excretion, serum potassium can rise and occasionally cause clinically significant hyperkalemia, particularly in patients with renal impairment.
How serious is the interaction between Enalapril and Ethinyl estradiol-drospirenone?
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 in patients on long-term ACE inhibitors. Avoid the combination in renal impairment or if potassium is already elevated.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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