Drug interactions
Ethinyl estradiol-drospirenone + Hemin
Severity: Moderate
Ethinyl estradiol-drospirenone and Hemin: 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
Estrogens can precipitate or aggravate acute porphyria attacks by inducing hepatic aminolevulinic acid synthase, which is the pathway hemin is used to suppress. Estrogen exposure may therefore counteract hemin treatment of an attack.
What this interaction means in plain words
Ethinyl estradiol-drospirenone and Hemin 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.
Ethinyl estradiol-drospirenone belongs to Endocrine; Hemin belongs to Miscellaneous.
Why it happens
Estrogen induction of hepatic ALA synthase opposes the feedback suppression produced by hemin.
What to do
Stop estrogen-containing contraceptives in a patient with acute porphyria and use a non-hormonal or progestin-only alternative judged safe for porphyria.
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 Hemin
- Hemin + Secobarbital Major
- Argatroban + Hemin Moderate
- Bazedoxifene-conjugated estrogens + Hemin Moderate
- Dabigatran etexilate + Hemin Moderate
- Dalteparin + Hemin Moderate
- Desogestrel-ethinyl estradiol + Hemin Moderate
Frequently asked questions
Can I take Ethinyl estradiol-drospirenone with Hemin?
MediHelp rates the interaction as moderate. Ethinyl estradiol-drospirenone and Hemin 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. Estrogens can precipitate or aggravate acute porphyria attacks by inducing hepatic aminolevulinic acid synthase, which is the pathway hemin is used to suppress. Estrogen exposure may therefore counteract hemin treatment of an attack.
How serious is the interaction between Ethinyl estradiol-drospirenone and Hemin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Stop estrogen-containing contraceptives in a patient with acute porphyria and use a non-hormonal or progestin-only alternative judged safe for porphyria.
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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