Drug interactions
Ethinyl estradiol-drospirenone + Ketoconazole
Severity: Moderate
Ethinyl estradiol-drospirenone and Ketoconazole: 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
Ketoconazole, a strong CYP3A4 inhibitor, raises exposure to drospirenone and ethinyl estradiol. The increase in drospirenone exposure is modest, but the combination may increase estrogenic effects and potassium retention.
What this interaction means in plain words
Ethinyl estradiol-drospirenone and Ketoconazole 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; Ketoconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4 by ketoconazole reduces metabolism of ethinyl estradiol and drospirenone.
What to do
Monitor for estrogenic adverse effects and blood pressure; check serum potassium in patients with risk factors for hyperkalemia during prolonged ketoconazole use.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ethinyl estradiol-drospirenone and Ketoconazole, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Ethinyl estradiol-drospirenone with Ketoconazole?
MediHelp rates the interaction as moderate. Ethinyl estradiol-drospirenone and Ketoconazole 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. Ketoconazole, a strong CYP3A4 inhibitor, raises exposure to drospirenone and ethinyl estradiol. The increase in drospirenone exposure is modest, but the combination may increase estrogenic effects and potassium retention.
How serious is the interaction between Ethinyl estradiol-drospirenone and Ketoconazole?
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 for estrogenic adverse effects and blood pressure; check serum potassium in patients with risk factors for hyperkalemia during prolonged ketoconazole use.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
