Drug interactions
Ethinyl estradiol-drospirenone + Nefazodone
Severity: Moderate
Ethinyl estradiol-drospirenone and Nefazodone: 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
Nefazodone is a potent CYP3A4 inhibitor and can raise ethinyl estradiol exposure, potentially increasing estrogen-related adverse effects such as nausea, breast tenderness and thrombotic risk. It may also raise drospirenone exposure, which matters because drospirenone has antimineralocorticoid activity and can raise potassium.
What this interaction means in plain words
Ethinyl estradiol-drospirenone and Nefazodone 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
Nefazodone inhibits CYP3A4, reducing the metabolism of ethinyl estradiol and drospirenone.
What to do
Monitor for estrogenic adverse effects and consider checking serum potassium if the patient has renal impairment or takes other potassium-raising drugs. Consider an alternative antidepressant if tolerability problems arise.
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
Frequently asked questions
Can I take Ethinyl estradiol-drospirenone with Nefazodone?
MediHelp rates the interaction as moderate. Ethinyl estradiol-drospirenone and Nefazodone 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. Nefazodone is a potent CYP3A4 inhibitor and can raise ethinyl estradiol exposure, potentially increasing estrogen-related adverse effects such as nausea, breast tenderness and thrombotic risk. It may also raise drospirenone exposure, which matters because drospirenone has antimineralocorticoid activity and can raise potassium.
How serious is the interaction between Ethinyl estradiol-drospirenone and Nefazodone?
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 consider checking serum potassium if the patient has renal impairment or takes other potassium-raising drugs. Consider an alternative antidepressant if tolerability problems arise.
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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