Drug interactions
Ethinyl estradiol-drospirenone + Rifabutin
Severity: Major
Ethinyl estradiol-drospirenone and Rifabutin: major interaction.
Last updated Sources: US FDA label
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
Rifabutin induces hepatic enzymes and can reduce contraceptive hormone exposure, though less than rifampin. Contraceptive failure and breakthrough bleeding may result.
What this interaction means in plain words
Ethinyl estradiol-drospirenone and Rifabutin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ethinyl estradiol-drospirenone belongs to Endocrine; Rifabutin belongs to Anti Bacterial.
Why it happens
CYP3A4 induction by rifabutin increases clearance of ethinyl estradiol and progestin.
What to do
Use a non-hormonal contraceptive method, such as an IUD, during rifabutin therapy and for a period after stopping.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Ethinyl estradiol-drospirenone with Rifabutin?
MediHelp rates the interaction as major. Ethinyl estradiol-drospirenone and Rifabutin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifabutin induces hepatic enzymes and can reduce contraceptive hormone exposure, though less than rifampin. Contraceptive failure and breakthrough bleeding may result.
How serious is the interaction between Ethinyl estradiol-drospirenone and Rifabutin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a non-hormonal contraceptive method, such as an IUD, during rifabutin therapy and for a period after stopping.
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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