Drug interactions
Ethinyl estradiol-drospirenone + Tacrolimus
Severity: Moderate
Ethinyl estradiol-drospirenone and Tacrolimus: 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
Ethinyl estradiol may weakly inhibit CYP3A4 and raise tacrolimus concentrations, which have a narrow therapeutic range. Higher levels raise the risk of nephrotoxicity and neurotoxicity. Estrogen-containing contraceptives also carry hypertension and thrombotic concerns in transplant recipients.
What this interaction means in plain words
Ethinyl estradiol-drospirenone and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Weak CYP3A4 inhibition by ethinyl estradiol reduces tacrolimus clearance.
What to do
Monitor tacrolimus trough levels and renal function when starting or stopping the contraceptive, and consider non-estrogen methods in transplant patients.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Ethinyl estradiol-drospirenone with Tacrolimus?
MediHelp rates the interaction as moderate. Ethinyl estradiol-drospirenone and Tacrolimus 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 may weakly inhibit CYP3A4 and raise tacrolimus concentrations, which have a narrow therapeutic range. Higher levels raise the risk of nephrotoxicity and neurotoxicity. Estrogen-containing contraceptives also carry hypertension and thrombotic concerns in transplant recipients.
How serious is the interaction between Ethinyl estradiol-drospirenone and Tacrolimus?
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 tacrolimus trough levels and renal function when starting or stopping the contraceptive, and consider non-estrogen methods in transplant patients.
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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