Modify Therapy/Monitor Closely.ketorolacdrospirenone and ketorolac both increase serum potassium. Modify Therapy/Monitor Closely.ketorolac intranasaldrospirenone and ketorolac intranasal both increase serum potassium. Modify Therapy/Monitor Closely.labetalollabetalol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.lamotriginedrospirenone will decrease the level or effect of lamotrigine by increasing hepatic clearance. Use Caution/Monitor. Combination oral contraceptives have been shown to significantly decrease plasma concentrations of lamotrigine, likely due to induction of lamotrigine glucuronidation.lemborexantdrospirenone will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.levalbuteroldrospirenone increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.liraglutidedrospirenone decreases effects of liraglutide by passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.lisinoprillisinopril, drospirenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.lomitapidedrospirenone increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.lonapegsomatropindrospirenone will decrease the level or effect of lonapegsomatropin by Other (see comment). Use Caution/Monitor. Oral estrogens may reduce serum insulin-like growth factor-1 response to lonapegsomatropin. Patients receiving oral estrogen replacement may require higher lonapegsomatropin dosages.drospirenone will decrease the level or effect of lonapegsomatropin by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Oral estrogens may reduce serum insulin-like growth factor I (IGF-1) response to growth hormone (GH) analogs. Higher GH dose may be requiredlornoxicamdrospirenone and lornoxicam both increase serum potassium. Modify Therapy/Monitor Closely.losartanlosartan and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.maravirocdrospirenone increases levels of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity.mavacamtendrospirenone will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. meclofenamatedrospirenone and meclofenamate both increase serum potassium. Modify Therapy/Monitor Closely.mefenamic aciddrospirenone and mefenamic acid both increase serum potassium. Modify Therapy/Monitor Closely.meloxicamdrospirenone and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.metaproterenoldrospirenone increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.metformindrospirenone decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.methyclothiazidedrospirenone increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely. .metolazonedrospirenone increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.metoprololmetoprolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.midazolam intranasaldrospirenone will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.mifepristonemifepristone decreases effects of drospirenone by pharmacodynamic antagonism. Use Caution/Monitor. Backup contraceptive method recommended.moexiprilmoexipril, drospirenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.nabumetonedrospirenone and nabumetone both increase serum potassium. Modify Therapy/Monitor Closely.nadololnadolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.naproxendrospirenone and naproxen both increase serum potassium. Modify Therapy/Monitor Closely.nebivololnebivolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.noni juicedrospirenone and noni juice both increase serum potassium. Use Caution/Monitor.norepinephrinedrospirenone increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.olmesartanolmesartan and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.oxaprozindrospirenone and oxaprozin both increase serum potassium. Modify Therapy/Monitor Closely.parecoxibdrospirenone and parecoxib both increase serum potassium. Modify Therapy/Monitor Closely.penbutololpenbutolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.perindoprilperindopril, drospirenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.pindololpindolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.pirbuteroldrospirenone increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.piroxicamdrospirenone and piroxicam both increase serum potassium. Modify Therapy/Monitor Closely.pivmecillinampivmecillinam increases effects of drospirenone by unspecified interaction mechanism. Use Caution/Monitor. Hyperkalemia.potassium citrate/citric aciddrospirenone and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.potassium iodidepotassium iodide and drospirenone both increase serum potassium. Use Caution/Monitor.propranololpropranolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.quinaprilquinapril, drospirenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.ramiprilramipril, drospirenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.sacubitril/valsartansacubitril/valsartan and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.salicylates (non-asa)drospirenone and salicylates (non-asa) both increase serum potassium. Modify Therapy/Monitor Closely.salmeteroldrospirenone increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.salsalatedrospirenone and salsalate both increase serum potassium. Modify Therapy/Monitor Closely.siltuximabsiltuximab, drospirenone. Other (see comment). Use Caution/Monitor. Comment: CYP450 activity in the liver is down regulated by infection and inflammation stimuli including cytokines (eg, IL-6); inhibition of IL-6 by siltuximab may restore CYP450 enzymatic activity; caution if coadministered with CYP substrates that have a narrow therapeutic index.somapacitandrospirenone will decrease the level or effect of somapacitan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Oral estrogens may reduce serum insulin-like growth factor I (IGF-1) response to growth hormone (GH) analogs. Higher GH dose may be requiredsomatrogondrospirenone will decrease the level or effect of somatrogon by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Oral estrogens may reduce serum insulin-like growth factor I (IGF-1) response to growth hormone (GH) analogs. Higher GH dose may be requiredsomatropindrospirenone will decrease the level or effect of somatropin by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Oral estrogens may reduce serum insulin-like growth factor I (IGF-1) response to growth hormone (GH) analogs. Higher GH dose may be requiredsotalolsotalol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.sparsentansparsentan and drospirenone both increase serum potassium. Use Caution/Monitor. Monitor serum potassium frequently.succinylcholinedrospirenone and succinylcholine both increase serum potassium. Modify Therapy/Monitor Closely.sulfasalazinedrospirenone and sulfasalazine both increase serum potassium. Modify Therapy/Monitor Closely.sulindacdrospirenone and sulindac both increase serum potassium. Modify Therapy/Monitor Closely.tazemetostatdrospirenone will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.telmisartantelmisartan and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.temocillintemocillin increases effects of drospirenone by unspecified interaction mechanism. Use Caution/Monitor. Hyperkalemia.terbutalinedrospirenone increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.ticarcillinticarcillin increases effects of drospirenone by unspecified interaction mechanism. Use Caution/Monitor. Hyperkalemia.timololtimolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.tinidazoledrospirenone will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tolfenamic aciddrospirenone and tolfenamic acid both increase serum potassium. Modify Therapy/Monitor Closely.tolmetindrospirenone and tolmetin both increase serum potassium. Modify Therapy/Monitor Closely.tolvaptandrospirenone and tolvaptan both increase serum potassium. Modify Therapy/Monitor Closely.torsemidedrospirenone increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.trandolapriltrandolapril, drospirenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.valoctocogene roxaparvovecdrospirenone and valoctocogene roxaparvovec both increase Other (see comment). Use Caution/Monitor. Medications that may cause hepatotoxicity when combined with valoctogene roxaparvovec may potentiate the risk of elevated liver enzymes. Closely monitor these medications and consider alternative medications in case of potential drug interactions.valsartanvalsartan and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.voclosporinvoclosporin and drospirenone both increase serum potassium. Use Caution/Monitor.warfarindrospirenone increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.xipamidexipamide increases effects of drospirenone by pharmacodynamic synergism. Use Caution/Monitor.Minor (34)agrimonyagrimony increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.birchbirch increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.brimonidinebrimonidine increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.cadexomer iodinecadexomer iodine, drospirenone. Mechanism: decreasing renal clearance. Minor/Significance Unknown. Hyperkalemia.calcium acetatedrospirenone decreases levels of calcium acetate by increasing renal clearance. Minor/Significance Unknown.calcium carbonatedrospirenone decreases levels of calcium carbonate by increasing renal clearance. Minor/Significance Unknown.calcium chloridedrospirenone decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.calcium citratedrospirenone decreases levels of calcium citrate by increasing renal clearance. Minor/Significance Unknown.calcium gluconatedrospirenone decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.cornsilkcornsilk increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.enasidenibenasidenib, drospirenone. unknown mechanism. Minor/Significance Unknown. Coadministration of enasidenib may increase or decrease the concentrations of combined hormonal contraceptives. Clinical significance of this interaction is unknown.epoprostenolepoprostenol increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.forskolinforskolin increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.goldenrodgoldenrod increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.iodinated glyceroliodinated glycerol, drospirenone. Mechanism: decreasing renal clearance. Minor/Significance Unknown. Hyperkalemia.iodineiodine, drospirenone. Mechanism: decreasing renal clearance. Minor/Significance Unknown. Hyperkalemia.magnesium chloridedrospirenone increases levels of magnesium chloride by decreasing renal clearance. Minor/Significance Unknown.magnesium citratedrospirenone increases levels of magnesium citrate by decreasing renal clearance. Minor/Significance Unknown.magnesium hydroxidedrospirenone increases levels of magnesium hydroxide by decreasing renal clearance. Minor/Significance Unknown.magnesium oxidedrospirenone increases levels of magnesium oxide by decreasing renal clearance. Minor/Significance Unknown.magnesium sulfatedrospirenone increases levels of magnesium sulfate by decreasing renal clearance. Minor/Significance Unknown.maitakemaitake increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.minoxidildrospirenone increases effects of minoxidil by pharmacodynamic synergism. Minor/Significance Unknown.octacosanoloctacosanol increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.reishireishi increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.ruxolitinibdrospirenone will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicaldrospirenone will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.shepherd's purseshepherd's purse, drospirenone. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.sulfadiazinedrospirenone increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.sulfamethoxazoledrospirenone, sulfamethoxazole. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Hyperkalemia.drospirenone increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.sulfisoxazoledrospirenone increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.tizanidinetizanidine increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.treprostiniltreprostinil increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.trimethoprimdrospirenone, trimethoprim. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Hyperkalemia.acebutololMonitor Closely (1)acebutolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.aceclofenacMonitor Closely (1)drospirenone and aceclofenac both increase serum potassium. Modify Therapy/Monitor Closely.acemetacinMonitor Closely (1)drospirenone and acemetacin both increase serum potassium. Modify Therapy/Monitor Closely.agrimonyMinor (1)agrimony increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.albiglutideMonitor Closely (1)drospirenone decreases effects of albiglutide by passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.albuterolMonitor Closely (1)drospirenone increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.aldesleukinMonitor Closely (1)aldesleukin increases effects of drospirenone by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.amilorideSerious - Use Alternative (2)amiloride and drospirenone both increase serum potassium. Avoid or Use Alternate Drug. amiloride, drospirenone. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Hyperkalemia.arformoterolMonitor Closely (1)drospirenone increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.aspirinMonitor Closely (1)drospirenone and aspirin both increase serum potassium. Modify Therapy/Monitor Closely.aspirin rectalMonitor Closely (1)drospirenone and aspirin rectal both increase serum potassium. Modify Therapy/Monitor Closely.aspirin/citric acid/sodium bicarbonateMonitor Closely (1)drospirenone and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Modify Therapy/Monitor Closely.atazanavirMonitor Closely (1)atazanavir, drospirenone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Atazanavir may increase or decrease levels of drospirenone. Use alternatives if available.atenololMonitor Closely (1)atenolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.atogepantMonitor Closely (1)drospirenone will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.avapritinibMonitor Closely (1)drospirenone will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.axitinibMonitor Closely (1)drospirenone increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.belzutifanSerious - Use Alternative (1)belzutifan will decrease the level or effect of drospirenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of belzutifan with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. Advise females of reproductive potential to use effective nonhormonal contraception. Based on animal studies, belzutifan can cause fetal harm.benazeprilMonitor Closely (1)benazepril and drospirenone both increase serum potassium. Use Caution/Monitor.bendroflumethiazideMonitor Closely (1)drospirenone increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.betaxololMonitor Closely (1)betaxolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.birchMinor (1)birch increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.bisoprololMonitor Closely (1)bisoprolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.brimonidineMinor (1)brimonidine increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.bumetanideMonitor Closely (1)drospirenone increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.cadexomer iodineMinor (1)cadexomer iodine, drospirenone. Mechanism: decreasing renal clearance. Minor/Significance Unknown. Hyperkalemia.calaspargase pegolSerious - Use Alternative (1)calaspargase pegol, drospirenone. unknown mechanism. Avoid or Use Alternate Drug. Due to the potential for an indirect interaction between calaspargase pegol and oral contraceptives, concomitant use of these drugs is not recommended. Use another non-oral contraceptive method for females of childbearing potential.calcium acetateMinor (1)drospirenone decreases levels of calcium acetate by increasing renal clearance. Minor/Significance Unknown.calcium carbonateMinor (1)drospirenone decreases levels of calcium carbonate by increasing renal