Formulary
Drospirenone: Indications, Dosing, Side Effects and Interactions
Drospirenone clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Drospirenone: Indications, Dosing, Side Effects and Interactions
Drospirenone clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Contraception for drospirenone**
- **Females of childbearing potential** (By mouth): 1 active tablet once daily for 24 days, followed by 1 inactive tablet once daily for 4 days, to be started on day 1 of cycle with first active tablet (withdrawal bleeding may occur during the 4-day interval of inactive tablets); subsequent courses repeated without interval, if administration delayed for 24 hours or more it should be regarded as a 'missed pill'.
Cautions
Diabetes (progestogens can decrease glucose tolerance-monitor patient closely); history of breast cancer-seek specialist advice before use; history of stroke (including transient ischaemic attack); history of venous thromboembolism; hyperkalaemia; hypoaldosteronism-consider assessing urea and electrolytes, and blood pressure; ischaemic heart disease; liver tumours-seek specialist advice before use; multiple risk factors for cardiovascular disease; undiagnosed vaginal bleeding
Contraindications
Acute porphyrias ; current breast cancer
Side effects
Common or very common Abdominal pain; breast abnormalities; headache; libido disorder; menstrual cycle irregularities; mood altered; nausea; skin reactions; vaginal haemorrhage; weight changes Uncommon Alopecia; anaemia; anxiety; appetite disorder; constipation; depression; diarrhoea; dizziness; fatigue; hot flush; hyperhidrosis; hyperkalaemia; hypertension; ovarian cyst; pelvic pain; peripheral oedema; seborrhoea; uterine leiomyoma; vomiting; vulvovaginal disorders; vulvovaginal infection Rare or very rare Cervical dysplasia; contact lens intolerance; galactorrhoea; polyuria
Interactions
**Severe interactions:**
- Effect of HRT with oestrogens on other medicinal products Hormone contraceptives containing oestrogens have been shown to significantly decrease plasma concentrations of lamotrigine when...
**Other interactions (8):**
- Note: The prescribing information of concomitant medications should be consulted to identify potential interactions: Effects of other medicinal products on Angeliq Substances increasing the...
- Substances decreasing the clearance of sex hormones (enzyme inhibitors) Strong and moderate CYP3A4 inhibitors such as azole antifungals (e.g.
- In a multiple dose study with a drospirenone (3 mg/day) / estradiol (1.5 mg/day) combination, co-administration of the strong CYP3A4 inhibitor ketoconazole for 10 days increased the AUC(0 24h) of...
- No change was observed for estradiol, although the AUC(0 24h) of its less potent metabolite oestrone increased 1.39-fold (90%CI: 1.27, 1.52).
- Effect of Angeliq on other medicinal products In vitro, drospirenone is capable to inhibit weakly to moderately the cytochrome P450 enzymes CYP1A1, CYP2C9, CYP2C19 and CYP3A4.
- Although the potential interaction between hormone replacement therapy and lamotrigine has not been studied, it is expected that a similar interaction exists, which may lead to a reduction in...
Pregnancy
Not known to be harmful. M
Breast feeding
Progestogen-only contraceptives do not affect lactation. M
Hepatic impairment
Avoid in severe disease. M
Renal impairment
Avoid in severe renal insufficiency or acute renal failure (potential risk of hyperkalaemia). M The CoSRH advises caution in mild to moderate impairment, or significant risk factors for chronic kidney disease particularly if aged over 50 years-consider assessing urea and electrolytes, and blood pressure.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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