Drospirenone and ethinyl estradiol and Fludrocortisone interaction

Drospirenone and ethinyl estradiol and Fludrocortisone: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Drospirenone and ethinyl estradiol (Yaz) label · effective 2025-05-29

Moderate

• Hyperkalemia : DRSP has anti-mineralocorticoid activity.

Warnings and precautionsby drug classView label on DailyMed
Moderate

…[See Adverse Reactions ( 6 ).] Figure 1: VTE Risk with Yasmin Relative to LNG-Containing COCs (adjusted risk#) Figure 2 Likelihood of Developing a VTE 5.2 Hyperkalemia Yaz contains 3 mg of the progestin DRSP which has anti-mineralocorticoid activity, including the potential for hyperkalemia in high-risk patients, comparable to a 25 mg dose of spironolactone.

Warnings and precautionsby drug classView label on DailyMed
Moderate

DRSP causes an increase in plasma renin activity and plasma aldosterone induced by its mild anti-mineralocorticoid activity.

Warnings and precautionsby drug classView label on DailyMed
Minor

Steroid hormones may be poorly metabolized in patients with impaired liver function.

Warnings and precautionsby drug classView label on DailyMed
Minor

Antibiotics : There have been reports of pregnancy while taking hormonal contraceptives and antibiotics, but clinical pharmacokinetic studies have not shown consistent effects of antibiotics on plasma concentrations of synthetic steroids.

Drug interactionsby drug classView label on DailyMed

From the Fludrocortisone (Fludrocortisone Acetate) label · effective 2026-05-06

Moderate

Estrogen —increased levels of corticosteroid-binding globulin thereby increasing the bound (inactive) fraction; this effect is at least balanced by decreased metabolism of corticosteroids.

Drug interactionsby drug classView label on DailyMed
Moderate

When estrogen therapy is initiated, a reduction in corticosteroid dosage may be required, and increased amounts may be required when estrogen is terminated.

Drug interactionsby drug classView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.