Drospirenone

Mechanism :

It is a spironolactone analogue that is antimineralocorticoid and antiandrogenic. This drug acts by suppressing ovulation, thickening cervical mucus, and altering the endometrium.

Indication :

It is used for contraception.

Contraindications :

• Renal insufficiency

• Adrenal insufficiency

• Cervical cancer

• Benign/malignant liver tumor

• Hepatic insufficiency

• Abnormal uterine bleeding

• bleeding

During pregnancy, there is no data suggesting teratogenesis but there is no reason to continue this drug. A very small amount of the drug is excreted in the breastmilk.

Dosing :

1 tablet is 4 mg to be taken perorally.

Start on the first day of the menstrual cycle for 24 days and then for the next 4 days 4 inert tablets. They are supposed to be at the same time every day.

Adverse Effect :

Breakthrough bleeding, acne, increased bleeding, headache, mastalgia, weight gain, increased weight, decreased libido, depression, and irregular menstruation.

Interaction :

• Amiloride: increase sodium level

• Belzutifan, mavacamten, mobocertinib: decreases levels by affecting CYP3A4 metabolism.

• Eplerenone: synergism

• Fedratinib: increase the level

• isavuconazonium sulfate, lonafarnib: increases levels by affecting CYP3A4 metabolism.

• potassium acid phosphate, potassium chloride, potassium citrate, potassium phosphates, IV, spironolactone, triamterene: increase potassium level

Hepatic Dose :

Contraindicated in hepatic impairment.