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Drug Interactions between eplerenone and Yaz

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

drospirenone eplerenone

Applies to: Yaz (drospirenone / ethinyl estradiol) and eplerenone

Using drospirenone together with eplerenone may increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia while using these medications if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. Regular or long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk. It is important that you maintain adequate fluid intake during treatment with these medications, especially if you are using them for prolonged periods. In addition, talk to your doctor to see if you should limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Major

eplerenone food

Applies to: eplerenone

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of eplerenone. The primary mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Inhibition of hepatic CYP450 3A4 may also contribute. In drug interaction studies, administration of a single 100 mg dose of eplerenone in combination with grapefruit juice resulted in a 25% increase in eplerenone systemic exposure (AUC). High blood levels of eplerenone can increase the risk of side effects including hyperkalemia. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition.

MANAGEMENT: It may be advisable for patients to avoid the consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with eplerenone.

References

  1. "Product Information. Inspra (eplerenone)." Searle (2002):
  2. "Product Information. Eplerenone (eplerenone)." MSN Laboratories Europe Ltd (2021):
  3. "Product Information. Eplerenone (Apotex) (eplerenone)." Apotex Pty Ltd (2023):
Moderate

drospirenone food

Applies to: Yaz (drospirenone / ethinyl estradiol)

Grapefruit juice may increase the blood levels of certain medications such as drospirenone. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with drospirenone. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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Minor

ethinyl estradiol food

Applies to: Yaz (drospirenone / ethinyl estradiol)

Information for this minor interaction is available on the professional version.

Minor

ethinyl estradiol food

Applies to: Yaz (drospirenone / ethinyl estradiol)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Potassium sparing diuretics

Therapeutic duplication

The recommended maximum number of medicines in the 'potassium sparing diuretics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'potassium sparing diuretics' category:

  • eplerenone
  • Yaz (drospirenone/ethinyl estradiol)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.