Drug Interaction Report

Ticagrelor may increase the blood levels of drospirenone in some patients. This can increase the risk of developing hyperkalemia, or high levels of potassium in the blood, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. Hyperkalemia is usually more likely to occur in people who are 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), or prescription medications such as potassium supplements or certain medications used to treat high blood pressure or heart conditions, may also increase the risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, 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.

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

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.

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of ethinyl estradiol may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 1A2. In a study of 30 healthy volunteers administered the CYP450 1A2 substrate tizanidine, the systemic exposure (AUC) of tizanidine was 3.9 times greater in women using an oral contraceptive containing ethinyl estradiol.

MANAGEMENT: Patients should be monitored for increased adverse effects of the CYP450 1A2 substrate during concomitant use with ethinyl estradiol. Product labeling for the specific CYP450 1A2 substrate should be consulted for additional recommendations.

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

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