Drospirenone 4mg tablets
Requires a prescription from a doctor or prescriber
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Yellow Card reports
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Suspected adverse reactions reported for Drospirenone
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Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
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Suspected adverse reactions reported for Drospirenone
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1 branded products available
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Slynd 4mg tablets
This is the NHS Drug Tariff indicative price used for reimbursement purposes. It may not reflect the price paid by patients or pharmacies.
View full Drug TariffSource: NHS Drug Tariff via NHSBSA. Derived from dm+d VMPP (Virtual Medicinal Product Pack) pricing data. Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Guidelines from the National Institute for Health and Care Excellence
NICE clinical guidance(1)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
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Supply & safety information
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Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF code shown is the factual mapping value distributed by NHS Business Services Authority (NHSBSA) in the dm+d supplementary file under OGL v3.0; it is not affiliated with, nor licensed from, the publishers of the British National Formulary. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 13 · Randomised trials: 23 · 1995–2026
Showing the 50 most relevant studies, sorted by most relevant.
CQ Wu, Sonia M. Grandi, Kristian B. Filion, et al.
BJOG An International Journal of Obstetrics & Gynaecology, 2013
- Androstenes
- Arteries
- Contraceptives, Oral, Hormonal
David F. Archer, Ian H. Thorneycroft, Marie L. Foegh, et al.
Menopause The Journal of The North American Menopause Society, 2005
- Mineralocorticoid Receptor Antagonists
- Androstenes
- Blood Pressure
Tasuku Harada, Saori Kosaka, J. Elliesen, et al.
Fertility and Sterility, 2017
- Androstenes
- Contraceptives, Oral, Combined
- Endometriosis
Jing Li, Jing Ren, Wenxia Sun
European journal of obstetrics, gynecology, and reproductive biology, 2017
N. Larivée, N. Larivée, S. Suissa, et al.
BJOG: An International Journal of Obstetrics & Gynaecology, 2017
Amr Menshawy, Ammar Ismail, Mohamed Abdel-Maboud, et al.
Journal of gynecology obstetrics and human reproduction, 2019
Jinghua Shi, Jinhua Leng
Frontiers in Medicine, 2022
Jinghua Shi (252041), Jinhua Leng (5518013)
2022
Xu Zhao, Xiao-Fang Zhang, Yang Zhao, et al.
Gynecological Endocrinology, 2016
Kristina Biskupska-Bodova, Joanna Sójka-Kupny, Tamás Nyirády, et al.
The European Journal of Contraception & Reproductive Health Care, 2024
- Androstenes
- Nandrolone
- Ethinyl Estradiol
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
30 hours
Mechanism
Drospirenone and ethinyl estradiol in combination suppress the release of follic…
Food interactions
3 warnings
Human targets
4 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
76%
[A182591][L7973]…
Half-life
30 hours
[A182591]…
Protein binding
95%
[A2439]…
Volume of distribution
4 L/kg
[L7973]…
Metabolism
Elimination
10 days
Clearance
2-3 days
[A182597]…
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Drospirenone has been the subject of widespread safety concern due to the possibility of an increased risk of venous thromboembolism associated with its use.[A182543][A182552] In 2012, however, a safety statement by the FDA concluded that the increase in the risk of thromboembolism resulting from the use of drospirenone remains unclear, as studies regarding this risk are conflicting. Some studies have demonstrated a significantly increased risk and some demonstrating no risk of thromboembolic events. In its statement, the FDA has mentioned that increased risk of venous thromboembolism with oral contraceptives such as drospirenone exists but remains lower than the risk of this condition during pregnancy and during the postpartum period, and this should be considered when assessing potential risks of hormonal contraceptive use.[L7979]
[L7973][L33174]
In addition to its use for contraceptive effects, this combination is used to treat moderate acne vulgaris and the symptoms of premenstrual dysphoric disorder.
[L7973][L7976]
The drug has approved indications for combination with estrogens for the treatment of menopause-associated symptoms, such as vasomotor symptoms and vulvovaginal atrophy. Drospirenone combined with estrogen may also may aid in the prevention of osteoporosis in women who have been post-menopausal for at least a year and are not candidates for other therapies.
[L7997][L8075]
It can sometimes be found in preparations containing estrogen and folic acid for folic acid replenishment during oral contraception.
[L8078]
When used for the treatment of acne vulgaris, drospirenone-containing contraceptives should only be used in women ≥14 years of age who have experienced menarche, desire oral contraception, and do not have any contraindications to oral contraceptives.
[L7976]
Off-label uses for this drug include the treatment of menstrual irregularities, dysmenorrhea, hirsutism, and endometriosis.
[A2439][A182576]
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 1550 interactions
[L7994]
Overdose information
An overdose of drospirenone, like other oral contraceptives, may lead to cause nausea or withdrawal bleeding. For drospirenone in particular, as an analog of spironolactone, may affect the levels of serum sodium and potassium. Their concentrations should be monitored in cases of overdose in addition to monitoring from metabolic acidosis and hyperkalemia, which may also result.
[A182600][L7973]
Drospirenone is an analog of the diuretic spironolactone, which exerts anti-mineralocorticoid activity, blocking aldosterone receptors, which increases sodium and water excretion.[A2439] Studies in animals have demonstrated that drospirenone administration leads to antiandrogenic activity. This activity helps to oppose the effects of naturally occurring androgens, inhibiting the binding of dihydrotestosterone (DHT) to its receptor, and preventing androgen synthesis in the ovaries, helping to treat acne and hirsutism.[A2439][A182588][L7973] Drospirenone may also decrease the level of edema in sebaceous follicle during the second half of the menstrual cycle, when acne often appears.[L7973]
A note on venous thromboembolism risk and antimineralcorticoid effects
As with other oral contraceptives, the risk of venous thromboembolism and cardiovascular events may be increased when drospirenone is taken. The risk is especially higher in smokers and women aged 35 and older. Women taking this drug should be advised not to smoke. In addition, drospirenone, due to its antimineralcorticoid effects, may increase the risk of hyperkalemia. Patients at high risk for hyperkalemia should not be administered this drug. Consult the official prescribing information for detailed and updated information on the cardiovascular and other risks associated with drospirenone use.[L7973][L7976][L7997]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[A182591][L7973]
The maximum plasma concentration of drospirenone occurs within 1 to 2 hours after oral administration and is estimated to range between 60 and 87 ng/mL.
[A2439]
A European prescribing monograph for the combination product of estradiol and drospirenone indicates that drospirenone is both completely and rapidly absorbed. It reports a Cmax of 21.9 ng/ml, achieved approximately 1-hour post-administration. The absolute bioavailability is reported to range between 76 to 85%.
[L7997]
[A182591]
The half-life of drospirenone metabolite excretion in the urine and feces is approximately 40 hours.
[L7997]
[A2439]
During in vitro studies, drospirenone was found to bind with low affinity to sex hormone-binding globulin (SHBG).
[L7976]
Another reference indicates that drospirenone binds to serum albumin but does not bind to sex hormone-binding globulin (SHBG), nor corticoid binding globulin (CBG). Only 3-5% of the total drospirenone concentration is measured as a free steroid.
[L7997]
[L7973]
Prescribing information from a combination of estradiol and drospirenone estimates the volume of distribution to range from 3.7- 4.2 L/kg.
[L7997]
[A2439][A182591]
Drospirenone also undergoes oxidative metabolism via the hepatic cytochrome enzyme CYP3A4.
[A183044][A35775][L7997]
[L7997]
Between 38% to 47% of the metabolites are identified as glucuronide and sulfate conjugates in the urine. In the feces, approximately 17% to 20% of identifiable metabolites are found to be excreted as glucuronides and sulfates.
[A2439]
[A182597]
The rate of clearance of drospirenone calculated in the serum ranges from 1.2-1.5 ml/min/kg, however, this value can vary by up to 25% according to the patient.
[L7997]
Proteins and enzymes this drug interacts with in the body
PMID:19022849
Transcription factor activity is modulated by bound coactivator and corepressor proteins like ZBTB7A that recruits NCOR1 and NCOR2 to the androgen response elements/ARE on target genes, negatively regulating androgen receptor signaling and androgen-induced cell proliferation .
PMID:20812024
Transcription activation is also down-regulated by NR0B2. Activated, but not phosphorylated, by HIPK3 and ZIPK/DAPK3
PMID:27120390 PMID:37478846
Has a dual mode of action: as a transcription factor that binds to glucocorticoid response elements (GRE), both for nuclear and mitochondrial DNA, and as a modulator of other transcription factors .
PMID:28139699
Affects inflammatory responses, cellular proliferation and differentiation in target tissues. Involved in chromatin remodeling .
PMID:9590696
Plays a role in rapid mRNA degradation by binding to the 5' UTR of target mRNAs and interacting with PNRC2 in a ligand-dependent manner which recruits the RNA helicase UPF1 and the mRNA-decapping enzyme DCP1A, leading to RNA decay .
PMID:25775514
Could act as a coactivator for STAT5-dependent transcription upon growth hormone (GH) stimulation and could reveal an essential role of hepatic GR in the control of body growth (By similarity)
Enzymes involved in drug metabolism — important for understanding drug interactions
ATC G03AA18
ATC G03AC10
ATC G03FA17
ATC G03AA12
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Drospirenone
Additional database identifiers
Drugs Product Database (DPD)
13375
ChemSpider
62105
BindingDB
150275
ZINC
ZINC000003927200
HUGO Gene Nomenclature Committee (HGNC)
HGNC:7979
GenAtlas
NR3C2
GeneCards
NR3C2
GenBank Gene Database
M16801
GenBank Protein Database
307166
Guide to Pharmacology
626
UniProt Accession
MCR_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:644
GenAtlas
AR
GeneCards
AR
GenBank Gene Database
M20132
GenBank Protein Database
178628
Guide to Pharmacology
628
UniProt Accession
ANDR_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:8910
GenAtlas
PGR
GeneCards
PGR
GenBank Gene Database
X51730
GenBank Protein Database
35652
Guide to Pharmacology
627
UniProt Accession
PRGR_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:7978
GenAtlas
NR3C1
GeneCards
NR3C1
GenBank Gene Database
X03225
GenBank Protein Database
31680
Guide to Pharmacology
625
UniProt Accession
GCR_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9605
GenAtlas
PTGS2
GeneCards
PTGS2
GenBank Gene Database
L15326
GenBank Protein Database
291988
Guide to Pharmacology
1376
UniProt Accession
PGH2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9204
GenAtlas
PON1
GeneCards
PON1
GenBank Gene Database
M63012
GenBank Protein Database
190192
UniProt Accession
PON1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:2637
GenAtlas
CYP3A4
GeneCards
CYP3A4
GenBank Gene Database
M18907
Guide to Pharmacology
1337
UniProt Accession
CP3A4_HUMAN
DrugBank citations
If you use DrugBank data in your research, please cite the following publications:
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Structured knowledge from the free knowledge base
ATC classifications (Wikidata)
Linked open data from Wikidata (Q419646), a free and open knowledge base operated by the Wikimedia Foundation. Data is available under the Creative Commons CC0 1.0 Public Domain Dedication. WHO INN from the World Health Organization.