Drospirenone

How it works

It provides contraception chiefly by inhibiting ovulation, with additional effects on cervical mucus and the endometrium; its anti-mineralocorticoid action counteracts oestrogen-related fluid retention.

Prescribing in practice

• Because of its anti-mineralocorticoid effect, use caution and consider potassium monitoring when co-prescribed with other potassium-raising drugs, as hyperkalaemia can occur.
• When used in a combined preparation, the standard venous thromboembolism risks and contraindications of combined hormonal contraception apply.
• The progestogen-only drospirenone pill provides an oestrogen-free option with a more forgiving missed-pill window than older progestogen-only pills.

Monitoring

Monitor blood pressure; consider checking serum potassium in women also taking other agents that raise potassium or with relevant renal impairment.

Counselling the patient

• Take the pill regularly as directed and follow missed-pill advice for your specific product.
• Report symptoms of a blood clot such as calf swelling, breathlessness or chest pain promptly.
• Tell your clinician about other medicines, particularly those affecting potassium levels.

Evidence & guidelines

Drospirenone-containing contraceptives are established options within UK contraceptive guidance, with attention to thromboembolic and potassium-related considerations.