The Association Between Drospirenone and Hyperkalemia

A Comparative-safety Study

Steven T Bird; Salvatore R Pepe; Mahyar Etminan; Xinyue Liu; James M Brophy; Joseph AC Delaney


BMC Clin Pharmacol. 2011;11(23):1-6. 

In This Article

Future Implications

Although a clinically significant increase in the diagnosis of hyperkalemia was not found in our analysis, a subclinical increase in serum potassium in this population cannot be ruled out. Increased utilization of spironolactone in patients taking drospirenone and poor compliance with the requirement for potassium monitoring in the package insert suggests a lack of attention to the possibility of hyperkalemia. Spironolactone however has a strong association with hyperkalemia, and, for patients taking both spironolactone and drospirenone, it is concerning that so few physicians follow the package insert monitoring recommendations. This suggests that package inserts may not be an effective mechanism for the communication of drug safety information. If an increase in hyperkalemia had been found in patients taking drospirenone, this current monitoring practice may not have been sufficient to detect it.


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