Drospirenone
孕激素 C
Drospirenone
Drospirenone
Oral
Drospirenone is a synthetic progestogen structurally derived from spironolactone, possessing simultaneous anti-androgenic and anti-mineralocorticoid (spironolactone-like) activity. A non-mainstream option in transfeminine HRT, its unique pharmacological profile may be valuable in select scenarios [1] .
Mechanism
Section titled “Mechanism”Drospirenone has multiple pharmacological activities:
- Progestogenic activity: Binds progesterone receptors
- Anti-androgenic activity: Competitive androgen receptor binding (similar mechanism to spironolactone)
- Anti-mineralocorticoid activity: Spironolactone-like diuretic effect
- No estrogenic or glucocorticoid activity
Unique Positioning
Section titled “Unique Positioning”Drospirenone is the only progestogen that combines anti-androgenic and anti-mineralocorticoid activity. For users seeking both progestogenic effects and mild anti-androgenic coverage, drospirenone may reduce the need for a separate anti-androgen.
Dosing
Section titled “Dosing”| Source | Dose | Notes |
|---|---|---|
| In oral contraceptives | 3-4 mg/day | Combined with ethinylestradiol (NOT recommended for HRT) |
| Single-agent | 4 mg/day | Slynd (drospirenone-only pill) |
| HRT adjunct (exploratory) | 3-4 mg/day | No large-scale HRT clinical trial data |
Brands & Availability
Section titled “Brands & Availability”| Brand | Formulation | Notes |
|---|---|---|
| Slynd | 4 mg drospirenone only | EE-free, suitable for HRT |
| Yaz / Yasmin | 3 mg drospirenone + EE | Contains ethinylestradiol, PROHIBITED for HRT |
| Generics | Various | Confirm EE-free |
Monitoring
Section titled “Monitoring”- K+ (potassium): Drospirenone has spironolactone-like potassium-sparing effects; monitor potassium
- PRL: Every 6 months
- If co-administered with spironolactone, hyperkalemia risk increases significantly