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While using this medication, you might experience mild side effects such as nausea, vomiting, headache, bloating, breast tenderness, acne, or weight gain. Spotting or irregular periods can also occur, particularly during the initial months. These effects are generally not serious, but if they persist or worsen, consult your healthcare provider. Missing two consecutive periods, or even one if the medication has not been taken correctly, may warrant a pregnancy test.

Serious side effects are less common but require immediate attention. These include breast lumps, mood changes like worsening depression, severe abdominal pain, signs of high potassium levels such as muscle weakness or irregular heartbeat, unusual vaginal bleeding patterns, dark urine, or yellowing of the skin or eyes.

Allergic reactions to this medication are rare but can be serious. Seek urgent medical care if you notice a rash, swelling—especially of the face, tongue, or throat—severe dizziness, or difficulty breathing. If you encounter side effects not mentioned here, reach out to your healthcare provider.

Certain medications can interact with this drug. These include atazanavir/cobicistat and fezolinetant. Drospirenone may increase potassium levels in your blood. Inform your doctor if you regularly use medications that could also elevate potassium, such as aliskiren, ACE inhibitors (like enalapril or lisinopril), angiotensin receptor blockers (like losartan or valsartan), heparin, NSAIDs (such as ibuprofen or naproxen), and potassium-sparing diuretics (like eplerenone, spironolactone, or triamterene).

Some medications can reduce the effectiveness of hormonal birth control by lowering hormone levels in your body, which may lead to pregnancy. Examples include griseofulvin, modafinil, rifamycins (such as rifampin or rifabutin), ritonavir, St. John's wort, and certain anti-seizure medications (like barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), as well as some HIV medications (like nelfinavir or nevirapine).

Always inform your doctor when you start a new medication, and discuss whether additional birth control methods are necessary. Alert your doctor if you experience new spotting or breakthrough bleeding, as these may indicate reduced birth control effectiveness.

This medication may affect the results of certain lab tests, leading to inaccurate outcomes. Ensure that all healthcare providers and laboratory staff are aware of your medication use.