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What the FDA labels say about taking them together

Drospirenone/ethinyl estradiol and tizanidine

Drospirenone/ethinyl estradiol's FDA label of May 29, 2025 names tizanidine in its drug interactions section; the tizanidine labels PlainMeds reads (3) do not name drospirenone/ethinyl estradiol. The drospirenone/ethinyl estradiol label: “COCs Increasing the Plasma Concentrations of CYP450 Enzymes: In clinical studies, administration of a hormonal contraceptive containing EE did not lead to any increase or only to a weak increase in plasma concentrations …”

Check it at the source: the drospirenone/ethinyl estradiol FDA label on DailyMed (effective May 29, 2025, Bayer HealthCare Pharmaceuticals Inc.); the tizanidine FDA label on DailyMed (effective January 2, 2026, Legacy Pharma USA, Inc.).

What does the drospirenone/ethinyl estradiol label say about tizanidine?

Drospirenone/ethinyl estradiol label, drug interactions

COCs Increasing the Plasma Concentrations of CYP450 Enzymes: In clinical studies, administration of a hormonal contraceptive containing EE did not lead to any increase or only to a weak increase in plasma concentrations of CYP3A4 substrates (e.g., midazolam) while plasma concentrations of CYP2C19 substrates (e.g., omeprazole and voriconazole) and CYP1A2 substrates (e.g., theophylline and tizanidine) can have a weak or moderate increase.

Source: FDA drug label (Yaz), Bayer HealthCare Pharmaceuticals Inc., effective May 29, 2025 (SPL set 065f33e4-b587-4e66-b896-ca9ab7b7c876), via openFDA; the full label on DailyMed

What does the tizanidine label say about drospirenone/ethinyl estradiol?

Tizanidine's label (effective January 2, 2026) and its 2 other brand-application labels do not name drospirenone/ethinyl estradiol in these sections. A label lists what its studies and reports found; it is not a complete list.

Source: FDA drug label (Zanaflex), Legacy Pharma USA, Inc., effective January 2, 2026 (SPL set 60c27d35-7349-4fc6-86ad-70fffdbe3e08), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

15Drospirenone/ethinyl estradiol generic labelers
49Tizanidine generic labelers
Drospirenone/ethinyl estradiolTizanidine
Labeled forAcne, Birth controlMuscle spasms and spasticity
Boxed warningYesNo
Pharmacy cost (NADAC)$0.151 per tablet 3-0.03 mg tablet$0.0331 per tablet 4 mg tablet
Shortage nowNo current entryNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

What next?