It should not be used concomitantly with medications known to prolong the QTc interval (. 5-HT3 antagonists , tricyclic antidepressants , citalopram , etc.) as this may lead to an increased risk of QTc interval prolongation.   Neither should it be given concurrently with lithium (medication) as it may increase the risk of lithium toxicity and neuroleptic malignant syndrome .    It should not be given concurrently with other antipsychotics due to the potential for this to increase the risk of side effects, especially neurological side effects such as neuroleptic malignant syndrome .    It should be avoided in patients on CNS depressants such as opioids, alcohol and barbiturates. 
Drospirenone is 8 to 10 times more potent as an antimineralocorticoid relative to spironolactone (3 mg drospirenone is equivalent to about 20–25 mg spironolactone in this regard  ).   It is more potent as an antiandrogen relative to spironolactone also but is less potent relative to cyproterone acetate , having about one-third the potency of this drug.   Progestogenic, antimineralocorticoid, and mild antiandrogenic effects have been observed in humans during treatment with drospirenone at a dosage range of to 4 mg per day orally.