What You Need to Know About Intrarosa and Drug Interactions

Before starting any new medication, it's smart to ask: will this interact with anything else I'm taking? If you've been prescribed Intrarosa (Prasterone) for painful sex caused by menopause, you'll be relieved to know that it has a very low risk of drug interactions. But that doesn't mean you should skip the conversation with your doctor.

Here's what you need to know about Intrarosa interactions with other medications, supplements, and more.

How Drug Interactions Work

A drug interaction happens when one substance changes how another substance works in your body. Interactions can:

• Make a medication less effective
• Increase side effects
• Create new, unexpected effects

Drug interactions are most common with medications that are processed through the liver or that affect hormone levels throughout the body. This is where Intrarosa has an advantage: because it works locally in vaginal tissue with minimal absorption into the bloodstream, the potential for systemic drug interactions is very low.

Medications That May Interact With Intrarosa

The official Intrarosa prescribing information does not list any specific drug interactions. This is because Prasterone (DHEA) is converted into hormones locally in vaginal cells and doesn't significantly enter the bloodstream.

However, there are some theoretical considerations your doctor may want to discuss:

Other Hormonal Therapies

If you're already using another form of hormone therapy, combining it with Intrarosa could theoretically result in additive hormonal effects. This includes:

• Systemic estrogen therapy (pills, patches, or gels like Premarin, Estrace, or Vivelle-Dot)
• Vaginal estrogen products (Vagifem, Estrace cream, Estring)
• Combination hormone therapy (estrogen + progestin products)
• Ospemifene (Osphena) — an oral SERM also used for dyspareunia

Using Intrarosa alongside another vaginal hormone product is generally not recommended unless your doctor specifically advises it. There's usually no reason to double up, since they treat the same condition through similar mechanisms.

Anti-Estrogen Medications

If you're taking medications that block estrogen — such as aromatase inhibitors (Arimidex, Femara, Aromasin) or tamoxifen — talk to your doctor before using Intrarosa. Since Prasterone is partially converted to estrogen, even locally produced estrogen could theoretically interfere with anti-estrogen treatment goals, particularly in breast cancer care.

Blood Thinners

While no direct interaction is documented, estrogen (even in small amounts) has been associated with changes in blood clotting. If you take blood thinners like warfarin, let your doctor know you're using Intrarosa.

Supplements and Over-the-Counter Products

Oral DHEA Supplements

Over-the-counter DHEA supplements are widely available. However, do not take oral DHEA supplements and Intrarosa at the same time without discussing it with your doctor. Combining them could increase your total DHEA exposure beyond what's intended.

Vaginal Lubricants and Moisturizers

Water-based vaginal lubricants and moisturizers are generally safe to use alongside Intrarosa, but timing matters:

• Use lubricants as needed during intercourse
• Apply vaginal moisturizers at a different time of day than Intrarosa (not right before or after insertion)
• Avoid oil-based products that could interfere with the insert dissolving properly

Herbal Supplements

Some herbal supplements have estrogen-like effects (called phytoestrogens), including:

• Black cohosh
• Red clover
• Soy isoflavones
• Dong quai

While these are unlikely to cause a significant interaction with Intrarosa, mention them to your doctor so they have the full picture of what you're taking.

Food and Drink Interactions

There are no known food interactions with Intrarosa. You don't need to change your diet or avoid any specific foods while using this medication.

Since Intrarosa is applied vaginally and works locally, what you eat and drink doesn't affect how the medication is absorbed or how it works.

What to Tell Your Doctor

Before starting Intrarosa, make sure your doctor knows about:

• All prescription medications you're currently taking — especially hormone therapies, anti-estrogen drugs, and blood thinners
• Over-the-counter medications — including pain relievers, allergy medicines, and anything you use regularly
• Supplements and vitamins — particularly DHEA, herbal menopause remedies, and phytoestrogen products
• Other vaginal products — creams, suppositories, moisturizers, or other inserts
• Your complete medical history — especially breast cancer, blood clots, stroke, liver or kidney problems, and undiagnosed vaginal bleeding

It also helps to keep an updated medication list on your phone or in your wallet. Bring it to every doctor visit and every pharmacy pickup.

A Note on Intrarosa's Safety Profile

The fact that Intrarosa has no listed drug interactions in its prescribing information is a genuine advantage. Its local mechanism of action — converting DHEA to hormones inside vaginal cells without significant systemic absorption — means it's less likely to interfere with other medications than systemic hormone therapies.

That said, "no listed interactions" doesn't mean "no need to check." Your doctor and pharmacist are your best resources for evaluating your specific medication combination. For more on Intrarosa's safety, read our guide on Intrarosa side effects.

Final Thoughts

Intrarosa has one of the cleanest drug interaction profiles you'll find in a hormone-related medication. For most women, it can be used alongside their existing medications without issues. But always keep your doctor informed about everything you take — prescribed or otherwise.

If you're ready to start Intrarosa and need help finding it at a pharmacy, MedFinder can help you check stock near you without calling around.