Thank you very much for the comprehensive answers, it is very difficult to get such anywhere :) The last thing I would like to ask is, can brintellix or coaxil be taken together for Slinda or do you need to take a break between them?

To @Joanna:

To sum up my answers and my colleague's answer, Brintellix and Coaxil should not affect the effect of hormonal contraception, either in relation to Slinda or combined contraceptive pills containing ethinylestradiol and levonorgestrel. There are no contraindications to their combined use.

And does it matter in this case that Slinda is a single-ingredient pill? Can we also say that these drugs (Brintellix, Coaxil) do not affect hormonal contraception in such a general way? I mean, were there any tests and other recommendations for two-component drugs, or can it be standardized that there are such recommendations for all contraceptives?

To @Joanna:

As I mentioned, this interaction is not clinically significant, it concerns the effect of drospirenone (Slinda) on the concentration of vortioxetine (Brintellix) in the body, not the other way around. I have not found information that vortioxetine or tianeptine (Coaxil) would affect the effectiveness of Slinda. Slinda may have a weak to moderate effect on the enzymes that metabolize vortioxetine, potentially resulting in elevated vortioxetine levels. Still, this interaction is unlikely and there are no contraindications to combining the two drugs. Ultimately, the decision to use a particular medication should be made by a doctor based on clinical experience and full information about your health, medications taken and the course of the disease.

If necessary, the Gdziepolek.pl portal allows you to use teleconsultations:

https://www.gdziepolek.pl/telekonsultacja

You wrote that there are studies that say that Slinda can affect vortioxetine concentrations, does it mean that it is better not to combine them? Is it possible not to worry about it? Do you know if it increases or decreases this concentration?
And there is no reverse effect that vortioxetine affects the slinde and reduces its concentration?

To @Joanna:

Yes, according to current medical knowledge, there are no contraindications to combining both drugs with Slinda. However, it is difficult to determine which of them would be potentially safer.

So we can say that coaxil and brintellix are safe for anti-contraception and should not reduce the effect? Do you think any of them are safer?

To @Joanna:

For vortioxetine, the active substance in Brintellix, there was no significant effect on sex hormone levels compared to placebo, but this study involved the concomitant use of combined contraceptive pills containing 30 mcg of ethinyl estradiol and 150 mcg of levonorgestrel. Slinda, in turn, contains drospirenone. Drospirenone (Slinda) may affect vortioxetine (Brintellix) concentrations in the body, but this interaction is unlikely and not clinically relevant.

Thank you for your reply, and is brintellix more confident in not interacting with contraception? Is it somehow more confirmed in its case that it does not weaken the effect of contraception?