Spironolactone

Spironolactone binds to androgen receptor and may increase PSA levels in abiraterone-treated prostate cancer patients. Concomitant use not recommended.

Avoid concomitant use of spironolactone and mitotane.

Concomitant use can produce severe hyperkalemia. Avoid concomitant use.

Concomitant administration can produce severe hyperkalemia and should be avoided.

Concomitant administration can lead to severe hyperkalemia. Potassium supplementation should be discontinued in heart failure patients starting spironolactone.

Angiotensin II antagonists, aldosterone blockers, heparin, low molecular weight heparin, and other drugs known to cause hyperkalemia: Concomitant administration may lead to severe hyperkalemia.

Potassium-sparing diuretic can increase the risk of hyperkalemia. Frequent monitoring of serum potassium is recommended if concomitant use is indicated.

ARBs can increase serum potassium; concomitant use with spironolactone may lead to severe hyperkalemia. Check potassium levels when therapy is altered.

May cause significant increase in serum potassium. Should only be given for documented hypokalemia and with caution due to risk of hyperkalemia.

Hyperkalemic metabolic acidosis has been reported with concomitant use of spironolactone and cholestyramine.

Spironolactone increases half-life of digoxin, resulting in increased serum levels and potential digitalis toxicity.

Potassium-sparing diuretic may lead to significant increases in serum potassium. Avoid in heart failure patients.

Potassium-sparing diuretic may lead to significant increases in serum potassium when used with enalapril.

Potassium-sparing diuretic; enalapril attenuates diuretic-induced potassium loss, increasing hyperkalemia risk.

Potassium-sparing diuretic that can increase risk of hyperkalemia when used with fosinopril. Requires caution and frequent monitoring of serum potassium levels.

Heparin can increase serum potassium; concomitant use with spironolactone may lead to severe hyperkalemia.

Combination with potassium-sparing diuretics has been associated with severe hyperkalemia and reduced diuretic effects.

Potassium-sparing diuretic can increase risk of hyperkalemia when used with lisinopril; requires frequent monitoring of serum potassium.

Potassium-sparing diuretic may lead to significant hyperkalemia when used with lisinopril which attenuates potassium loss.

Spironolactone reduces renal clearance of lithium, increasing the risk of lithium toxicity. Monitor lithium levels periodically.

Concomitant use may lead to increases in serum potassium, which can be serious.

Low molecular weight heparin can increase serum potassium; concomitant use with spironolactone may lead to severe hyperkalemia.

ACE inhibitors can increase serum potassium; concomitant use with spironolactone may lead to severe hyperkalemia. Check potassium levels when therapy is altered.

Potassium-sparing diuretic may lead to increases in serum potassium. Monitoring of serum potassium is advisable.

Risk of hyperkalemia. Perindopril may increase serum potassium by decreasing aldosterone production.

Concomitant use can produce severe hyperkalemia. Avoid concomitant use.

Potassium-sparing diuretic increases risk of hyperkalemia. Frequent monitoring of serum potassium recommended if concomitant use indicated.

May lead to increased serum potassium levels. Monitor potassium levels during concomitant use.

Increased risk of severe and potentially fatal hyperkalemia when potassium chloride solution is administered.

Potassium-sparing diuretic increases risk of hyperkalemia when used with trandolapril; requires caution and appropriate serum potassium monitoring.

Trimethoprim can increase serum potassium; concomitant use with spironolactone may lead to severe hyperkalemia.

Potassium-sparing diuretic may lead to increases in serum potassium and in heart failure patients, increases in serum creatinine. Monitoring of serum potassium is advisable.

Potassium-sparing diuretic may lead to increases in serum potassium and in heart failure patients to increases in serum creatinine when used with valsartan.

Potentiation of orthostatic hypotension may occur.

Potassium-sparing diuretic that may increase serum potassium when combined with valsartan. Monitor serum potassium levels.

ASA may reduce the efficacy of spironolactone. May require higher maintenance doses; monitor patient closely.

Potentiation of orthostatic hypotension may occur.

Increased risk of hyperkalemia. Monitor serum potassium frequently during concomitant use.

Intensified electrolyte depletion, particularly hypokalemia, may occur.

May falsely elevate plasma cortisol levels, affecting test accuracy. Should be stopped on day of COSYNTROPIN testing.

Potassium-sparing diuretic may lead to significant increases in serum potassium when combined with enalapril. Avoid in heart failure patients.

Potassium-sparing diuretic may lead to significant increases in serum potassium when used concomitantly with enalaprilat. Use with caution and monitor serum potassium frequently.

Potassium-sparing diuretic that can increase risk of hyperkalemia when combined with fosinopril. Serum potassium should be monitored frequently.

Potassium-sparing diuretic may increase risk of hyperkalemia when used with fosinopril sodium and hydrochlorothiazide; requires monitoring of serum potassium.

Potassium-sparing diuretic may increase risk of hyperkalemia when used with CLINIMIX E due to its potassium content; administer with caution.

Potassium-sparing diuretic may increase risk of hyperkalemia when used concomitantly with moexipril. Requires caution and monitoring of serum potassium levels.

NSAIDs may reduce diuretic, natriuretic, and antihypertensive effects of spironolactone. Monitor closely for desired diuretic effect.

Spironolactone reduces vascular responsiveness to norepinephrine; caution needed during anesthesia.

Potassium-sparing diuretic may increase serum potassium when used with quinapril. Use with caution and monitor serum potassium appropriately.

Intensified electrolyte depletion, particularly hypokalemia, may occur.

Potassium-sparing diuretic that increases risk of hyperkalemia when used with ACE inhibitors. Use with caution and monitor serum potassium.

Possible increased responsiveness to the nondepolarizing muscle relaxant may result.

Dosage adjustments of the drugs metabolized by CYP2C8 (e.g., repaglinide) and CYP3A4/5 (e.g., midazolam, sirolimus and tacrolimus) may be necessary if they are given concurrently with spironolactone.