Hyles Drug Interactions

Potassium-sparing Agents: Spironolactone should not be used concurrently with another potassium-sparing agent (e.g., amiloride, triamterene), since concomitant therapy with these drugs may increase the risk of hyperkalemia as compared with spironolactone alone.
Because indomethacin may increase serum potassium concentrations, indomethacin and spironolactone should be administered concomitantly with caution.
Potassium-sparing diuretics should also be used with caution and serum potassium should be determined frequently in patients receiving an ACE inhibitor (e.g., captopril).
Potassium-containing Preparations: Concomitant use of spironolactone and potassium supplements or other substances containing potassium (e.g., salt substitutes, low-salt milk) may increase the risk of hyperkalemia as compared with spironolactone therapy alone.
Antihypertensive and Hypotensive Agents: When used in conjunction with other diuretics or hypotensive agents, spironolactone may be additive with or may potentiate the action of these drugs. Therefore, dosage of these drugs, particularly ganglionic blocking agents, may need to be reduced by at least 50% when concomitant spironolactone therapy is instituted.
Cardiac Glycosides: Spironolactone has been shown to increase the half-life of digoxin, resulting in increased serum digoxin concentrations and subsequent cardiac glycoside toxicity.
Aspirin: Aspirin has been shown to slightly reduce the natriuretic effect of spironolactone in healthy individuals, possibly by reducing active renal tubular secretion of canrenone, the active metabolite of spironolactone. Patients receiving both drugs should be monitored for signs and symptoms of decreased clinical response to spironolactone.
Anticoagulants: When used in conjunction with spironolactone, the hypoprothrombinemic effect of anticoagulants (e.g., warfarin) may be decreased.
Lithium: Spironolactone may reduce lithium renal clearance and increase the risk of lithium toxicity.
Mitotane: Adrenolytic effects of mitotane may be blocked by spironolactone.
Alcohol, barbiturates, narcotics: Potentiation of orthostatic hypotension may occur.
NSAIDS: Effects of spironolactone maybe decreased. Coadministration has also been associated with severe hyperkalemia.
Corticosteroids, corticotropin (ACTH): Intensified electrolyte depletion particularly hypokalemia may occur.
Other Drugs: Spironolactone reportedly reduces vascular responsiveness to norepinephrine and regional or general anesthesia should be used with caution in patients receiving spironolactone.