Potentiated antihypertensive & diuretic effects w/ K-sparing diuretics & K supplements. Increased risk of hyperkalemia w/ ACE inhibitors, ARBs, trimethoprim. Monitor lithium plasma conc. Renal impairment & increased risk of hyperkalaemia w/ cyclosporin, tacrolimus. Acute renal failure w/ NSAIDs. Increased hypotensive effect &/or postural hypotension by α
1-blockers eg, prazosin, alfuzosin. Increased antihypertensive effects & risk of postural hypotension w/ TCAs, neuroleptics, amifostine, baclofen. Decreased antihypertensive effects w/ glucocorticoids, tetracosactide. Increased systemic exposure to digoxin. Increased AUC by mild to moderate (eg, erythromycin, saquinavir, amiodarone, diltiazem, verapamil, fluconazole) & strong (eg, ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin, telithromycin, nefazodone) CYP3A4 inhibitors. Decreased AUC by strong CYP3A4 inducers eg, St. John's wort, rifampicin, carbamazepine, phenytoin, phenobarb.
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