Spiros Drug Interactions

ACE inhibitors decreases aldosterone production and they should not routinely be used with spironolactone, particularly in patients with marked renal impairment. Concomitant use of Spironolactone with ACE inhibitors may lead to severe hyperkalemia, particularly in patients with renal failure. Spironolactone may also have been an enhanced hypotensive effect when administered concomitantly with ACE inhibitors.
Anti-diabetics administration with chlorpropamide may increase risk of hyponatremia.
Co-administration of potassium sparring diuretics with ciclosporin may result in hyperkalemia. Avoid concurrent use of spironolactone and ciclosporin. If concurrent therapy is necessary monitor serum potassium levels.
Aspirin may reduce the diuretic effect of Spironolactone.
Sympathomimetics-Spironolactone reduces vascular responses to noradrenaline (norepinephrine); Caution should be exercised in management of individuals being subjected to regional or general anesthesia receiving therapy with spironolactone.
Estrogen: diuretic effect of Spironolactone antagonized by Estrogen.
Coumarins: in patients receiving oral anticoagulant therapy with warfarin, the prothrombin time ratio or INR (international normalized ratio) should be monitored with the addition and withdrawal of treatment with Spironolactone, and should be reassessed periodically during concurrent therapy. Adjustments of the warfarin dose may be necessary in order to maintain the desired level of anticoagulation.