Spironolactoneinteractions
spironolactone 25 MG Oral Tablet
This is the interactions section of this product’s FDA label — what the manufacturer documented for this drug. It is not a check of your medication list, and a drug missing from it has not been cleared: licensed clinical databases list far more interactions than any single label does. Before combining medicines, ask a pharmacist, who can check everything you take at once and will do it for free.
Named on this label
Every name above is printed in the text below. This is not the full set of drugs that interact with this one — it is the set this manufacturer wrote down.
Drug interactions
Agents increasing serum potassium: Concomitant administration can lead to hyperkalemia.
Lithium: Increased risk of lithium toxicity.
NSAIDs: May reduce the diuretic, natriuretic and antihypertensive effect of spironolactone.
Digoxin: Spironolactone can interfere with radioimmunologic assays of digoxin exposure.
Cholestyramine: Hyperkalemic metabolic acidosis has been reported with concomitant use.
Acetylsalicylic Acid (ASA): ASA may reduce the efficacy of spironolactone.
Abiraterone: May increase prostate-specific antigen (PSA) levels.
Mitotane: Avoid concomitant use of spironolactone and mitotane.
7.1 Drugs and
Supplements Increasing Serum Potassium Concomitant administration of spironolactone with potassium supplementation or drugs that can increase potassium may lead to severe hyperkalemia. In general, discontinue potassium supplementation in heart failure patients who start spironolactone. Check serum potassium levels when ACE inhibitor or ARB therapy is altered in patients receiving spironolactone. Examples of drugs that can increase potassium include:
ACE inhibitors
angiotensin receptor blockers
non-steroidal anti-inflammatory drugs (NSAIDs)
heparin and low molecular weight heparin
trimethoprim
7.2 Lithium
Like other diuretics, spironolactone reduces the renal clearance of lithium, thus increasing the risk of lithium toxicity. Monitor lithium levels periodically when spironolactone is coadministered.
7.3 Nonsteroidal
Anti-Inflammatory Drugs (NSAIDs) In some patients, the administration of an NSAID can reduce the diuretic, natriuretic, and antihypertensive effect of diuretics. Therefore, when spironolactone and NSAIDs are used concomitantly, monitor closely to determine if the desired effect of the diuretic is obtained.
7.4 Digoxin
Spironolactone and its metabolites interfere with radioimmunoassays for digoxin and increase the apparent exposure to digoxin. It is unknown to what extent, if any, spironolactone may increase actual digoxin exposure. In patients taking concomitant digoxin, use an assay that does not interact with spironolactone.
7.5 Cholestyramine
Hyperkalemic metabolic acidosis has been reported in patients given spironolactone concurrently with cholestyramine.
7.6 Acetylsalicylic
Acid Acetylsalicylic acid may reduce the efficacy of spironolactone. Therefore, when spironolactone and acetylsalicylic acid are used concomitantly, spironolactone may need to be titrated to higher maintenance dose and the patient should be observed closely to determine if the desired effect is obtained.
7.7 Abiraterone
Spironolactone binds to the androgen receptor and may increase prostate-specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. Concomitant use of spironolactone and abiraterone is not recommended.
7.8 Mitotane
Avoid concomitant use of spironolactone and mitotane. Spironolactone reduces mitotane plasma levels.
Text above is quoted in full from the FDA-approved drug label published by openFDA, effective December 29, 2025. Matched to this product by RxNorm code. Cross-references to other sections of the full prescribing information have been removed, since they point to a document not shown here. Nothing else is changed: no sentence is shortened, reworded or summarised.
This page reproduces regulatory text for reference. It is not medical advice, and KenyRx is not a pharmacy or a prescriber. Talk to a doctor or pharmacist about whether a medicine is right for you.
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