Drug interactions
Amlodipine-perindopril + Spironolactone
Severity: Major
Amlodipine-perindopril and Spironolactone: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Perindopril reduces aldosterone and spironolactone blocks its receptor, so together they can cause significant hyperkalemia and renal impairment. The risk is greatest in renal impairment, diabetes, older age or potassium supplementation.
What this interaction means in plain words
Amlodipine-perindopril and Spironolactone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amlodipine-perindopril belongs to Cardiovascular; Spironolactone belongs to Cardiovascular.
Why it happens
Additive reduction of renal potassium excretion through ACE inhibition and mineralocorticoid receptor antagonism.
What to do
Check serum potassium and creatinine at baseline, within the first week or so, and periodically thereafter. Avoid potassium supplements and reduce or stop spironolactone if potassium rises.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Amlodipine-perindopril
- Aliskiren + Amlodipine-perindopril Contraindicated
- Amlodipine-perindopril + Protein a column Contraindicated
- Amlodipine-perindopril + Sacubitril / valsartan Contraindicated
- Amifostine + Amlodipine-perindopril Major
- Amiloride + Amlodipine-perindopril Major
- Amlodipine-perindopril + Azilsartan Major
Other interactions of Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Amlodipine-perindopril with Spironolactone?
MediHelp rates the interaction as major. Amlodipine-perindopril and Spironolactone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Perindopril reduces aldosterone and spironolactone blocks its receptor, so together they can cause significant hyperkalemia and renal impairment. The risk is greatest in renal impairment, diabetes, older age or potassium supplementation.
How serious is the interaction between Amlodipine-perindopril and Spironolactone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and creatinine at baseline, within the first week or so, and periodically thereafter. Avoid potassium supplements and reduce or stop spironolactone if potassium rises.
What other medicines interact with Amlodipine-perindopril?
MediHelp also lists interactions of Amlodipine-perindopril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Amlodipine-perindopril page.
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