Drug interactions
Ammonium chloride + Spironolactone
Severity: Moderate
Ammonium chloride and Spironolactone: moderate interaction.
Last updated
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
Ammonium chloride is an acidifying agent, and spironolactone can contribute to hyperchloremic metabolic acidosis, particularly in cirrhosis or renal impairment. Together they may worsen acidosis and also promote hyperkalemia, as acidosis shifts potassium out of cells.
What this interaction means in plain words
Ammonium chloride and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive acid load: ammonium chloride delivers hydrogen ions while aldosterone antagonism reduces distal hydrogen and potassium secretion.
What to do
Avoid the combination in patients with renal or hepatic impairment; otherwise monitor serum bicarbonate, chloride and potassium.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Ammonium chloride with Spironolactone?
MediHelp rates the interaction as moderate. Ammonium chloride and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ammonium chloride is an acidifying agent, and spironolactone can contribute to hyperchloremic metabolic acidosis, particularly in cirrhosis or renal impairment. Together they may worsen acidosis and also promote hyperkalemia, as acidosis shifts potassium out of cells.
How serious is the interaction between Ammonium chloride and Spironolactone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination in patients with renal or hepatic impairment; otherwise monitor serum bicarbonate, chloride and potassium.
What other medicines interact with Spironolactone?
MediHelp also lists interactions of Spironolactone with, for example, Amiloride, Eplerenone, Triamterene. The full list is on the Spironolactone page.
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