Drug interactions
aspirin + spironolactone
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.
Overview
NSAIDs may reduce diuretic efficacy and increase risk of hyperkalemia and renal impairment with potassium‑sparing diuretics.
Mechanism of action
NSAID prostaglandin inhibition decreases renal perfusion and renin; spironolactone reduces potassium excretion, increasing hyperkalemia risk.
Clinical management
Avoid or use with caution; monitor serum potassium and creatinine within 3–7 days of NSAID initiation or dose change and periodically thereafter; consider alternatives to NSAIDs.
Drug reference
References
- Spironolactone (Aldactone) Prescribing Information — FDA Label
- Potassium-sparing diuretics and NSAIDs: Interaction Monograph — Lexicomp
Frequently asked questions
Can I take aspirin with spironolactone?
The interaction is rated: Major. NSAIDs may reduce diuretic efficacy and increase risk of hyperkalemia and renal impairment with potassium‑sparing diuretics.
How serious is the interaction between aspirin and spironolactone?
The interaction is rated: Major. Evidence level: High.
How is the interaction between aspirin and spironolactone managed?
Avoid or use with caution; monitor serum potassium and creatinine within 3–7 days of NSAID initiation or dose change and periodically thereafter; consider alternatives to NSAIDs.
Why do aspirin and spironolactone interact?
NSAID prostaglandin inhibition decreases renal perfusion and renin; spironolactone reduces potassium excretion, increasing hyperkalemia risk.
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