Drug interactions
Canagliflozin-metformin + Spironolactone
Severity: Moderate
Canagliflozin-metformin 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
Spironolactone is a potassium-sparing diuretic that commonly causes hyperkalemia, and canagliflozin may add slightly to potassium elevation in some patients. Both also lower intravascular volume, which may affect renal function and raise the risk of metformin accumulation.
What this interaction means in plain words
Canagliflozin-metformin 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.
Canagliflozin-metformin belongs to Endocrine; Spironolactone belongs to Cardiovascular.
Why it happens
Aldosterone antagonism reduces renal potassium excretion, with additive effects from canagliflozin on potassium and volume status.
What to do
Monitor serum potassium, creatinine and volume status at baseline and regularly, particularly in patients with CKD. Reduce or stop spironolactone if hyperkalemia or marked renal decline occurs.
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 Canagliflozin-metformin
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 Canagliflozin-metformin with Spironolactone?
MediHelp rates the interaction as moderate. Canagliflozin-metformin 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. Spironolactone is a potassium-sparing diuretic that commonly causes hyperkalemia, and canagliflozin may add slightly to potassium elevation in some patients. Both also lower intravascular volume, which may affect renal function and raise the risk of metformin accumulation.
How serious is the interaction between Canagliflozin-metformin 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: Monitor serum potassium, creatinine and volume status at baseline and regularly, particularly in patients with CKD. Reduce or stop spironolactone if hyperkalemia or marked renal decline occurs.
What other medicines interact with Canagliflozin-metformin?
MediHelp also lists interactions of Canagliflozin-metformin with, for example, Contrast media, Diatrizoate, Diatrizoate meglumine / diatrizoate. The full list is on the Canagliflozin-metformin page.
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