Drug interactions
Captopril + Eplerenone
Severity: Major
Captopril and Eplerenone: 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
ACE inhibitors lower aldosterone and eplerenone blocks its receptor, so potassium retention is additive. Clinically significant hyperkalemia can occur, particularly in renal impairment.
What this interaction means in plain words
Captopril and Eplerenone 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.
Captopril belongs to Cardiovascular; Eplerenone belongs to Cardiovascular.
Why it happens
Additive suppression of aldosterone-mediated renal potassium excretion.
What to do
Check potassium and renal function at baseline, within the first week, and periodically thereafter. Avoid potassium supplements and salt substitutes.
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 Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Other interactions of Captopril
- Aliskiren + Captopril Contraindicated
- Captopril + Sacubitril / valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Amifostine + Captopril Major
- Amiloride + Captopril Major
- Amlodipine-hydrochlorothiazide-valsartan + Captopril Major
Frequently asked questions
Can I take Captopril with Eplerenone?
MediHelp rates the interaction as major. Captopril and Eplerenone 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. ACE inhibitors lower aldosterone and eplerenone blocks its receptor, so potassium retention is additive. Clinically significant hyperkalemia can occur, particularly in renal impairment.
How serious is the interaction between Captopril and Eplerenone?
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 potassium and renal function at baseline, within the first week, and periodically thereafter. Avoid potassium supplements and salt substitutes.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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