Drug interactions
Captopril + Spironolactone
Severity: Major
Captopril 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
Together these drugs can cause serious hyperkalemia and additive blood pressure lowering, especially in renal impairment, heart failure or diabetes. Although used deliberately in heart failure, the combination needs careful surveillance.
What this interaction means in plain words
Captopril 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.
Captopril belongs to Cardiovascular; Spironolactone belongs to Cardiovascular.
Why it happens
ACE inhibition reduces aldosterone secretion and spironolactone blocks its receptor, additively decreasing renal potassium excretion.
What to do
Measure potassium and creatinine at baseline, within the first week, and regularly afterward, and monitor blood pressure. Avoid potassium supplements and reduce or stop spironolactone if potassium becomes elevated.
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 Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
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 Spironolactone?
MediHelp rates the interaction as major. Captopril 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. Together these drugs can cause serious hyperkalemia and additive blood pressure lowering, especially in renal impairment, heart failure or diabetes. Although used deliberately in heart failure, the combination needs careful surveillance.
How serious is the interaction between Captopril 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: Measure potassium and creatinine at baseline, within the first week, and regularly afterward, and monitor blood pressure. Avoid potassium supplements and reduce or stop spironolactone if potassium becomes elevated.
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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