Drug interactions
Captopril-hydrochlorothiazide + Spironolactone
Severity: Major
Captopril-hydrochlorothiazide 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
Captopril and spironolactone both raise serum potassium, which may cause serious hyperkalemia, especially in renal impairment, diabetes, or heart failure. The hydrochlorothiazide component partly counters this but does not remove the risk.
What this interaction means in plain words
Captopril-hydrochlorothiazide 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-hydrochlorothiazide belongs to Cardiovascular; Spironolactone belongs to Cardiovascular.
Why it happens
ACE inhibition reduces aldosterone, and spironolactone blocks mineralocorticoid receptors, so potassium excretion decreases.
What to do
Monitor serum potassium and creatinine within the first week and periodically afterward. Avoid potassium supplements and reduce or stop spironolactone if hyperkalemia develops.
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 Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-hydrochlorothiazide Major
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 Captopril-hydrochlorothiazide with Spironolactone?
MediHelp rates the interaction as major. Captopril-hydrochlorothiazide 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 and spironolactone both raise serum potassium, which may cause serious hyperkalemia, especially in renal impairment, diabetes, or heart failure. The hydrochlorothiazide component partly counters this but does not remove the risk.
How serious is the interaction between Captopril-hydrochlorothiazide 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: Monitor serum potassium and creatinine within the first week and periodically afterward. Avoid potassium supplements and reduce or stop spironolactone if hyperkalemia develops.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sacubitril / valsartan. The full list is on the Captopril-hydrochlorothiazide page.
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