Drug interactions
Cosyntropin + Spironolactone
Severity: Moderate
Cosyntropin 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 can cross-react in fluorometric cortisol assays and falsely raise measured cortisol during adrenal stimulation testing. This can mask adrenal insufficiency.
What this interaction means in plain words
Cosyntropin 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.
Cosyntropin belongs to Musculoskeletal; Spironolactone belongs to Cardiovascular.
Why it happens
Assay interference, as spironolactone and its metabolites fluoresce and are measured as cortisol.
What to do
Withhold spironolactone on the day of the test, or use a cortisol assay not affected by interference such as immunoassay or LC-MS/MS.
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 Cosyntropin
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 Cosyntropin with Spironolactone?
MediHelp rates the interaction as moderate. Cosyntropin 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 can cross-react in fluorometric cortisol assays and falsely raise measured cortisol during adrenal stimulation testing. This can mask adrenal insufficiency.
How serious is the interaction between Cosyntropin 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: Withhold spironolactone on the day of the test, or use a cortisol assay not affected by interference such as immunoassay or LC-MS/MS.
What other medicines interact with Cosyntropin?
MediHelp also lists interactions of Cosyntropin with, for example, Amlodipine-hydrochlorothiazide-valsartan, Amlodipine-olmesartan-hydrochlorothiazide, Atenolol-chlorthalidone. The full list is on the Cosyntropin page.
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