Drug interactions
Diclofenac + Spironolactone
Severity: Moderate
Diclofenac 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
Diclofenac can blunt the diuretic and antihypertensive effect of spironolactone and, together, they raise the risk of hyperkalemia and acute kidney injury. The risk is highest in older patients, those with kidney disease or heart failure, and those on other RAAS-active drugs.
What this interaction means in plain words
Diclofenac 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.
Diclofenac belongs to Musculoskeletal; Spironolactone belongs to Cardiovascular.
Why it happens
NSAIDs reduce renal prostaglandin synthesis, lowering renal perfusion, sodium excretion and renin-aldosterone-mediated potassium excretion, adding to spironolactone's potassium retention.
What to do
Monitor serum potassium, creatinine and blood pressure after starting and periodically. Use the lowest NSAID dose for the shortest time or choose an alternative analgesic.
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 Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac 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 Diclofenac with Spironolactone?
MediHelp rates the interaction as moderate. Diclofenac 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. Diclofenac can blunt the diuretic and antihypertensive effect of spironolactone and, together, they raise the risk of hyperkalemia and acute kidney injury. The risk is highest in older patients, those with kidney disease or heart failure, and those on other RAAS-active drugs.
How serious is the interaction between Diclofenac 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 blood pressure after starting and periodically. Use the lowest NSAID dose for the shortest time or choose an alternative analgesic.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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