Drug interactions
Empagliflozin + Spironolactone
Severity: Moderate
Empagliflozin 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
Empagliflozin increases urine output, and with spironolactone this can lead to excess fluid loss, low blood pressure and a fall in renal function. The effect is most important in elderly or volume-depleted patients.
What this interaction means in plain words
Empagliflozin 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.
Empagliflozin belongs to Endocrine; Spironolactone belongs to Cardiovascular.
Why it happens
Additive osmotic and natriuretic diuresis from SGLT2 inhibition and aldosterone antagonism.
What to do
Assess volume status and renal function before and after starting empagliflozin. Consider lowering the diuretic dose if signs of hypovolemia appear.
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 Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Other interactions of Empagliflozin
- Amiloride + Empagliflozin Moderate
- Amlodipine-hydrochlorothiazide-valsartan + Empagliflozin Moderate
- Amlodipine-olmesartan-hydrochlorothiazide + Empagliflozin Moderate
- Atenolol-chlorthalidone + Empagliflozin Moderate
- Azilsartan-chlorthalidone + Empagliflozin Moderate
- Bendroflumethiazide + Empagliflozin Moderate
Frequently asked questions
Can I take Empagliflozin with Spironolactone?
MediHelp rates the interaction as moderate. Empagliflozin 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. Empagliflozin increases urine output, and with spironolactone this can lead to excess fluid loss, low blood pressure and a fall in renal function. The effect is most important in elderly or volume-depleted patients.
How serious is the interaction between Empagliflozin 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: Assess volume status and renal function before and after starting empagliflozin. Consider lowering the diuretic dose if signs of hypovolemia appear.
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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