Drug interactions
Empagliflozin-metformin + Spironolactone
Severity: Moderate
Empagliflozin-metformin 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 causes osmotic diuresis and spironolactone is a diuretic, so together they can increase volume depletion, hypotension and acute kidney injury risk. Reduced kidney function can also raise metformin exposure.
What this interaction means in plain words
Empagliflozin-metformin 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-metformin belongs to Endocrine; Spironolactone belongs to Cardiovascular.
Why it happens
Additive diuretic and natriuretic effects leading to volume depletion.
What to do
Monitor volume status, blood pressure, renal function and potassium, and consider lowering the diuretic dose if volume depletion develops. Hold during dehydrating illness.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Empagliflozin-metformin and Spironolactone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Empagliflozin-metformin
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 Empagliflozin-metformin with Spironolactone?
MediHelp rates the interaction as moderate. Empagliflozin-metformin 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 causes osmotic diuresis and spironolactone is a diuretic, so together they can increase volume depletion, hypotension and acute kidney injury risk. Reduced kidney function can also raise metformin exposure.
How serious is the interaction between Empagliflozin-metformin 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 volume status, blood pressure, renal function and potassium, and consider lowering the diuretic dose if volume depletion develops. Hold during dehydrating illness.
What other medicines interact with Empagliflozin-metformin?
MediHelp also lists interactions of Empagliflozin-metformin with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Empagliflozin-metformin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
