Drug interactions
Eplerenone + Perindopril
Severity: Major
Eplerenone and Perindopril: 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
Perindopril and eplerenone both reduce renal potassium excretion, so hyperkalemia may occur, especially with renal impairment or diabetes.
What this interaction means in plain words
Eplerenone and Perindopril 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.
Eplerenone belongs to Cardiovascular; Perindopril belongs to Cardiovascular.
Why it happens
Additive inhibition of aldosterone-mediated potassium excretion.
What to do
Monitor potassium and creatinine at baseline, within the first week, and periodically. Avoid potassium supplements and salt substitutes.
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 Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Other interactions of Perindopril
- Aliskiren + Perindopril Contraindicated
- Perindopril + Protein a column Contraindicated
- Perindopril + Sacubitril / valsartan Contraindicated
- Perindopril + Sacubitril-valsartan Contraindicated
- Amifostine + Perindopril Major
- Amiloride + Perindopril Major
Frequently asked questions
Can I take Eplerenone with Perindopril?
MediHelp rates the interaction as major. Eplerenone and Perindopril 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. Perindopril and eplerenone both reduce renal potassium excretion, so hyperkalemia may occur, especially with renal impairment or diabetes.
How serious is the interaction between Eplerenone and Perindopril?
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 potassium and creatinine at baseline, within the first week, and periodically. Avoid potassium supplements and salt substitutes.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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