Drug interactions
Eplerenone + Ramipril
Severity: Major
Eplerenone and Ramipril: 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
Ramipril combined with eplerenone increases the risk of hyperkalemia, which may be serious in patients with kidney disease, diabetes, or advanced age.
What this interaction means in plain words
Eplerenone and Ramipril 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; Ramipril belongs to Cardiovascular.
Why it happens
Additive suppression of the renin-angiotensin-aldosterone system reducing renal potassium excretion.
What to do
Monitor potassium and creatinine at baseline, within the first week, and periodically. Avoid potassium supplements and reduce doses if potassium rises.
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 Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Eplerenone with Ramipril?
MediHelp rates the interaction as major. Eplerenone and Ramipril 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. Ramipril combined with eplerenone increases the risk of hyperkalemia, which may be serious in patients with kidney disease, diabetes, or advanced age.
How serious is the interaction between Eplerenone and Ramipril?
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 reduce doses if potassium rises.
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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