Drug interactions
Eplerenone + Trandolapril
Severity: Major
Eplerenone and Trandolapril: 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
Eplerenone and ACE inhibitors such as trandolapril both reduce aldosterone effect on potassium excretion. The combination is used in heart failure and after myocardial infarction but can cause serious hyperkalemia and worsening renal function.
What this interaction means in plain words
Eplerenone and Trandolapril 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; Trandolapril belongs to Cardiovascular.
Why it happens
Additive reduction of renal potassium excretion through aldosterone receptor blockade and decreased angiotensin II/aldosterone production.
What to do
Measure potassium and creatinine before starting, within the first week, and regularly afterwards. Reduce the dose or stop eplerenone if potassium becomes elevated, and 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 Trandolapril
- Aliskiren + Trandolapril Contraindicated
- Protein a column + Trandolapril Contraindicated
- Sacubitril / valsartan + Trandolapril Contraindicated
- Sacubitril-valsartan + Trandolapril Contraindicated
- Aldesleukin + Trandolapril Major
- Amifostine + Trandolapril Major
Frequently asked questions
Can I take Eplerenone with Trandolapril?
MediHelp rates the interaction as major. Eplerenone and Trandolapril 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 and ACE inhibitors such as trandolapril both reduce aldosterone effect on potassium excretion. The combination is used in heart failure and after myocardial infarction but can cause serious hyperkalemia and worsening renal function.
How serious is the interaction between Eplerenone and Trandolapril?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure potassium and creatinine before starting, within the first week, and regularly afterwards. Reduce the dose or stop eplerenone if potassium becomes elevated, and 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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