Drug interactions
Hydrochlorothiazide-lisinopril + Spironolactone
Severity: Major
Hydrochlorothiazide-lisinopril and Spironolactone: major 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
Spironolactone and lisinopril both reduce renal potassium excretion, and the combination can cause serious hyperkalemia. Hydrochlorothiazide offsets some of this, but the risk remains, especially with renal impairment, diabetes or heart failure.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Spironolactone 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.
Hydrochlorothiazide-lisinopril belongs to Cardiovascular; Spironolactone belongs to Cardiovascular.
Why it happens
Spironolactone blocks the mineralocorticoid receptor and lisinopril lowers aldosterone, both reducing potassium excretion.
What to do
Check potassium and creatinine within about a week of starting or changing doses and regularly afterward; avoid potassium supplements and reduce or stop spironolactone if potassium is high.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrochlorothiazide-lisinopril 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 14 days on the web. No card needed.
Other interactions of Hydrochlorothiazide-lisinopril
- Dofetilide + Hydrochlorothiazide-lisinopril Contraindicated
- Hydrochlorothiazide-lisinopril + Sacubitril / valsartan Contraindicated
- Amifostine + Hydrochlorothiazide-lisinopril Major
- Amiloride + Hydrochlorothiazide-lisinopril Major
- Benazepril + Hydrochlorothiazide-lisinopril Major
- Bendroflumethiazide + Hydrochlorothiazide-lisinopril Major
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 Hydrochlorothiazide-lisinopril with Spironolactone?
MediHelp rates the interaction as major. Hydrochlorothiazide-lisinopril and Spironolactone 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. Spironolactone and lisinopril both reduce renal potassium excretion, and the combination can cause serious hyperkalemia. Hydrochlorothiazide offsets some of this, but the risk remains, especially with renal impairment, diabetes or heart failure.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Spironolactone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check potassium and creatinine within about a week of starting or changing doses and regularly afterward; avoid potassium supplements and reduce or stop spironolactone if potassium is high.
What other medicines interact with Hydrochlorothiazide-lisinopril?
MediHelp also lists interactions of Hydrochlorothiazide-lisinopril with, for example, Dofetilide, Sacubitril / valsartan, Amifostine. The full list is on the Hydrochlorothiazide-lisinopril 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.
