Drug interactions
lisinopril + spironolactone
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.
Overview
Additive risk of significant hyperkalemia and renal impairment when ACE inhibitor is combined with a potassium-sparing diuretic.
Mechanism of action
Additive RAAS inhibition and aldosterone antagonism reduces potassium excretion and may reduce GFR.
Clinical management
Avoid unless compelling indication. If used, start low doses and check serum potassium and creatinine at baseline, within 3–7 days after initiation or dose change, and periodically; hold therapy if K>5.5 mmol/L or creatinine rises significantly.
Drug reference
References
- Lisinopril Prescribing Information — FDA Label
- Spironolactone (Aldactone) Prescribing Information — FDA Label
- Spironolactone–ACE inhibitors: Drug Interaction Monograph — Lexicomp
Frequently asked questions
Can I take lisinopril with spironolactone?
The interaction is rated: Major. Additive risk of significant hyperkalemia and renal impairment when ACE inhibitor is combined with a potassium-sparing diuretic.
How serious is the interaction between lisinopril and spironolactone?
The interaction is rated: Major. Evidence level: High.
How is the interaction between lisinopril and spironolactone managed?
Avoid unless compelling indication. If used, start low doses and check serum potassium and creatinine at baseline, within 3–7 days after initiation or dose change, and periodically; hold therapy if K>5.5 mmol/L or creatinine rises significantly.
Why do lisinopril and spironolactone interact?
Additive RAAS inhibition and aldosterone antagonism reduces potassium excretion and may reduce GFR.
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