Drug interactions
Sirolimus + Spironolactone
Severity: Moderate
Sirolimus and Spironolactone: moderate 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 is not a clinically meaningful CYP3A4 inhibitor, so a pharmacokinetic effect on sirolimus is unlikely. Both agents can raise serum potassium, and sirolimus can impair renal function, so hyperkalemia is a more relevant concern.
What this interaction means in plain words
Sirolimus and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Sirolimus belongs to Miscellaneous; Spironolactone belongs to Cardiovascular.
Why it happens
Additive hyperkalemic effects; any CYP3A4 effect of spironolactone is weak and unproven.
What to do
Monitor serum potassium and creatinine after starting or changing the combination. Check sirolimus trough levels if clinical changes occur.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Sirolimus with Spironolactone?
MediHelp rates the interaction as moderate. Sirolimus and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Spironolactone is not a clinically meaningful CYP3A4 inhibitor, so a pharmacokinetic effect on sirolimus is unlikely. Both agents can raise serum potassium, and sirolimus can impair renal function, so hyperkalemia is a more relevant concern.
How serious is the interaction between Sirolimus and Spironolactone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and creatinine after starting or changing the combination. Check sirolimus trough levels if clinical changes occur.
What other medicines interact with Spironolactone?
MediHelp also lists interactions of Spironolactone with, for example, Amiloride, Eplerenone, Triamterene. The full list is on the Spironolactone page.
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