Drug interactions
Spironolactone + Tolfenamic acid
Severity: Moderate
Spironolactone and Tolfenamic acid: 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
NSAIDs can reduce renal prostaglandin production, lowering renin and aldosterone and impairing renal potassium excretion. With spironolactone this raises the risk of hyperkalemia and acute kidney injury, and NSAIDs may also blunt the diuretic and antihypertensive effects.
What this interaction means in plain words
Spironolactone and Tolfenamic acid 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 belongs to Cardiovascular; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Prostaglandin inhibition causes hyporeninemic hypoaldosteronism and reduced renal perfusion, adding to aldosterone antagonist potassium retention.
What to do
Avoid prolonged NSAID use where possible, and use the lowest effective dose for the shortest time if needed. Monitor potassium, creatinine and blood pressure, and watch for fluid retention.
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 Tolfenamic acid
Frequently asked questions
Can I take Spironolactone with Tolfenamic acid?
MediHelp rates the interaction as moderate. Spironolactone and Tolfenamic acid 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. NSAIDs can reduce renal prostaglandin production, lowering renin and aldosterone and impairing renal potassium excretion. With spironolactone this raises the risk of hyperkalemia and acute kidney injury, and NSAIDs may also blunt the diuretic and antihypertensive effects.
How serious is the interaction between Spironolactone and Tolfenamic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid prolonged NSAID use where possible, and use the lowest effective dose for the shortest time if needed. Monitor potassium, creatinine and blood pressure, and watch for fluid retention.
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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