Drug interactions
Spironolactone + Trandolapril
Severity: Major
Spironolactone and Trandolapril: 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
ACE inhibitors reduce aldosterone production and spironolactone blocks its receptor, so potassium excretion falls markedly. Severe, sometimes fatal hyperkalemia has been reported, especially in heart failure, diabetes, and renal impairment.
What this interaction means in plain words
Spironolactone 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.
Spironolactone belongs to Cardiovascular; Trandolapril belongs to Cardiovascular.
Why it happens
Additive suppression of the renin-angiotensin-aldosterone system, reducing renal potassium excretion.
What to do
Check potassium and creatinine within the first week and regularly thereafter. Use the lowest effective spironolactone dose 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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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 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 Spironolactone with Trandolapril?
MediHelp rates the interaction as major. Spironolactone 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. ACE inhibitors reduce aldosterone production and spironolactone blocks its receptor, so potassium excretion falls markedly. Severe, sometimes fatal hyperkalemia has been reported, especially in heart failure, diabetes, and renal impairment.
How serious is the interaction between Spironolactone 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: Check potassium and creatinine within the first week and regularly thereafter. Use the lowest effective spironolactone dose and avoid potassium supplements and salt substitutes.
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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