Drug interactions
Spironolactone + Valsartan
Severity: Major
Spironolactone and Valsartan: 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
Both drugs reduce renal potassium excretion, so combining them can cause clinically significant hyperkalemia. Risk is higher with renal impairment, diabetes, older age or volume depletion.
What this interaction means in plain words
Spironolactone and Valsartan 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; Valsartan belongs to Cardiovascular.
Why it happens
Additive potassium retention through aldosterone receptor blockade and angiotensin II receptor blockade reducing aldosterone release.
What to do
Measure potassium and creatinine at baseline, shortly after initiation or dose changes, and periodically thereafter. Reduce or stop spironolactone if potassium becomes elevated, 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 Valsartan
- Aliskiren + Valsartan Contraindicated
- Sparsentan + Valsartan Contraindicated
- Aldesleukin + Valsartan Major
- Amifostine + Valsartan Major
- Amiloride + Valsartan Major
- Amlodipine-benazepril + Valsartan Major
Frequently asked questions
Can I take Spironolactone with Valsartan?
MediHelp rates the interaction as major. Spironolactone and Valsartan 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. Both drugs reduce renal potassium excretion, so combining them can cause clinically significant hyperkalemia. Risk is higher with renal impairment, diabetes, older age or volume depletion.
How serious is the interaction between Spironolactone and Valsartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure potassium and creatinine at baseline, shortly after initiation or dose changes, and periodically thereafter. Reduce or stop spironolactone if potassium becomes elevated, 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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