Spironolactone oral tablet interactions: Alcohol, medications, and other factors

Spironolactone interactions with other drugs

Before you start treatment with spironolactone, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

To learn whether spironolactone interacts with supplements, herbs, or vitamins, see the “Spironolactone and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with spironolactone. Keep in mind this table doesn’t include all drugs that may interact with spironolactone. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid Spironolactone  

Sometimes, factors or conditions could prevent your doctor from prescribing spironolactone due to the risk of harm. These are known as contraindications. Below are the contraindications of spironolactone.

Note: Before you start treatment with spironolactone, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe spironolactone.

Having hyperkalemia

Doctors typically won’t prescribe spironolactone for people with hyperkalemia (high blood potassium levels). This is because spironolactone may increase your blood potassium levels further. Extremely high potassium levels may lead to serious side effects.

If you have hyperkalemia, talk with your doctor before taking spironolactone. They’ll likely prescribe a treatment other than spironolactone for your condition.

Taking eplerenone

Doctors typically do not prescribe spironolactone in combination with eplerenone (Inspra), which is a type of diuretic (water pill).

This is because taking spironolactone with eplerenone can increase your risk of hyperkalemia.

Before you start treatment with spironolactone, it’s important to tell your doctor if you take eplerenone. They’ll likely prescribe a different medication than spironolactone.

Having Addison’s disease

Doctors typically won’t prescribe spironolactone if you have Addison’s disease. This is because spironolactone may worsen your condition.

If you have Addison’s disease, tell your doctor before you start spironolactone. They can discuss alternative medications that are safer for you to take.

Having had an allergic reaction to spironolactone or any of its ingredients

If you have had an allergic reaction to spironolactone or any of its ingredients, your doctor will likely not prescribe spironolactone. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Spironolactone interaction with alcohol 

There are no known interactions between spironolactone and alcohol. However, if you drink alcohol, your doctor may advise you to avoid or limit it during spironolactone treatment.

This is because drinking alcohol while taking the drug may worsen some of spironolactone’s side effects. For example, you may experience:

• headache
• dizziness
• sleepiness
• diarrhea
• sexual problems

Alcohol can also worsen the condition you’re receiving spironolactone to treat. For example, if you have high blood pressure, drinking alcohol may raise your blood pressure further.

If you consume alcohol during spironolactone treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking spironolactone, talk with your doctor.

Drug interactions in depth 

Here’s a closer look at certain drug interactions of spironolactone.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Taking spironolactone with an NSAID can increase the risk of side effects of both drugs. Spironolactone and NSAIDs can both cause kidney problems. Therefore, the risk of kidney problems is more likely if you take them together.

Combining spironolactone and an NSAID can also make spironolactone less effective at treating high blood pressure, heart failure, and edema (fluid retention and swelling). This is because NSAIDs can raise blood pressure and cause your body to hold onto fluid.

Here are some NSAIDs that may interact with Spironolactone:

• ibuprofen (Advil, Motrin)
• naproxen (Naprosyn, Aleve)
• indomethacin (Indocin)
• celecoxib (Celebrex)
• meloxicam (Mobic)

Steps you or your doctor may take

Talk with a doctor before starting any NSAIDs. They can help determine whether it’s safe to combine spironolactone and the NSAID. If you’re taking these drugs together, your doctor may monitor your heart, kidney function, and blood pressure more closely.

Lithium

Taking spironolactone with lithium can increase the risk of side effects of lithium. This is because spironolactone can make it harder to clear lithium from your system. This can lead to higher levels of lithium in your blood, which increases your risk of side effects from lithium.

Steps you or your doctor may take

Tell your doctor if you take lithium before you start spironolactone. They can discuss whether it’s safe for you to combine these medications. If you’re taking lithium and spironolactone together, your doctor will likely monitor your lithium levels closely during treatment.

ACE inhibitors

Taking spironolactone with an ACE inhibitor can increase your risk of hyperkalemia. This is because both spironolactone and ACE inhibitors increase blood potassium levels. Therefore, combining these drugs can make high potassium levels more likely.

Here are some ACE inhibitors that may interact with Spironolactone:

• lisinopril (Zestril, others)
• enalapril (Vasotec)
• benazepril (Lotensin)
• captopril (Capoten)

Steps you or your doctor may take

Tell your doctor if you take ACE inhibitors before starting spironolactone. They can help determine if it’s safe for you to start spironolactone. If you and your doctor decide to combine these drugs, your doctor will likely order blood tests to monitor your potassium levels.

Spironolactone and other interactions

Spironolactone may have other interactions, such as with supplements, foods, vaccines, or lab tests.

Here are some potential interactions with spironolactone. Keep in mind that the following information does not include all other possible spironolactone interactions.

Spironolactone interactions with supplements

Before you start treatment with spironolactone, tell your doctor and pharmacist about any supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

Spironolactone oral tablet can interact with potassium supplements. Potassium has many health benefits, such as supporting the kidneys, heart, muscles, and nervous system. However, taking spironolactone with potassium supplements can increase your risk of hyperkalemia (high blood potassium levels).

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Spironolactone interactions with herbs

There are no specific reports of herbs interacting with spironolactone. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during spironolactone treatment.

Spironolactone interactions with vitamins

There are no specific reports of vitamins interacting with spironolactone. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with spironolactone.

Spironolactone interactions with food

Spironolactone may interact with salt substitutes that contain potassium. Combining these products with spironolactone can increase the risk of high blood potassium levels.

Spironolactone can also interact with licorice and licorice extract. Taking spironolactone with these products can make spironolactone less effective.

Because of this interaction, your doctor will likely recommend avoiding these foods during spironolactone treatment. If you’d like to learn more about eating certain foods during treatment with spironolactone, talk with your doctor.

Spironolactone interactions with vaccines

There are no known interactions between spironolactone and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines.

Spironolactone interactions with lab tests

Spironolactone is not known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

SPIRONOLACTONE INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Spironolactone. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Spironolactone. The impact of cannabis may affect how well you stick to your Spironolactone treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Spironolactone and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with spironolactone. Before you take this drug, be sure to talk with your doctor about your health history. Spironolactone may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with spironolactone include:

• High potassium levels in your blood: Spironolactone can increase your blood potassium levels. If you already have high potassium levels in your blood, spironolactone may worsen your condition. Talk with your doctor about alternative options for you.
• Kidney problems: If you have kidney problems, you may be more likely to develop side effects from spironolactone, including high blood potassium levels. If you have kidney problems and take spironolactone, your doctor will likely closely monitor your kidney function and potassium levels.
• Addison’s disease: If you have Addison’s disease, taking spironolactone may worsen your condition. Your doctor can discuss alternative treatment options that are safer for you.
• Allergic reaction: If you’ve had an allergic reaction to spironolactone or any of its ingredients, your doctor will likely not prescribe spironolactone. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be a better option for you.
• Breastfeeding: It is unknown whether it’s safe to use spironolactone while breastfeeding. A metabolite of the drug passes into breast milk. (Metabolites are chemicals that form as your body breaks down a drug.) This metabolite can cause side effects in a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using spironolactone.
• Pregnancy: Doctors typically won’t prescribe spironolactone during pregnancy unless there are no alternative treatments you can use. This is because the drug has been shown to cause problems with fetal development. If you’re pregnant or planning to become pregnant, tell your doctor before starting spironolactone. They can advise you on the right treatment plan for you.

Preventing interactions  

You can take certain steps to help prevent interactions with spironolactone. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the spironolactone label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If spironolactone doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with spironolactone by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.