How does spironolactone interact with other medications or food?

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Your doctor will advise you not to take spironolactone if you are currently taking high blood pressure medications such as eplerenone, other medications containing spironolactone such as Aldactazide, or similar diuretics that affect potassium levels like amiloride and triamterene. Spironolactone may also react with the following medications:  

  • Digoxin
  • Blood pressure medications like angiotensin converting enzyme (ACE) inhibitors
  • Lithium (Eskalith, Lithobid)
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen or diclofenac
  • Norepinephrine
  • Steroids such as prednisone or dexamethasone and
  • Tubocurarine and other drugs that relax skeletal muscles

Tell your doctor if you take any of these medications, so you can discuss if spironolactone treatment is safe for you. Spironolactone may react with drugs that are not on this list, so it is important to inform your doctor if you take any over-the-counter drugs, dietary supplements (especially potassium supplements), vitamins or minerals and herbal supplements. Make sure to tell your doctor if you use alcohol, nicotine or illegal drugs, as these may also react with spironolactone treatment.   Diet plays an important role in the effectiveness and safety of spironolactone treatment. During treatment, do not eat a diet high in salt or salt substitutes. It is best to avoid excess sodium and potassium intake while you are being treated with spironolactone. Follow your doctor's advice on how to stay hydrated during treatment, as too much or too little fluid in your system can be dangerous.