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Spironolactone can interact with a wide range of medications and supplements. It is important to let your healthcare provider and pharmacist know about all medicines and supplements you are taking, including prescription, over-the-counter, vitamins, and herbal products. Certain medicines, such as eplerenone and triamterene, should not be used with spironolactone. In other cases, your doctor may need to adjust the dosages or monitor you more closely if spironolactone is used along with drugs such as lithium, certain blood pressure medications, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and potassium supplements.

Products that may increase potassium levels in your blood—such as amiloride, cyclosporine, eplerenone, tacrolimus, triamterene, and birth control pills containing drospirenone—can pose added risks if combined with spironolactone. Some medicines and supplements may also increase the risk of certain side effects, so always consult with your doctor before starting new medications. It is especially important to discuss use of medications that can affect blood pressure or cause swelling, like cough and cold remedies, diet aids, and NSAIDs.

Spironolactone can also interfere with the results of certain laboratory tests, such as those measuring digoxin or cortisol levels, possibly producing inaccurate results. Always inform your doctor and laboratory staff that you are taking spironolactone before undergoing any lab testing.

If you experience unexpected symptoms or signs of an allergic reaction while taking spironolactone, seek medical attention promptly. Be mindful of these potential drug interactions and always follow your healthcare provider’s instructions to use spironolactone safely and effectively.

Common side effects:

• dizziness
• drowsiness
• headache
• nausea
• vomiting
• diarrhea
• stomach upset

Less common but important to monitor:

• breast pain or enlargement in men
• lower sex drive
• menstrual irregularities

Serious side effects:

• muscle cramps
• irregular heartbeats
• confusion
• changes in urination
• muscle weakness
• trouble breathing
• persistent nausea or vomiting
• dark urine
• yellowing of the skin or eyes
• rash
• swelling
• severe dizziness
• difficulty breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Eplerenone
• Triamterene

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Ibuprofen
• Naproxen
• Captopril
• Enalapril
• Lithium
• Digoxin

Interactions with low risk that usually do not require a change in therapy:

• Digitoxin
• Licorice