التداخل بين سبيرونولاكتون وهيدروكلوروثيازيد وتوراسيميد

CONTRAINDICATIONS Spironolactone and hydrochlorothiazide tablets are contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, hypercalcemia, hyperkalemia, Addison's disease, and in patients who are allergic to thiazide diuretics or to other sulfonamide-derived drugs.

Concomitant administration of spironolactone and hydrochlorothiazide tablets with the following drugs or potassium sources may lead to severe hyperkalemia: • other potassium-sparing diuretics • ACE inhibitors • angiotensin II receptor antagonists • aldosterone blockers • non-steroidal anti-inflammatory drugs (NSAIDs), e.g., indomethacin • heparin and low molecular…

Spironolactone, when used with ACE inhibitors or indomethacin, even in the presence of a diuretic, has been associated with severe hyperkalemia.

Lithium generally should not be given with diuretics (see Precautions: Drug interactions ).

Thiazides may add to or potentiate the action of other antihypertensive drugs.

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment.

Organic Anion Drugs: May decrease diuretic activity of torsemide.

The antihypertensive and diuretic effects of torsemide can be reduced by NSAIDs.

Monitor diuretic effect and blood pressure when used in combination with CYP2C9 inhibitor or inducer.