Spironolactone and hydrochlorothiazide interactions

Spironolactone and hydrochlorothiazide (Aldactazide), an aldosterone antagonist has 421 documented interactions across the FDA labels and fact sheets we index: 52 major, 320 moderate, 47 minor, and 2 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (52)

  • Acetazolamidecarbonic anhydrase inhibitorMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Amiloridepotassium-sparing diureticMajor

    Antikaliuretic Therapy or Potassium Supplementation Amiloride HCl should not be given to patients receiving other potassium-conserving agents, such as spironolactone or triamterene. (Amiloride label, Contraindications)

  • Arsenic trioxideQT-prolonging drugMajor

    The risk of torsade de pointes is related to the extent of QTc prolongation, concomitant administration of QTc prolonging drugs, a history of torsade de pointes, pre-existing QTc interval prolongation, congestive heart failure, administration of potassium-wasting diuretics, or other conditions that result in hypokalemia or hypomagnesemia. (Arsenic trioxide label, Warnings and precautions)

  • Lotensin HCT is also contraindicated in patients who are hypersensitive to benazepril, to any other ACE inhibitor, to hydrochlorothiazide, or to other sulfonamide-derived drugs. (Benazepril and hydrochlorothiazide label, Contraindications)

  • Brinzolamidecarbonic anhydrase inhibitorMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Bumetanideloop diureticMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Candesartanangiotensin II receptor blocker (ARB)Major

    Triple combination of candesartan cilexetil with an ACE-inhibitor and a mineralocorticoid receptor antagonist is generally not recommended. (Candesartan label, Drug interactions)

  • Because the use of diuretics can accentuate the diminished intravascular volume, avoid diuretics except in the late phase of resolution. (Choriogonadotropin alfa label, Warnings)

  • ClozapineantipsychoticMajor

    Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)

  • CyclosporineimmunosuppressantMajor

    Potassium-Sparing Diuretics Cyclosporine should not be used with potassium-sparing diuretics because hyperkalemia can occur. (Cyclosporine label, Drug interactions)

  • Dalfampridinepotassium supplementMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • CONTRAINDICATIONS PROGLYCEM is contraindicated in patients with: Functional hypoglycemia Hypersensitivity to diazoxide, any of the excipients in PROGLYCEM, or other thiazides (Diazoxide label, Contraindications)

  • Dichlorphenamidecarbonic anhydrase inhibitorMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Digoxindigitalis glycosideMajor

    Thiazide-induced electrolyte disturbances, i.e. hypokalemia, hypomagnesemia, increase the risk of digoxin toxicity, which may lead to fatal arrhythmic events (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • DofetilideantiarrhythmicMajor

    The concomitant use of hydrochlorothiazide (alone or in combinations such as with triamterene) with dofetilide is contraindicated (see PRECAUTIONS, Drug-Drug Interactions ) because this has been shown to significantly increase dofetilide plasma concentrations and QT interval prolongation. (Dofetilide label, Contraindications)

  • Dorzolamidecarbonic anhydrase inhibitorMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Dorzolamide and timololcarbonic anhydrase inhibitorMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Droperidoldopamine antagonistMajor

    Droperidol should be administered with extreme caution to patients who may be at risk for development of prolonged QT syndrome (e.g., congestive heart failure, bradycardia, use of a diuretic, cardiac hypertrophy, hypokalemia, hypomagnesemia, or administration of other drugs known to increase the QT interval). (Droperidol label, Boxed warning)

  • EnalaprilACE inhibitorMajor

    Avoid potassium sparing agents in patients with heart failure ( 7.3 ). (Enalapril label, Drug interactions)

  • EnalaprilatACE inhibitorMajor

    …sometimes associated with oliguria and/or progressive azotemia, and rarely with acute renal failure and/or death, include those with the following conditions or characteristics: heart failure, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis, or severe volume and/or salt depletion of any etiology. (Enalaprilat label, Warnings)

  • Eplerenonealdosterone antagonistMajor

    …serum creatinine > 2.0 mg/dL in males or >1.8 mg/dL in females, • creatinine clearance < 50 mL/min, or • concomitant administration of potassium supplements or potassium-sparing diuretics (e.g., amiloride, spironolactone, or triamterene) [see Warnings and Precautions (5.1) , Adverse Reactions (6.2) , Drug Interactions (7) , and Clinical Pharmacology (12.3) ] . (Eplerenone label, Contraindications)

  • Eptifibatideantiplatelet agentMajor

    …of active abnormal bleeding within the previous 30 days Severe hypertension (systolic blood pressure >200 mm Hg or diastolic blood pressure >110 mm Hg) not adequately controlled on antihypertensive therapy Major surgery within the preceding 6 weeks History of stroke within 30 days or any history of hemorrhagic stroke Current or planned administration of another… (Eptifibatide label, Contraindications)

  • Ethacrynic acidloop diureticMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Because the use of diuretics can accentuate the diminished intravascular volume, diuretics should be avoided except in the late phase of resolution as described below. (Follitropin label, Warnings and precautions)

  • Furosemideloop diureticMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • GentamicinaminoglycosideMajor

    The concurrent use of gentamicin with potent diuretics, such as ethacrynic acid or furosemide, should be avoided, since certain diuretics by themselves may cause ototoxicity. (Gentamicin label, Boxed warning)

  • Avoid diuretics or laxatives in patients with diarrhea. (Irinotecan label, Warnings and precautions)

  • Itraconazoleazole antifungalMajor

    Diuretics Eplerenone Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

  • Methazolamidecarbonic anhydrase inhibitorMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Metolazonethiazide diureticMajor

    Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)

  • MinoxidilvasodilatorMajor

    Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)

  • MitotaneCYP3A4 inducerMajor

    Mitotane: Avoid concomitant use of spironolactone and hydrochlorothiazide tablets and mitotane. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • NateglinidemeglitinideMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • NeomycinaminoglycosideMajor

    The concurrent use of neomycin with potent diuretics such as ethacrynic acid or furosemide should be avoided, since certain diuretics by themselves may cause ototoxicity. (Neomycin label, Boxed warning)

  • …2 , Drug Interactions (7.3) ] ) • Immunosuppressants: voclosporin • Microsomal triglyceride transfer protein inhibitor: lomitapide • Migraine medications: eletriptan, ubrogepant • Mineralocorticoid receptor antagonists: finerenone • Non-opioid analgesic (selective blocker of Na v 1.8 sodium channels): suzetrigine • Opioid antagonists: naloxegol • PDE5 inhibitor:… (Nirmatrelvir and ritonavir label, Contraindications)

  • PotassiumVitamin and mineralMajor

    …blockers • non-steroidal anti-inflammatory drugs (NSAIDs), e.g., indomethacin • heparin and low molecular weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements • diet rich in potassium • salt substitutes containing potassium Spironolactone and hydrochlorothiazide tablets should not be administered concurrently with other… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Potassium chloridepotassium supplementMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • Potassium citratepotassium supplementMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • QuinaprilACE inhibitorMajor

    …sometimes associated with oliguria and/or progressive azotemia, and rarely with acute renal failure and/or death, include patients with the following conditions or characteristics: heart failure, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis, or severe volume and/or salt depletion of any etiology. (Quinapril label, Warnings)

  • …sometimes associated with oliguria and/or progressive azotemia, and rarely acute renal failure and/or death, include patients with the following conditions or characteristics: heart failure, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis or severe volume and/or salt depletion of any etiology. (Quinapril and hydrochlorothiazide label, Warnings)

  • RepaglinidemeglitinideMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • Silver sulfadiazinesulfonamideMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Sodium bicarbonateantacidMajor

    Sodium bicarbonate injection is contraindicated in patients who are losing chloride by vomiting or from continuous gastrointestinal suction and in patients receiving diuretics known to produce a hypochloremic alkalosis. (Sodium bicarbonate label, Contraindications)

  • Sodium polystyrene sulfonatepotassium supplementMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • SulfadiazinesulfonamideMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • 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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • SulfasalazinesulfonamideMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • TadalafilPDE5 inhibitorMajor

    …coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)

  • Torsemideloop diureticMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Triamterenepotassium-sparing diureticMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticMajor

    Information for patients Patients who receive spironolactone and hydrochlorothiazide tablets should be advised to avoid potassium supplements and foods containing high levels of potassium including salt substitutes. (Spironolactone and hydrochlorothiazide label, Precautions)

  • ZonisamideanticonvulsantMajor

    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. (Spironolactone and hydrochlorothiazide label, Contraindications)

Moderate interactions (320)

  • AbirateroneCYP2D6 inhibitorModerate

    Abiraterone: Spironolactone binds to the androgen receptor and may increase prostate‑specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • AcarboseantidiabeticModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Acebutololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Albuterolbeta-adrenergic agonistModerate

    Diuretics: Use with caution. (Albuterol label, Drug interactions)

  • AlcoholAlcoholModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alfuzosinalpha blockerModerate

    Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)

  • AliskirenantihypertensiveModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Allopurinolxanthine oxidase inhibitorModerate

    Hypersensitivity reactions to allopurinol tablets may be increased in patients with decreased kidney function receiving thiazide diuretics and allopurinol tablets concurrently. (Allopurinol label, Warnings and precautions)

  • AlogliptinDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alogliptin and metforminDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • AmikacinaminoglycosideModerate

    Ethacrynic Acid, Furosemide, Urea, or Mannitol Some diuretics can enhance aminoglycoside toxicity by altering aminoglycoside concentrations in serum and tissue. (Amikacin label, Drug interactions)

  • AmiodaroneantiarrhythmicModerate

    Give special attention to electrolyte and acid-base balance in patients experiencing severe or prolonged diarrhea or in patients receiving concomitant diuretics and laxatives. (Amiodarone label, Warnings and precautions)

  • Amlodipinedihydropyridine calcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Amlodipine and atorvastatindihydropyridine calcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Amlodipine and benazeprildihydropyridine calcium channel blockerModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Amlodipine and olmesartandihydropyridine calcium channel blockerModerate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Amlodipine and valsartandihydropyridine calcium channel blockerModerate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Amoxicillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Amoxicillin and clavulanatepenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Ampicillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Ampicillin and sulbactampenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Arformoterolbeta-adrenergic agonistModerate

    Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. (Arformoterol label, Drug interactions)

  • AripiprazoleantipsychoticModerate

    Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)

  • ArmodafinilCNS stimulantModerate

    There was also a slightly greater proportion of patients on NUVIGIL requiring new or increased use of antihypertensive medications (2.9%) compared to patients on placebo (1.8%). (Armodafinil label, Warnings and precautions)

  • AsenapineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)

  • AspirinNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Aspirin and dipyridamoleantiplatelet agentModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Atenololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Atenolol and chlorthalidonebeta blockerModerate

    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 and hydrochlorothiazide label, Warnings)

  • Atomoxetinenorepinephrine reuptake inhibitorModerate

    Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)

  • AvanafilPDE5 inhibitorModerate

    • Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 ) (Avanafil label, Warnings and precautions)

  • Azilsartanangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Baclofenmuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Belladonna and opiumopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • BenazeprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • BenzphetamineCNS stimulantModerate

    Amphetamines may decrease the hypotensive effect of antihypertensives. (Benzphetamine label, Drug interactions)

  • Betaxololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • BexagliflozinSGLT2 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • BicalutamideandrogenModerate

    Abiraterone: Spironolactone binds to the androgen receptor and may increase prostate‑specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Bisoprololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • 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 and hydrochlorothiazide label, Warnings)

  • BortezomibModerate

    Hypotension: Use caution when treating patients taking antihypertensives, with a history of syncope, or with dehydration. (Bortezomib label, Warnings and precautions)

  • BrexpiprazoleantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)

  • Brimonidinealpha-adrenergic agonistModerate

    Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)

  • Brimonidine and timololalpha-adrenergic agonistModerate

    Antihypertensives/Cardiac Glycosides Because brimonidine tartrate/timolol maleate ophthalmic solution may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate/timolol maleate ophthalmic solution is advised. (Brimonidine and timolol label, Drug interactions)

  • Bromocriptinedopamine agonistModerate

    Use caution in patients taking antihypertensive medications. (Bromocriptine label, Warnings and precautions)

  • Central Nervous System (CNS) depressants Antihistamines have additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, antianxiety agents, etc.). Antihypertensive drugs Sympathomimetic may reduce the effects of antihypertensive drugs. (Brompheniramine, pseudoephedrine, and dextromethorphan label, Drug interactions)

  • Budesonide and formoterolcorticosteroidModerate

    Diuretics: Use with caution. (Budesonide and formoterol label, Drug interactions)

  • BuprenorphineopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Butalbital and acetaminophenbarbiturateModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • ButorphanolopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Calcitriolvitamin D analogModerate

    Thiazides Thiazides are known to induce hypercalcemia by the reduction of calcium excretion in urine. (Calcitriol label, Drug interactions)

  • Drugs That Increase the Risk of Hypercalcemia Increase frequency of monitoring of calcium concentrations in patients taking concomitant Calcium Chloride Injection and other drugs that increase the risk of hypercalcemia (e.g., calcipotriene, estrogen, lithium, parathyroid hormone, teriparatide, thiazide diuretics, Vitamin A, and Vitamin D). (Calcium chloride label, Drug interactions)

  • CanagliflozinSGLT2 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Candesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • CaptoprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • CarbamazepineanticonvulsantModerate

    Elderly patients and patients treated with diuretics are at greater risk of developing hyponatremia. (Carbamazepine label, Warnings and precautions)

  • CarbidopaModerate

    Symptomatic postural hypotension has occurred when carbidopa, given with levodopa or carbidopa-levodopa combination products, was added to the treatment of a patient receiving antihypertensive drugs. (Carbidopa label, Drug interactions)

  • Carbidopa and levodopadopaminergic drugModerate

    Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)

  • Carbidopa, levodopa, and entacaponedopaminergic drugModerate

    Antihypertensive Agents Symptomatic postural hypotension has occurred when carbidopa/levodopa was added to the treatment of patients receiving antihypertensive drugs. (Carbidopa, levodopa, and entacapone label, Drug interactions)

  • CariprazineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)

  • Carisoprodolmuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Carvedilolbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • CefepimecephalosporinModerate

    Diuretics: Nephrotoxicity has been reported with concomitant administration of cephalosporins with potent diuretics such as furosemide. (Cefepime label, Drug interactions)

  • CeftazidimecephalosporinModerate

    Drug Interactions Nephrotoxicity has been reported following concomitant administration of cephalosporins with aminoglycoside antibacterial drugs or potent diuretics such as furosemide. (Ceftazidime label, Drug interactions)

  • CelecoxibNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Chlorothiazidethiazide diureticModerate

    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 and hydrochlorothiazide label, Warnings)

  • ChlorpromazineantipsychoticModerate

    Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Chlorpromazine label, Precautions)

  • Chlorthalidonethiazide diureticModerate

    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 and hydrochlorothiazide label, Warnings)

  • Chlorzoxazonemuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Cholestyraminebile acid sequestrantModerate

    Drug Interactions Cholestyramine for Oral Suspension USP may delay or reduce the absorption of concomitant oral medication such as phenylbutazone, warfarin, thiazide diuretics (acidic), or propranolol (basic), as well as tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, estrogens and progestins, and digitalis. (Cholestyramine label, Drug interactions)

  • CitalopramSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume depleted may be at greater risk for developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Citalopram label, Warnings and precautions)

  • ClofarabineantimetaboliteModerate

    Consider use of diuretics and/or albumin. (Clofarabine label, Warnings and precautions)

  • Clonidinealpha-adrenergic agonistModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • CodeineopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Colestipolbile acid sequestrantModerate

    The absorption of tetracycline, furosemide, penicillin G, hydrochlorothiazide, and gemfibrozil was significantly decreased when given simultaneously with colestipol hydrochloride; these drugs were not tested to determine the effect of administration one hour before colestipol hydrochloride. (Colestipol label, Drug interactions)

  • Cyclobenzaprinemuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • CyclophosphamideimmunosuppressantModerate

    …inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Cyclophosphamide label, Drug interactions)

  • DanazolandrogenModerate

    Abiraterone: Spironolactone binds to the androgen receptor and may increase prostate‑specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Dantrolenemuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • DapagliflozinSGLT2 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Dapagliflozin and metforminSGLT2 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Desipraminetricyclic antidepressantModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with NORPRAMIN. (Desipramine label, Warnings)

  • DesmopressinModerate

    …Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Desmopressin label, Drug interactions)

  • DesvenlafaxineSNRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk [see Use in Specific Populations (8.5) and Clinical Pharmacology (12.3) ] . (Desvenlafaxine label, Warnings and precautions)

  • Dexlansoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Dexlansoprazole label, Warnings and precautions)

  • DexmethylphenidateCNS stimulantModerate

    • Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)

  • DiclofenacNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Dicloxacillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • DiethylpropionCNS stimulantModerate

    The pressor effects of diethylpropion and those of other drugs may be additive when the drugs are used concomitantly; conversely, diethylpropion may interfere with antihypertensive drugs (i.e., guanethidine, a-methyldopa). (Diethylpropion label, Drug interactions)

  • DiflunisalNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Diltiazemcalcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Doxazosinalpha blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Doxercalciferolvitamin D analogModerate

    Risk may be increased when used concomitantly with high dose calcium preparations, thiazide diuretics, or vitamin D compounds. (Doxercalciferol label, Warnings and precautions)

  • Drospirenone and ethinyl estradioloral contraceptiveModerate

    …[See Adverse Reactions ( 6 ).] Figure 1: VTE Risk with Yasmin Relative to LNG-Containing COCs (adjusted risk#) Figure 2 Likelihood of Developing a VTE 5.2 Hyperkalemia Yaz contains 3 mg of the progestin DRSP which has anti-mineralocorticoid activity, including the potential for hyperkalemia in high-risk patients, comparable to a 25 mg dose of spironolactone. (Drospirenone and ethinyl estradiol label, Warnings and precautions)

  • DulaglutideGLP-1 receptor agonistModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • DuloxetineSNRIModerate

    The risk of BP decreases may be greater in patients taking concomitant medications that induce orthostatic hypotension (such as antihypertensives) or are potent CYP1A2 inhibitors [see Drug Interactions ( 7.1 )] and in patients taking duloxetine delayed-release capsules at doses above 60 mg daily. (Duloxetine label, Warnings and precautions)

  • EluxadolineopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • EmpagliflozinSGLT2 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Empagliflozin and metforminSGLT2 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • EnoxaparinanticoagulantModerate

    …potassium-sparing diuretics • ACE inhibitors • angiotensin II receptor antagonists • aldosterone blockers • non-steroidal anti-inflammatory drugs (NSAIDs), e.g., indomethacin • heparin and low molecular weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements • diet rich in potassium • salt substitutes containing potassium Spironolactone… (Spironolactone and hydrochlorothiazide label, Warnings)

  • EpinephrinesympathomimeticModerate

    …Precautions (5.6) and Adverse Reactions (6) ]. β-blockers, such as propranolol Cyclopropane or halogenated hydrocarbon anesthetics, such as halothane Antihistamines Thyroid hormones Diuretics Cardiac glycosides, such as digitalis glycosides Quinidine Drugs potentiating hypokalemic effects of epinephrine • Potassium depleting diuretics • Corticosteroids • Theophylline… (Epinephrine label, Drug interactions)

  • Epoetin alfaModerate

    Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa label, Warnings and precautions)

  • Epoprostenolprostaglandin analogModerate

    Additional reductions in blood pressure may occur when VELETRI is administered with diuretics, antihypertensive agents, or other vasodilators. (Epoprostenol label, Drug interactions)

  • EscitalopramSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Escitalopram label, Warnings and precautions)

  • Esmololbeta blockerModerate

    Antihypertensive agents clonidine, guanfacine, or moxonidine: Beta blockers also increase the risk of clonidine-, guanfacine-, or moxonidine-withdrawal rebound hypertension. (Esmolol label, Drug interactions)

  • Esomeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Esomeprazole label, Warnings and precautions)

  • Abiraterone: Spironolactone binds to the androgen receptor and may increase prostate‑specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • EtodolacNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • ExenatideGLP-1 receptor agonistModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Felodipinedihydropyridine calcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • FenoprofenNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • FentanylopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Fluconazoleazole antifungalModerate

    Hydrochlorothiazide In a pharmacokinetic interaction study, coadministration of multiple-dose hydrochlorothiazide to healthy volunteers receiving fluconazole increased plasma concentrations of fluconazole by 40%. (Fluconazole label, Drug interactions)

  • FludrocortisonecorticosteroidModerate

    Amphotericin B or potassium-depleting diuretics (benzothiadiazines and related drugs, ethacrynic acid and furosemide)—enhanced hypokalemia. (Fludrocortisone label, Drug interactions)

  • FluoxetineSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Fluoxetine label, Warnings and precautions)

  • FlurbiprofenNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • FlutamideandrogenModerate

    Abiraterone: Spironolactone binds to the androgen receptor and may increase prostate‑specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Fluticasone and salmeterolcorticosteroidModerate

    Diuretics: Use with caution. (Fluticasone and salmeterol label, Drug interactions)

  • FluvoxamineSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)

  • Formoterolbeta-adrenergic agonistModerate

    • Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. (Formoterol label, Drug interactions)

  • FoscarnetantiviralModerate

    When diuretics are indicated, thiazides are recommended over loop diuretics because the latter inhibit renal tubular secretion, and may impair elimination of FOSCAVIR, potentially leading to toxicity. (Foscarnet label, Drug interactions)

  • FosinoprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • GlimepiridesulfonylureaModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • GlipizidesulfonylureaModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Glipizide and metforminsulfonylureaModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • GlyburidesulfonylureaModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Glyburide and metforminsulfonylureaModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Guanfacinealpha-adrenergic agonistModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • HaloperidolantipsychoticModerate

    Caution is advised when haloperidol decanoate is used in combination with drugs known to cause electrolyte imbalance (e.g., diuretics or corticosteroids) because hypokalemia, hypomagnesemia, and hypocalcemia are risk factors for QT prolongation. (Haloperidol label, Drug interactions)

  • HeparinanticoagulantModerate

    …potassium-sparing diuretics • ACE inhibitors • angiotensin II receptor antagonists • aldosterone blockers • non-steroidal anti-inflammatory drugs (NSAIDs), e.g., indomethacin • heparin and low molecular weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements • diet rich in potassium • salt substitutes containing potassium Spironolactone… (Spironolactone and hydrochlorothiazide label, Warnings)

  • HydralazinevasodilatorModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Hydrochlorothiazidethiazide diureticModerate

    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 and hydrochlorothiazide label, Warnings)

  • HydrocodoneopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • HydromorphoneopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • IbuprofenNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • IloperidoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Iloperidone label, Warnings and precautions)

  • Imipraminetricyclic antidepressantModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with imipramine hydrochloride tablets. (Imipramine label, Warnings)

  • Indapamidethiazide diureticModerate

    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 and hydrochlorothiazide label, Warnings)

  • IndomethacinNSAIDModerate

    Spironolactone, when used with ACE inhibitors or indomethacin, even in the presence of a diuretic, has been associated with severe hyperkalemia. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Insulin aspartinsulinModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Insulin degludecinsulinModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Insulin detemirinsulinModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Insulin glargineinsulinModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Insulin lisproinsulinModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Ipratropium and albuterolanticholinergicModerate

    Diuretics The electrocardiogram (ECG) changes and/or hypokalemia that may result from the administration of non-potassium sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by β-agonists, especially when the recommended dose of the β-agonist is exceeded. (Ipratropium and albuterol label, Drug interactions)

  • Irbesartanangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Irbesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Isradipinedihydropyridine calcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Ketoconazoleazole antifungalModerate

    Diuretics eplerenone The potential increase in plasma concentrations of eplerenone when coadministered with ketoconazole tablets may increase the risk of hyperkalemia and hypotension. (Ketoconazole label, Drug interactions)

  • KetoprofenNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • KetorolacNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Labetalolbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Lansoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Lansoprazole label, Warnings and precautions)

  • Levalbuterolbeta-adrenergic agonistModerate

    Diuretics The ECG changes or hypokalemia that may result from the administration of non-potassium-sparing diuretics (such as loop and thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Levalbuterol label, Drug interactions)

  • LevomilnacipranSNRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

  • LevorphanolopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • LinagliptinDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Linagliptin and metforminDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • LinezolidantibioticModerate

    Monitor serum sodium levels regularly in the elderly, in patients taking diuretics, and in other patients at risk of hyponatremia and/or SIADH while taking Linezolid injection. (Linezolid label, Warnings and precautions)

  • LiraglutideGLP-1 receptor agonistModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • LisinoprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Lithiumserotonergic drugModerate

    Lithium generally should not be given with diuretics (see Precautions: Drug interactions ). (Spironolactone and hydrochlorothiazide label, Warnings)

  • Lofexidinealpha-adrenergic agonistModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Losartanangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • LovastatinstatinModerate

    Caution should also be exercised if an HMG-CoA reductase inhibitor or other agent used to lower cholesterol levels is administered to patients also receiving other drugs (e.g., spironolactone, cimetidine) that may decrease the levels or activity of endogenous steroid hormones. (Lovastatin label, Drug interactions)

  • LumateperoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)

  • LurasidoneantipsychoticModerate

    Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)

  • MecamylamineantihypertensiveModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Mefenamic acidNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • MeloxicamNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • MeperidineopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Metaxalonemuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • MetforminbiguanideModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • MethadoneopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Methocarbamolmuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • MethohexitalbarbiturateModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • MethyldopaantihypertensiveModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • MethylphenidateCNS stimulantModerate

    Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)

  • MethyltestosteroneandrogenModerate

    Abiraterone: Spironolactone binds to the androgen receptor and may increase prostate‑specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Metoprololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • 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 and hydrochlorothiazide label, Warnings)

  • MiglitolantidiabeticModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • MilnacipranSNRIModerate

    Also, patients taking diuretics or who are otherwise volume-depleted may be at greater risk [see Geriatric Use ( 8.5 )] . (Milnacipran label, Warnings and precautions)

  • MirtazapineantidepressantModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia [see Use in Specific Populations (8.5) ] . (Mirtazapine label, Warnings and precautions)

  • ModafinilCNS stimulantModerate

    However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%). (Modafinil label, Warnings and precautions)

  • MoexiprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • MorphineopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • NabumetoneNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Nadololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Nafcillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • NalbuphineopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • NaproxenNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Nebivololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • NiacinModerate

    Antihypertensive Therapy Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. (Niacin label, Drug interactions)

  • Nicardipinedihydropyridine calcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Nifedipinedihydropyridine calcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Nimodipinedihydropyridine calcium channel blockerModerate

    Blood Pressure Lowering Drugs Nimodipine may increase the blood pressure lowering effect of concomitantly administered anti-hypertensives such as diuretics, beta-blockers, ACE inhibitors, angiotensin receptor blockers, other calcium channel blockers, α-adrenergic blockers, PDE5 inhibitors, and α-methyldopa. (Nimodipine label, Drug interactions)

  • Nisoldipinedihydropyridine calcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • NitroglycerinnitrateModerate

    Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)

  • NitroprussidevasodilatorModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • OlanzapineantipsychoticModerate

    …of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)

  • Olanzapine and fluoxetineantipsychoticModerate

    …and fluoxetine capsules should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions that would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Olanzapine and fluoxetine label, Warnings and precautions)

  • OliceridineopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Olmesartanangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Olmesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Olmesartan, amlodipine, and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Omeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (Omeprazole label, Warnings and precautions)

  • Omeprazole and sodium bicarbonateproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (Omeprazole and sodium bicarbonate label, Warnings and precautions)

  • Orphenadrinemuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant may result. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Oxacillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • OxaprozinNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • OxycodoneopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • OxymorphoneopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • PaliperidoneantipsychoticModerate

    Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)

  • Pantoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Pantoprazole label, Warnings and precautions)

  • Paricalcitolvitamin D analogModerate

    The risk may be increased when Paricalcitol Injection is used concomitantly with high dose calcium preparations, thiazide diuretics, or vitamin D compounds. (Paricalcitol label, Warnings and precautions)

  • ParoxetineSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SNRIs and SSRIs. [see Use in Specific Populations ( 8.5 )]. (Paroxetine label, Warnings and precautions)

  • PazopanibModerate

    Monitor blood pressure as clinically indicated and initiate and adjust antihypertensive therapy as appropriate. (Pazopanib label, Warnings and precautions)

  • Penicillin Gpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Penicillin Vpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • PentoxifyllinemethylxanthineModerate

    Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)

  • PerindoprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • PhenelzineMAO inhibitorModerate

    …hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl mirtazapine Phenelzine sulfate should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result. (Phenelzine label, Warnings)

  • PhenobarbitalbarbiturateModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Phenoxybenzaminealpha blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Phentermine and topiramateCNS stimulantModerate

    Concomitant administration of hydrochlorothiazide alone with topiramate alone has been shown to increase the C max and AUC of topiramate by 27% and 29%, respectively. (Phentermine and topiramate label, Drug interactions)

  • Pindololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • PioglitazonethiazolidinedioneModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Pioglitazone and glimepiridethiazolidinedioneModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Pioglitazone and metforminthiazolidinedioneModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Piperacillin and tazobactampenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Spironolactone and hydrochlorothiazide label, Warnings)

  • PiroxicamNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Concurrent use with potassium-containing medications, potassium-sparing diuretics and angiotensin-converting enzyme inhibitors (ACE inhibitors) may result in hyperkalemia and cardiac arrhythmias or cardiac arrest. (Potassium iodide label, Drug interactions)

  • Prazosinalpha blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • PrimidoneanticonvulsantModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • ProchlorperazineantipsychoticModerate

    Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Prochlorperazine label, Precautions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Propranololbeta blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • QuetiapineantipsychoticModerate

    Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)

  • QuinidineantiarrhythmicModerate

    Drugs that alkalinize the urine ( carbonic-anhydrase inhibitors, sodium bicarbonate, thiazide diuretics ) reduce renal elimination of quinidine. (Quinidine label, Drug interactions)

  • Rabeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Rabeprazole label, Warnings and precautions)

  • RamiprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • RemifentanilopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • RiociguatvasodilatorModerate

    Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)

  • RisperidoneantipsychoticModerate

    Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)

  • Sacubitril and valsartanangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Salmeterolbeta-adrenergic agonistModerate

    • Diuretics: Use with caution. (Salmeterol label, Drug interactions)

  • SalsalateNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • SaxagliptinDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Saxagliptin and metforminDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • SemaglutideGLP-1 receptor agonistModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • SertralineSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Sertraline label, Warnings and precautions)

  • SildenafilPDE5 inhibitorModerate

    Caution is advised when SILDENAFIL ORAL FILM is co-administered with alpha-blockers or antihypertensives. (Sildenafil label, Warnings and precautions)

  • Silodosinalpha blockerModerate

    However, patients in the Phase 3 clinical studies taking concomitant antihypertensive medications with silodosin capsules did not experience a significant increase in the incidence of syncope, dizziness, or orthostasis. (Silodosin label, Warnings and precautions)

  • SitagliptinDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Sitagliptin and metforminDPP-4 inhibitorModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Increase the dose of diuretics as needed [see Adverse Reactions (6) ] . (Sodium zirconium cyclosilicate label, Warnings and precautions)

  • SorafenibModerate

    Consider temporary or permanent discontinuation for severe or persistent hypertension despite antihypertensive therapy. (Sorafenib label, Warnings and precautions)

  • Sotalolbeta blockerModerate

    Special attention should be given to electrolyte and acid-base balance in patients experiencing severe or prolonged diarrhea or patients receiving concomitant diuretic drugs. (Sotalol label, Warnings and precautions)

  • Spironolactonealdosterone antagonistModerate

    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 and hydrochlorothiazide label, Warnings)

  • Succinylcholineneuromuscular blockerModerate

    Prolonged Neuromuscular Block in Patients with Hypokalemia or Hypocalcemia Neuromuscular blockade may be prolonged in patients with hypokalemia (e.g., after severe vomiting, diarrhea, digitalisation and diuretic therapy) or hypocalcemia (e.g., after massive transfusions). (Succinylcholine label, Warnings and precautions)

  • SulindacNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • SunitinibModerate

    Initiate and/or adjust antihypertensive therapy as appropriate. (Sunitinib label, Warnings and precautions)

  • TacrolimusimmunosuppressantModerate

    • Hypertension: May require antihypertensive therapy; monitor relevant drug interactions. (Tacrolimus label, Warnings and precautions)

  • TapentadolopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Telmisartanangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Telmisartan and amlodipineangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Telmisartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Terazosinalpha blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • Terbutalinebeta-adrenergic agonistModerate

    Diuretics The ECG changes and/or hypokalemia that may result from the administration of non-potassium sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Terbutaline label, Precautions)

  • TestosteroneandrogenModerate

    Abiraterone: Spironolactone binds to the androgen receptor and may increase prostate‑specific antigen (PSA) levels in abiraterone-treated prostate cancer patients. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • TirzepatideGLP-1 receptor agonistModerate

    Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Tizanidinemuscle relaxantModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • TobramycinaminoglycosideModerate

    Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)

  • TolmetinNSAIDModerate

    …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 weight heparin • other drugs or conditions known to cause hyperkalemia • potassium supplements… (Spironolactone and hydrochlorothiazide label, Warnings)

  • TolvaptanModerate

    Co-administration of diuretics also increases the risk of too rapid correction of serum sodium and such patients should undergo close monitoring of serum sodium. (Tolvaptan label, Warnings and precautions)

  • TopiramateanticonvulsantModerate

    Hydrochlorothiazide (HCTZ) Topiramate C max and AUC increased when HCTZ was added to immediate-release topiramate. (Topiramate label, Drug interactions)

  • Toremifeneselective estrogen receptor modulatorModerate

    Drugs that decrease renal calcium excretion, e.g., thiazide diuretics, may increase the risk of hypercalcemia in patients receiving FARESTON. (Toremifene label, Drug interactions)

  • TramadolopioidModerate

    Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • TrandolaprilACE inhibitorModerate

    …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 weight heparin… (Spironolactone and hydrochlorothiazide label, Warnings)

  • TrazodoneantidepressantModerate

    Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)

  • TrifluoperazineantipsychoticModerate

    Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Trifluoperazine label, Precautions)

  • Umeclidinium and vilanterolanticholinergicModerate

    • Diuretics: Use with caution. (Umeclidinium and vilanterol label, Drug interactions)

  • Valsartanangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    …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 weight heparin • other drugs… (Spironolactone and hydrochlorothiazide label, Warnings)

  • VardenafilPDE5 inhibitorModerate

    Vardenafil hydrochloride tablets can potentiate the hypotensive effects of nitrates, alpha- blockers, and antihypertensives. (Vardenafil label, Drug interactions)

  • VenlafaxineSNRIModerate

    Also, patients taking diuretics or who are otherwise volume-depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Venlafaxine label, Warnings and precautions)

  • Verapamilcalcium channel blockerModerate

    Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

  • VilazodoneSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs [see Use in Specific Populations ( 8.5 )] . (Vilazodone label, Warnings and precautions)

  • Vitamin DVitamin and mineralModerate

    Thiazide diuretics reduce calcium excretion; combined with vitamin D and calcium supplements this can lead to hypercalcemia, especially in older adults. (NIH Office of Dietary Supplements, Vitamin D)

  • VortioxetineantidepressantModerate

    Also, patients taking diuretics or who are otherwise volume-depleted can be at greater risk. (Vortioxetine label, Warnings and precautions)

  • ZiprasidoneantipsychoticModerate

    Hypokalemia may result from diuretic therapy, diarrhea, and other causes. (Ziprasidone label, Warnings and precautions)

  • Zoledronic acidbisphosphonateModerate

    Elderly patients and those receiving diuretic therapy are at increased risk of acute renal failure. (Zoledronic acid label, Warnings and precautions)

Minor mentions (47)

  • AmantadineanticholinergicMinor

    Coadministration of 1 Dyazide (triamterene/hydrochlorothiazide) resulted in a higher plasma amantadine hydrochloride concentration in a 61-year old man receiving amantadine hydrochloride 100 mg TID for Parkinson's disease. (Amantadine label, Drug interactions)

  • Patients required intervention with a diuretic, fluid management, or, in some cases, hospitalization for decompensating heart failure. (Ambrisentan label, Warnings and precautions)

  • Azelastine and fluticasoneantihistamineMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • BeclomethasonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • BetamethasonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • BosentanCYP3A4 inducerMinor

    Patients required intervention with a diuretic, fluid management, or hospitalization for decompensating heart failure. (Bosentan label, Warnings and precautions)

  • BudesonidecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • CalciumVitamin and mineralMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • Drugs that may cause hypercalcemia: Vitamin D, vitamin A, thiazide diuretics, estrogen, calcipotriene and teriparatide administration may cause hypercalcemia. (Calcium gluconate label, Drug interactions)

  • CiclesonidecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • ClobetasolcorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Acthar Gel may accentuate the electrolyte loss associated with diuretic therapy. (Corticotropin label, Drug interactions)

  • Fluid retention events were typically managed by supportive care measures that may include diuretics or short courses of steroids. (Dasatinib label, Warnings and precautions)

  • DeflazacortcorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Desogestrel and ethinyl estradioloral contraceptiveMinor

    If other contraceptive methods are not suitable, hormonal contraceptive therapy may continue combined with antihypertensive therapy. (Desogestrel and ethinyl estradiol label, Warnings)

  • DesonidecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • DexamethasonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • DextroamphetamineCNS stimulantMinor

    Examples of alkalinizing agents include gastrointestinal alkalinizing agents (e.g., sodium bicarbonate) and urinary alkalinizing agents (e.g. acetazolamide, some thiazides). (Dextroamphetamine label, Drug interactions)

  • DobutaminesympathomimeticMinor

    Drug Interactions There was no evidence of drug interactions in clinical studies in which dobutamine was administered concurrently with other drugs, including digitalis preparations, furosemide, spironolactone, lidocaine, glyceryl trinitrate, isosorbide dinitrate, morphine, atropine, heparin, protamine, potassium chloride, folic acid, and acetaminophen. (Dobutamine label, Drug interactions)

  • Patients developing peripheral edema may be treated with standard measures, e.g., salt restriction, oral diuretic(s). (Docetaxel label, Warnings and precautions)

  • DronedaroneantiarrhythmicMinor

    Hypokalemia and Hypomagnesemia with Potassium-Depleting Diuretics Hypokalemia or hypomagnesemia may occur with concomitant administration of potassium-depleting diuretics. (Dronedarone label, Warnings and precautions)

  • EphedrinesympathomimeticMinor

    Examples: α-adrenergic antagonists, β-adrenergic receptor antagonists, reserpine, quinidine, mephentermine Other Drug Interactions G u anethidine C linical Impact: Ephedrine may inhibit the neuron blockage produced by guanethidine, resulting in loss of antihypertensive effectiveness. (Ephedrine label, Drug interactions)

  • Febuxostatxanthine oxidase inhibitorMinor

    In Vivo Drug Interaction Studies Based on drug interaction studies in healthy patients, ULORIC does not have clinically significant interactions with colchicine, naproxen, indomethacin, hydrochlorothiazide, warfarin or desipramine [see Clinical Pharmacology (12.3) ]. (Febuxostat label, Drug interactions)

  • Finasteride5-alpha reductase inhibitorMinor

    …clinical studies with acetaminophen, acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives… (Finasteride label, Drug interactions)

  • FlecainideantiarrhythmicMinor

    Flecainide acetate has been used in a large number of patients receiving diuretics without apparent interaction. (Flecainide label, Drug interactions)

  • FlunisolidecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • FluocinonidecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • FluticasonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • HalobetasolcorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • HydrocortisonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • ACE Inhibitors FIRAZYR is a bradykinin B2 receptor antagonist and thereby has the potential to have a pharmacodynamic interaction with ACE inhibitors where FIRAZYR may attenuate the antihypertensive effect of ACE inhibitors. (Icatibant label, Drug interactions)

  • ImatinibCYP3A4 inhibitorMinor

    Weigh patients regularly and manage unexpected rapid weight gain by drug interruption and diuretics. (Imatinib label, Warnings and precautions)

  • Postmarketing cases of edema and fluid retention occurring within weeks of starting OPSUMIT, some requiring intervention with a diuretic or hospitalization for decompensated heart failure, have been reported [see Adverse Reactions (6.2) ] . (Macitentan label, Warnings and precautions)

  • MagnesiumVitamin and mineralMinor

    Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

  • MethylprednisolonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • MexiletineantiarrhythmicMinor

    In a large compassionate use program mexiletine has been used concurrently with commonly employed antianginal, antihypertensive, and anticoagulant drugs without observed interactions. (Mexiletine label, Drug interactions)

  • MilrinonePDE3 inhibitorMinor

    …been observed in limited experience with patients in whom milrinone was used concurrently with the following drugs: digitalis glycosides; lidocaine, quinidine; hydralazine, prazosin; isosorbide dinitrate, nitroglycerin; chlorthalidone, furosemide, hydrochlorothiazide, spironolactone; captopril; heparin, warfarin, diazepam, insulin; and potassium supplements. (Milrinone label, Drug interactions)

  • MometasonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Nortriptylinetricyclic antidepressantMinor

    The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)

  • Olopatadine and mometasoneantihistamineMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Posaconazoleazole antifungalMinor

    Management of pseudoaldosteronism may include discontinuation of Noxafil, substitution with an appropriate antifungal drug that is not associated with pseudoaldosteronism, or use of aldosterone receptor antagonists. (Posaconazole label, Warnings and precautions)

  • PrednisolonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • PrednisonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • Protriptylinetricyclic antidepressantMinor

    Protriptyline may block the antihypertensive effect of guanethidine or similarly acting compounds. (Protriptyline label, Warnings)

  • TerbinafineantifungalMinor

    There is no information available from adequate drug-drug interaction studies with the following classes of drugs: oral contraceptives, hormone replacement therapies, hypoglycemics, phenytoins, thiazide diuretics, and calcium channel blockers. (Terbinafine label, Drug interactions)

  • TriamcinolonecorticosteroidMinor

    Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)

  • ZincVitamin and mineralMinor

    Thiazide diuretics increase zinc loss in urine with long-term use. (NIH Office of Dietary Supplements, Zinc)

No significant interaction reported (2)

  • PamidronatebisphosphonateNo interaction

    Loop Diuretics Concomitant administration of a loop diuretic had no effect on the calcium-lowering action of pamidronate disodium. (Pamidronate label, Drug interactions)

  • Ropiniroledopamine agonistNo interaction

    Commonly Administered Drugs: Population analysis showed that commonly administered drugs (e.g., selegiline, amantadine, tricyclic antidepressants, benzodiazepines, ibuprofen, thiazides, antihistamines, anticholinergics) did not affect the clearance of ropinirole. (Ropinirole label, Drug interactions)

Check Spironolactone and hydrochlorothiazide against everything you take. Add your full list; every pair is checked at once.

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.