Lithium and Spironolactone interaction

Lithium and Spironolactone: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Lithium (Lithium Carbonate) label · effective 2026-06-04

Moderate

Diuretics, NSAID, renin-angiotensin system antagonists, or metronidazole may increase lithium serum concentrations.

Drug interactionsby drug classView label on DailyMed
Moderate

Drugs Having Clinically Important Interactions with Lithium Table 4: Clinically Important Drug Interactions with Lithium Diuretics Clinical Impact: Diuretic-induced sodium loss may reduce lithium clearance and increase serum lithium concentrations .

Drug interactionsby drug classView label on DailyMed

From the Spironolactone label · effective 2026-08-26

Moderate

Lithium: Increased risk of lithium toxicity ( 7.2 )

Drug interactionsnames LithiumView label on DailyMed
Moderate

…drugs that can increase potassium include: ACE inhibitors angiotensin receptor blockers aldosterone blockers non-steroidal anti-inflammatory drugs (NSAIDs) heparin and low molecular weight heparin trimethoprim 7.2 Lithium Like other diuretics, spironolactone oral suspension reduces the renal clearance of lithium, thus increasing the risk of lithium toxicity.

Drug interactionsnames LithiumView label on DailyMed
Moderate

Monitor lithium levels periodically when spironolactone oral suspension is coadministered [see Clinical Pharmacology ( 12.3 )] .

Drug interactionsnames LithiumView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.