Moexipril and Spironolactone and hydrochlorothiazide interaction

Moexipril and Spironolactone and hydrochlorothiazide: 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 Moexipril (Moexipril Hydrochloride) label · effective 2026-01-23

Moderate

Symptomatic hypotension is most likely to occur in patients who have been salt- and volume- depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting.

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Moderate

Volume- and salt-depletion should be corrected and, in general, diuretics stopped, before initiating therapy with moexipril hydrochloride (see PRECAUTIONS, Drug Interactions , and ADVERSE REACTIONS ).

Warningsby drug classView label on DailyMed
Moderate

In these patients, moexipril hydrochloride therapy should be started under close medical supervision, and patients should be followed closely for the first two weeks of treatment and whenever the dose of moexipril or an accompanying diuretic is increased.

Warningsby drug classView label on DailyMed
Moderate

Drug Interactions Diuretics: Excessive reductions in blood pressure may occur in patients on diuretic therapy when ACE inhibitors are started.

Drug interactionsby drug classView label on DailyMed
Moderate

Potassium Supplements and Potassium-Sparing Diuretics: Moexipril hydrochloride can increase serum potassium because it decreases aldosterone secretion.

Drug interactionsby drug classView label on DailyMed

From the Spironolactone and hydrochlorothiazide label · effective 2026-02-10

Moderate

…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…

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Moderate

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

Warningsby drug classView label on DailyMed
Moderate

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

Warningsby drug classView label on DailyMed
Moderate

Drug interactions ACE inhibitors, Angiotensin II receptor antagonists, aldosterone blockers, potassium supplements, heparin, low molecular weight heparin, and other drugs known to cause hyperkalemia: Concomitant administration may lead to severe hyperkalemia.

Drug interactionsby drug classView 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.