Spironolactone and hydrochlorothiazide and Triamterene and hydrochlorothiazide interaction

Spironolactone and hydrochlorothiazide and Triamterene and hydrochlorothiazide: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

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

Major

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.

Precautionsby drug classView label on DailyMed
Moderate

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…

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
Minor

Other Metabolic Disturbances Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides.

Precautionsnames Triamterene and hydrochlorothiazideView label on DailyMed

From the Triamterene and hydrochlorothiazide label · effective 2026-07-16

Major

CONTRAINDICATIONS Antikaliuretic Therapy and Potassium Supplementation Triamterene and hydrochlorothiazide should not be given to patients receiving other potassium-sparing agents such as spironolactone, amiloride, or other formulations containing triamterene.

Contraindicationsby drug classView label on DailyMed
Moderate

Other Considerations Concurrent use of hydrochlorothiazide with amphotericin B or corticosteroids or corticotropin (ACTH) may intensify electrolyte imbalance, particularly hypokalemia, although the presence of triamterene minimizes the hypokalemic effect.

Drug interactionsnames Spironolactone and hydrochlorothiazideView label on DailyMed
Moderate

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

Drug interactionsby drug classView label on DailyMed
Minor

See INDICATIONS AND USAGE for concomitant use with other antihypertensive drugs.

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.