Compatibility «Spironolactone» and «Hydrochlorothiazide+Telmisartan»

• Interactions Spironolactone with Hydrochlorothiazide+Telmisartan

  • Dangerous interactions
    • ⓘ In elderly patients, patients with dehydration (including those taking diuretics) or impaired renal function, the combined use of NSAIDs, including selective COX-2 inhibitors, with ARA II, in pm telmisartan, may lead to deterioration of renal function, including possible acute renal failure.
    • ⓘ Hypokalemia and hypomagnesemia caused by the action of thiazide diuretics increase the toxicity of cardiac glycosides.
    • ⓘ The risk increases with the use of the above-mentioned combinations, and is especially high when used simultaneously with potassium-sparing diuretics and salt substitutes containing potassium.
    • ⓘ Simultaneous administration of Spironolactone Medisorb with other potassium-sparing diuretics, ACE inhibitors, ARA II, aldosterone blockers, potassium preparations, as well as adherence to a potassium-rich diet, or the use of potassium-containing salt substitutes, can lead to the development of severe hyperkalemia.
    • ⓘ With the simultaneous use of potassium-sparing diuretics and potassium-containing salt substitutes, the risk of hyperkalemia is especially high.
    • ⓘ Previous therapy with high-dose diuretics, including furosemide (a 'loop' diuretic), may lead to a decrease in BCC and an increased risk of arterial hypotension at the beginning of telmisartan therapy.
  • Negative interactions
    • ⓘ The use of NSAIDs, including selective COX-2 inhibitors, can reduce the diuretic, natriuretic and antihypertensive effects of diuretics.
    • ⓘ Therefore, when using a combination of hydrochlorothiazide + telmisartan and NSAIDs, including selective COX-2 inhibitors, it is necessary to carefully monitor to determine whether the desired effect of the diuretic is achieved.
    • ⓘ The risk of hyperkalemia may increase when used concomitantly with other drugs that can cause hyperkalemia (potassium-containing dietary supplements and salt substitutes containing potassium, potassium-sparing diuretics, for example, spironolactone, eplerenone, triamterene or amiloride), NSAIDs, including selective COX-2 inhibitors, heparin, immunosuppressants (cyclosporine or tacrolimus) and trimethoprim.
    • ⓘ ARA II, such as telmisartan, reduce diuretic-induced potassium loss.
    • ⓘ Potassium-sparing diuretics, such as spironolactone, eplerenone, triamterene or amiloride, potassium-containing dietary supplements or salt substitutes can lead to a significant increase in the potassium content in blood plasma.
    • ⓘ Previous treatment with high doses of diuretics such as furosemide (loop diuretic) and hydrochlorothiazide (thiazide diuretic) may lead to hypovolemia and risk of hypotension at the beginning of treatment with telmisartan.
    • ⓘ In some patients, NSAIDs may reduce the diuretic, natriuretic and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.
    • ⓘ Antihypertensive drugs: spironolactone potentiates the effect of antihypertensive drugs, the dose of which, when taken simultaneously with spironolactone, may need to be reduced and adjusted further if necessary.
    • ⓘ Nonsteroidal anti-inflammatory drugs (NSAIDs): In some patients, NSAIDs may reduce the diuretic, natriuretic and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.
    • ⓘ Angiotensin II antagonists, aldosterone blockers, heparin, low molecular weight heparin and other drugs that cause hyperkalemia.
    • ⓘ The risk may increase when combined with other medications that can also provoke hyperkalemia (salt substitutes containing potassium, potassium‑sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, nonsteroidal anti‑inflammatory drugs (NSAIDs, including selective COX-2 inhibitors), heparin, immunosuppressants (cyclosporine or tacrolimus) and co-trimoxazole (trimethoprim + sulfamethoxazole).
    • ⓘ ARA II, such as telmisartan, reduces potassium loss caused by diuretics.
    • ⓘ Potassium-sparing diuretics such as spironolactone, eplerenone, triamterene or amiloride, potassium preparations or potassium-containing salts can cause a significant increase in serum potassium content.
  • Unclear interactions
    • ⓘ Diuretics, potassium-sparing diuretics, or potassium-containing dietary supplements.
    • ⓘ Potassium-sparing diuretics and salt substitutes containing potassium.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,027,037 possible combinations of drugs and their components were found 412,563 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-01-01

Category - medicine