Compatibility «Spironolactone» and «Indapamide+Ramipril»

• Interactions Spironolactone with Indapamide+Ramipril

  • Dangerous interactions
    • ⓘ With the simultaneous use of diuretics with metformin, renal failure may develop, and the risk of lactic acidosis increases.
    • ⓘ Against the background of taking diuretics, there is a decrease in BCC, an increased risk of acute renal failure, especially when using high doses of iodine-containing contrast agents.
    • ⓘ Functional renal insufficiency, which can occur against the background of taking diuretics, especially loop ones, increases the risk of developing metformin-induced lactic acidosis.
    • ⓘ In case of dehydration of the body while taking diuretic drugs, the risk of acute renal failure increases, especially when using high doses of iodine-containing contrast agents.
    • ⓘ 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.
    • ⓘ Since ACE inhibitors reduce the production of aldosterone, drugs of this group should not be used in conjunction with spironolactone on a regular basis, especially in patients with established renal dysfunction.
  • Negative interactions
    • ⓘ Concomitant use with potassium-containing drugs, potassium-sparing diuretics (amiloride, spironolactone, eplerenone, triamterene), and other drugs capable of increasing the potassium content in blood plasma (including trimethoprim, tacrolimus, cyclosporine, heparin) increases the risk of hyperkalemia (especially in patients with diabetes mellitus and patients with renal insufficiency).
    • ⓘ Concomitant use with potassium preparations, potassium-sparing diuretics (amiloride, spironolactone, eplerenone, triamterene), and other drugs capable of increasing the potassium content in blood plasma (including trimethoprim, tacrolimus, cyclosporine, heparin) increases the risk of hyperkalemia (especially in patients with diabetes mellitus and patients with renal insufficiency).
    • ⓘ If necessary, diuretic drugs can be used in combination with lithium preparations, while carefully monitoring the concentration of lithium in blood plasma and selecting the dose of the drug accordingly.
    • ⓘ Patients with arterial hypertension and, possibly, a reduced concentration of sodium ions in blood plasma due to previous diuretic intake should:.
    • ⓘ - 3 days before the start of treatment with an ACE inhibitor, stop taking diuretics; in the future, if necessary, non-potassium-sparing diuretics can be resumed;.
    • ⓘ Combination therapy with indapamide and potassium-sparing diuretics is advisable in some patients, however, the possibility of hypokalemia or hyperkalemia is not excluded (especially in patients with renal insufficiency or patients with diabetes mellitus).
    • ⓘ With potassium salts, potassium-sparing diuretics (for example, amiloride, triamterene, spironolactone, eplerenone (a derivative of spironolactone), other drugs capable of increasing serum potassium (including ARA II, tacrolimus, cyclosporine; trimethoprim and sulfamethoxazole, which are part of co-trimoxazole (a combined antibacterial agent containing sulfamethoxazole and trimethoprim).
    • ⓘ In combination with diuretics, the sodium content in the blood serum should be regularly monitored.
    • ⓘ 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.
    • ⓘ If simultaneous use of indapamide with potassium-sparing diuretics is necessary, then the potassium content in blood plasma, ECG readings should be monitored and, if necessary, therapy should be adjusted.
    • ⓘ Concomitant administration of ACE inhibitors with potassium-sparing diuretics has been associated with severe hyperkalemia.
    • ⓘ The effects are enhanced by antihypertensive agents, including beta-blockers, in pm with significant systemic absorption from ophthalmic forms, diuretics, opioid analgesics, drugs for anesthesia, alcohol.
    • ⓘ Reduces secondary hyperaldosteronism and hypokalemia caused by diuretics.
    • ⓘ Potassium-sparing diuretics, cyclosporine, potassium-containing drugs and additives, salt substitutes, low-salt milk increase the risk of hyperkalemia.
    • ⓘ With potassium salts, potassium-sparing diuretics (for example, amiloride, spironolactone, triamterene, eplerenone (a derivative of spironolactone)), other drugs capable of increasing serum potassium (including ARA II, tacrolimus, cyclosporine; trimethoprim, sulfamethoxazole, which are part of co-trimoxazole (a combined antibacterial agent containing sulfamethoxazole and trimethoprim)).
    • ⓘ With antihypertensive drugs (for example, diuretics) and other drugs that reduce blood pressure (nitrates, tricyclic antidepressants, general and local anesthesia, baclofen, alfuzosin, doxazosin, prazosin, tamsulosin, terazosin).
    • ⓘ Potentiation of the antihypertensive effect; in relation to combination with diuretics, see also the sections 'Method of administration and doses', 'Side effect', 'Special instructions', when combined with diuretics, the sodium content in blood serum should be regularly monitored.
    • ⓘ ACE inhibitors (C09A) + potassium-sparing diuretics => Severe hypotension, risk of renal failure, hyperkalemia.
  • Positive interactions
    • ⓘ With antihypertensive drugs (for example, diuretics) and other drugs that reduce blood pressure (nitrates, tricyclic antidepressants, general and local anesthesia, baclofen, alfuzosin, doxazosin, prazosin, tamsulosin, terazosin), there is a potentiation of the antihypertensive effect.
  • Unclear interactions
    • ⓘ Potassium-sparing diuretics (amiloride, spironolactone, triamterene).
    • ⓘ The simultaneous use of indapamide with potassium-sparing diuretics is advisable in some patients.
    • ⓘ ACE inhibitors.

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

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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