Spironolactone interaction

Fenster PE, Hager WD, Goodman MM. Digoxin-quinidine spironolactone interaction. Clin Pharmacol Ther 1984 36 70-73. 

Hydrochlorothiazide A Spironolactone Aldactazide) [Antihypertensive/Thiazide K Sparing Diuretic] Uses Edema, HTN Action Thiazide K -sparing diuretic Dose 25-200 mg each component/d, doses Caution [D, +] Contra Sulfonamide aUa-gy Disp Tabs (HCTZ/spironolactone) 25 mg/25 mg, 50 mg/50 mg SE Photosens, X BP, t or -1-K% -1- Na% hypoglycemia, hyperlipidemia, hyperuricemia Additional Interactions t Risk of hypokalemia W/ ACEIs, K-sparing diuretics, K supls, salt substitutes -1- effects OF digoxin EMS See Hydrochlorothiazide Amiloride OD See Hydrochlorothiazide Amiloride... 

Almost all diuretics exert their action at the luminal surface of the renal tubule cells. Their mechanism of action includes interaction with specific membrane transport proteins like thiazides, furosemide etc., osmotic effects which prevent the water permeable segments of the nephron from absorbing water like mannitol, and specific interaction with enzyme like carbonic anhydrase inhibitors i.e. acetazolamide, and hormone receptors in renal epithelial cells like spironolactone. 

Aspirin has been shown to slightly reduce the natriuretic effect of spironolactone in healthy individuals, possibly by reducing active renal tubular secretion of canrenone, the active metabolite of spironolactone. However, the hypotensive effect of spironolactone and its effect on urinary potassium excretion in hypertensive patients is apparently not affected. Until more clinical data are available on this potential interaction, patients receiving both drugs should be monitored for signs and symptoms of decreased clinical response to spironolactone [65]. 

Eq. 21 assumes that each cosolvent interacts independently. Of course this is not always the case. In fact the data of Pramar and Das Gupta show a synergistic affect for the solubilization of the nonpolar solute, spironolactone. In addition, the use of one cosolvent can be used to increase the solubility of a partially miscible cosolvent in water. The facilitated cosolvency effect of multiple species in water has been shown by Gupta et al. " and Riley. " ... 

O Reilly RA. Spironolactone and warfarin interaction. Clin Pharmacol Ther 1980 27(2) 198-201. 

Spironolactone increases steady-state digoxin concentrations by about 30%, probably by inhibiting the renal tubular secretion of digoxin by P glycoprotein. There may also be a pharmacodynamic interaction with digoxin. The clinical importance of these observations is uncertain (SEDA-9, 209). 

Clinically important, potentially hazardous interactions with ACE inhibitors, benazepril, captopril, cyclosporine, enalapril, fosinopril, lisinopril, magnesium, moexipril, potassium salts, quinapril, quinidine, ramipril, spironolactone, trandolapril, zofenopril... 

Clinically important, potentially hazardous interactions with amiloride, spironolactone, triamterene... 

Clinically important, potentially hazardous interactions with amiloride, aminoglycosides, amphotericin B, ampicillin, anisindione, anticoagulants, armodafinil, atorvastatin, azathioprine, azithromycin, bacampicillin, basiliximab, bezafibrate, bosentan, bupropion, carbenicillin, caspofungin, cholestyramine, clarithromycin, cloxacillin, co-trimoxazole, corticosteroids, cyclophosphamide, daclizumab, danazol, dicloxacillin, dicumarol, digoxin, diltiazem, disulfiram, echinacea, erythromycin, ethotoin, etoposide, ezetimibe, flunisolide, fluoxymesterone, fluvastatin, foscarnet, fosphenytoin, gemfibrozil, hemophilus B vaccine, HMG-CoA reductase inhibitors, imatinib, imipenem/cilastatin, influenza vaccines, ketoconazole, lanreotide, lopinavir, lovastatin, mephenytoin, methicillin, methoxsalen, methylphenidate, methylprednisolone, methyltestosterone, mezlocillin, mizolastine, mycophenolate, nafcillin, nisoldipine, NSAIDs, orlistat, oxacillin, penicillins, phellodendron, phenytoin, pravastatin, prednisolone, prednisone, pristinamycin, ranolazine, red rice yeast, rifabutin, rifampin, rifapentine, ritonavir, rosuvastatin, simvastatin, sirolimus, spironolactone, St John s wort, sulfacetamide, sulfadiazine, sulfamethoxazole, sulfisoxazole, sulfonamides, tacrolimus, telithromycin, tenoxicam, testosterone, ticarcillin, tolvaptan, trabectedin, triamterene, troleandomycin, ursodeoxycholic acid, vaccines, vecuronium, warfarin, zofenopril... 

Clinically important, potentially hazardous interactions with allopurinol, amiloride, cimetidine, corticosteroids, cyclosporine, insulin, lithium, potassium sparing diuretics, potassium supplements, procainamide, spironolactone, triamterene... 

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