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As is the case with any other medication, there may be some instances where spironolactone interactions can occur. In such cases, use is not recommended or usage will have to be adjusted in order to prevent or reduce the risk of negative interactions occurring from other drugs, medical conditions, or even food and drink.

Drug Interactions

According to the FDA, drugs that may interact with this medication include the following.

  • Medications that increase serum potassium due to the risk of hyperkalemia.
  • Lithium, as spironolactone may increase or decrease the elimination of Lithium.
  • NSAIDs, such as aspirin (acetylsalicylic acid) and ibuprofen (Advil), since they might decrease the effects of spironolactone.
  • Digoxin (Digox, Lanoxin), as spironolactone may diminish the effects of Digoxin and may also falsely increase or decrease Digoxin levels.
  • Cholestyramine (Prevalite) due to a risk of hyperkalemic metabolic acidosis.

Please note that this list may not be complete, and other interactions with drugs not listed here may occur.

Vyvanse (Lisdexamfetamine)

Possible interactions between Vyvanse and spironolactone are not fully understood; more research is needed to understand potential interactions better. Patients who take Vyvanse should talk to their medical provider about potential risks before taking spironolactone.

Ibuprofen (Advil)

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that might decrease the effectiveness of spironolactone, including its diuretic (urination promoting), antihypertensive (anti-high blood pressure), and natriuretic (sodium secretion) effects.


Certain antibiotics might not be safe to take with spironolactone. A 2015 study found that combining spironolactone with trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim), an antibiotic, raised the risk of sudden death compared to other antibiotics due to increase in potassium levels.

Tylenol (Acetaminophen)

Interactions between Tylenol and spironolactone are not known to occur. While it may be safe to take Tylenol while using spironolactone, you should talk to your medical provider first.

Metoprolol (Toprol XL)

Both of these medications are used to treat high blood pressure (hypertension). The combined use of spironolactone and metoprolol might result in blood pressure levels that are too low (hypotension). Hypotension can lead to dizziness, weakness, a fast heartbeat (tachycardia), an irregular heartbeat (arrhythmia), poor blood glucose control, or fainting. 

Sertraline (Zoloft)

Sertraline is associated with very low levels of sodium (hyponatremia) in the blood in some patients (though rare). Since spironolactone can also cause decreased sodium levels, these medications should not be combined without first talking to a medical provider about the risks.


Spironolactone can lead to increased levels of potassium (hyperkalemia), since it helps the body retain this mineral. Taking supplements or other products with potassium might lead to potassium levels that are too high.


A 2012 study found that a patient developed central serous chorioretinopathy (CSC) while taking Adderall and spironolactone. This condition, in which fluid accumulation occurs under the retina, resolved after the patient stopped taking spironolactone and returned when spironolactone use was started again. More research is needed to determine if the use of spironolactone raises the risk of this condition in other patients who take Adderall.

Food Interactions

Sometimes the foods we eat and the beverages we drink can also interact with our medications. Food and drink that may interact with this drug include:

  • Salt substitutes and foods that are high in potassium and low in sodium, which could lead to high potassium levels (hyperkalemia).
  • Foods that are high in salt or sodium, since these can affect spironolactone’s effectiveness at easing water retention.

Spironolactone and Alcohol

For more information, please visit our page on spironolactone and alcohol interactions.

Vitamins and Supplements

As a potassium-sparing diuretics—or “water pill” that helps the body retain potassium—spironolactone may increase potassium levels. Patients who are taking this medication should talk to their medical provider about any vitamins or supplements they normally take to make sure they’re safe. Supplements containing potassium might be unsafe as it could lead to hyperkalemia (high potassium levels).

Disease & Conditions Interactions

Sometimes certain medications can increase the risk of negative side effects for patients with certain diseases or other medical conditions. According to the FDA, diseases and medical conditions that are known to negatively interact with spironolactone include:

  • Liver disease: This medication may lead to a hepatic coma with symptoms such as confusion, concentration problems, memory problems, poor judgment, and abnormal movement.
  • Hyperkalemia (high potassium): This medication might increase the severity of this condition.
  • Kidney disease: This medication is associated with a higher risk of side effects in those who have kidney disease, and potassium levels must be closely monitored.
  • Addison’s disease (hypocortisolism or adrenal insufficiency): This medication might cause this disease to become more severe.
  • Heart disease: Those who have heart disease, such as heart failure, should avoid taking potassium supplements and consuming a high-sodium diet while taking this medication.

Please note that this list may not be complete, and there may be other diseases and medical conditions where patients should not take this medication.

Spironolactone and Pregnancy

For more information, please visit our page on spironolactone and pregnancy risks.

Spironolactone and Breastfeeding

For more information, please visit our page on spironolactone and pregnancy risks.

Weight Gain

Some patients have reported experiencing weight gain while taking spironolactone. However, it is not known if this medication was directly responsible for the weight gain. More research is needed in order to determine if this event is a potential side effect of this medication.


Spironolactone may cause headaches for some people. If you suffer from chronic headaches or migraines, talk to your medical provider about the potential side effects of spironolactone before using it.

Other Interactions

Other potential interactions include the following.


Spironolactone may decrease testosterone levels. A 2012 study showed that the use of this medication resulted in lower levels of circulating free testosterone, which might raise the risk of a decreased libido (sex drive) and gynecomastia (enlarged male breasts or “man boobs”).

Sex Drive

Spironolactone might lead to a lower sex drive (libido). A 2012 study found that this medication may decrease libido due to lower levels of testosterone.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.


Generic Name: Spironolactone


Class: Aldosterone antagonist, potassium-sparing diuretic

Availability: Prescription

Molecular Formula: C24H32O4S

Substance UNII: 27O7W4T232

What is Spironolactone?

Spironolactone is an aldosterone antagonist and potassium-sparing diuretic. It is often sold under the trade names Aldactone and CaroSpir.

What is Spironolactone Used For?

The FDA has approved spironolactone for the treatment of heart failure, hypertension, edema associated with nephrotic syndrome or hepatic cirrhosis, and primary hyperaldosteronism. People also sometimes use it to treat acne or to promote weight loss.

How Does Spironolactone Work?

Spironolactone works by blocking the activity of aldosterone, a steroid hormone associated with water retention. This fluid retention can cause certain problems to worsen such as kidney, heart, or liver diseases or conditions. Taking this medication causes higher amounts of water and sodium to be eliminated, thereby reducing water retention.

Spironolactone also prevents your body from excreting or getting rid of potassium. Notably, potassium helps reduce water retention through promoting urination and excretion of sodium during urination.

How Long Does It Take for Spironolactone to Work?

The time it takes for this drug to work depends on what it is being used for and other factors, such as the presence of other medical conditions and dosage being taken. A 2012 study found that it generally takes a few weeks for spironolactone to become effective when it is used for treating acne.

Do Not Use Spironolactone If:

There are several situations where this medication may not be the right choice for you. According to the FDA, the following should not use spironolactone:

  • Patients with hyperkalemia (high potassium)
  • Patients with Addison’s disease (hypocortisolism or adrenal insufficiency)
  • Patients who are using eplerenone (Inspra)

Please note that this list may not be complete, and there may be other situations where use of this drug is not advisable.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.

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