Aldactone (spironolactone) is a brand-name oral tablet that’s prescribed for heart failure, high blood pressure, and other conditions. Aldactone has interactions with certain other drugs and supplements. Examples include nonsteroidal anti-inflammatory drugs and potassium supplements.
An interaction occurs when one substance causes another substance to have a different effect than expected.
To learn more about Aldactone’s interactions, keep reading. For additional information about Aldactone, including details about its uses, see this article.
In some cases, factors or conditions could prevent your doctor from prescribing Aldactone due to the risk of harm. These are known as contraindications. Aldactone contraindications include:
Having a high blood level of potassium
Doctors typically will not prescribe Aldactone if you have a high blood level of potassium. This is because Aldactone may cause a high blood level of potassium as a side effect, which can worsen this condition.
If you have a high blood level of potassium, your doctor will likely manage it before prescribing Aldactone.
Having Addison’s disease
Doctors typically will not prescribe Aldactone if you have Addison’s disease. With this condition, the body doesn’t produce enough of certain hormones, including aldosterone. Aldactone works by lowering the aldosterone level in the body, which may worsen this condition.
If you have Addison’s disease, your doctor will likely prescribe a drug other than Aldactone for you.
Aldactone and eplerenone belong to the same drug class, called aldosterone antagonists. Taking these medications together may increase your risk of side effects from either drug.
If you take eplerenone, your doctor can recommend a treatment other than Aldactone.
Note: Before you start treatment with Aldactone, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Aldactone.
There are no known interactions between Aldactone and alcohol.
However, keep in mind that consuming large amounts of alcohol can lead to high blood pressure. Aldactone can be prescribed to manage high blood pressure. So drinking alcohol while taking Aldactone for high blood pressure may make it hard for you to tell if the drug is working.
If you have questions about drinking alcohol while taking Aldactone, talk with your doctor or pharmacist.
Before you start treatment with Aldactone, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Aldactone interacts with supplements, herbs, or vitamins, see the “Aldactone and other interactions” section below.)
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with Aldactone. Keep in mind that this table doesn’t include all drugs that may interact with Aldactone. Some of these interactions are described in detail just below in “Drug interactions in depth.”
|Drug class or drug name||Drug examples||Interaction result with Aldactone|
|eplerenone (Inspra)*||—||can increase the risk of side effects from Aldactone and eplerenone|
|lithium (Lithobid)||—||can increase the risk of side effects from lithium|
|cholestyramine (LoCholest, Prevalite)||—||can increase the risk of side effects from cholestyramine|
|angiotensin receptor blockers (ARBs)||• candesartan (Atacand)|
• irbesartan (Avapro)
• valsartan (Diovan)
|can increase the risk of side effects from Aldactone and ARBs|
|angiotensin converting enzyme (ACE) inhibitors||• lisinopril (Qbrelis, Zestril)|
• ramipril (Altace)
|can increase the risk of side effects from Aldactone and ACE inhibitors|
|nonsteroidal anti-inflammatory drugs (NSAIDs)||• aspirin|
• ibuprofen (Advil, Motrin)
• naproxen (Aleve, Anaprox DS, others)
|can increase the risk of side effects from Aldactone and NSAIDs or make Aldactone less effective|
|certain antibiotics||• sulfamethoxazole/|
trimethoprim (Bactrim, Septra)
|can increase the risk of side effects from Aldactone and certain antibiotics|
|certain blood thinners||• heparin|
• dalteparin (Fragmin)
• enoxaparin (Lovenox)
• warfarin (Jantoven)
|can increase the risk of side effects from Aldactone and certain blood thinners|
* For details about this interaction, see the “When to avoid Aldactone” section above.
Here’s a closer look at certain drug interactions of Aldactone.
Interaction result. Taking Aldactone with cholestyramine can increase the risk of side effects from cholestyramine.
Interaction explained. Cholestyramine may cause metabolic acidosis (high acid level in the blood) as a side effect. Because of the way Aldactone works in the body, taking the drug with cholestyramine may increase the risk of this side effect.
In addition, Aldactone may also cause a high blood level of potassium as a side effect. Having a high blood level of potassium can also worsen metabolic acidosis.
Steps you or your doctor may take. Before taking Aldactone, be sure to tell your doctor if you take cholestyramine. They can recommend whether it’s safe to take these medications together.
If you do take Aldactone with cholestyramine, your doctor may give you blood tests to monitor your electrolyte levels. This will help them determine whether you’re at risk of high potassium or metabolic acidosis.
Tell your doctor right away if you have symptoms of metabolic acidosis, such as confusion, shallow and rapid breathing, and increased heart rate. This condition can range from mild to life threatening. Your doctor can give you tests for this condition and tell you whether treatment is needed. If your symptoms are serious or you think you’re having a medical emergency, immediately call 911 or the local emergency number.
Nonsteroidal anti-inflammatory drugs
Interaction result. Taking Aldactone with NSAIDs can increase your risk of side effects from either drug. Taking them together can also make Aldactone less effective.
Interaction explained. Aldactone and NSAIDs can cause a high blood level of potassium when taken individually. Taking these medications together can further increase this risk.
In addition, NSAIDs can affect how well your kidneys remove water and sodium (salt) from your body. Having higher levels of water and sodium may increase your blood pressure.
Among other conditions, Aldactone is prescribed to manage high blood pressure. If you take Aldactone for this use, taking NSAIDs could raise your blood pressure and make it hard to tell whether Aldactone is working for your condition.
Examples of NSAID drugs. Here are some NSAIDs that may interact with Aldactone:
Steps you or your doctor may take. Before starting treatment with Aldactone, tell your doctor if you take any NSAIDs. They can advise you on whether it’s safe to take Aldactone with an NSAID.
Keep in mind that certain NSAIDs are available without a prescription. Talk with your doctor or pharmacist before taking any treatments for fever, pain, or inflammation. They can recommend products that are safe to take with Aldactone. For example, it’s likely safe to take Aldactone with acetaminophen (Tylenol).
Interaction result. The specific antibiotics that may interact with Aldactone include sulfamethoxazole/trimethoprim (Bactrim, Septra) and trimethoprim. Taking Aldactone in combination with these drugs can increase your risk of side effects from either medication.
Interaction explained. Aldactone and antibiotics that contain trimethoprim can cause a high blood level of potassium when taken individually. Taking Aldactone with these antibiotics can further increase this risk.
Steps you or your doctor may take. If you need an antibiotic while taking Aldactone, be sure the doctor prescribing the antibiotic knows that you’re taking Aldactone. They’ll decide whether the specific antibiotic you need can be taken with Aldactone. Your doctor can tell you whether an antibiotic that isn’t known to interact with Aldactone may be prescribed instead.
Aldactone may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Aldactone.
Aldactone interactions with supplements
Before you start treatment with Aldactone, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Aldactone and herbs
There are no specific reports of herbs interacting with Aldactone. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Aldactone treatment.
Aldactone interactions with minerals and vitamins
Here’s some information on Aldactone, minerals, and vitamins.
Due to this risk, your doctor will likely advise you to avoid potassium supplements while taking Aldactone. If you have questions about Aldactone and potassium, talk with your doctor or pharmacist.
There are no specific reports of vitamins interacting with Aldactone. However, certain multivitamins may contain potassium, which is known to interact with Aldactone. (For details, see “Minerals” above.)
Before taking any vitamin products with Aldactone, talk with your doctor or pharmacist. They can help you determine whether a product contains any potassium.
Aldactone interactions with food
Salt substitutes that contain potassium may interact with Aldactone. Using these products while taking Aldactone can increase your risk of a high blood potassium level as a side effect.
Due to this risk, your doctor will likely recommend avoiding salt substitutes that contain potassium while taking Aldactone. They can tell you whether other salt alternatives may be safe to use with Aldactone.
Aldactone and vaccines
There are no specific reports of vaccines interacting with Aldactone. To learn more about getting specific vaccines while taking Aldactone, talk with your doctor.
Aldactone interactions with lab tests
Aldactone may interact with a certain lab test that measures your blood level of digoxin (Lanoxin). Specifically, taking Aldactone while getting this test can make your blood level of digoxin appear higher than it actually is.
Before having a blood test to check your digoxin level, be sure your doctor knows if you’re taking Aldactone. They can give you a different type of test that isn’t affected by Aldactone.
ALDACTONE AND CANNABIS OR CBD
Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Aldactone. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Aldactone. The effects of cannabis may affect how well you stick to your Aldactone treatment plan.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with Aldactone. Before you take this drug, be sure to talk with your doctor about your health history. Aldactone may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with Aldactone include:
- High blood level of potassium. Doctors typically will not prescribe Aldactone for people with a high blood level of potassium. For details, see the “When to avoid Aldactone” section above.
- Addison’s disease. Doctors typically will not prescribe Aldactone for people with Addison’s disease. For details, see the “When to avoid Aldactone” section above.
- Kidney disease. If you have kidney disease, talk with your doctor before taking Aldactone. Having kidney disease may increase your risk of high blood potassium as a side effect of the drug. Your doctor may watch your blood potassium level closely during Aldactone treatment.
- Liver disease. If you have liver disease, such as cirrhosis, talk with your doctor before taking Aldactone. They’ll likely have you stay in the hospital to receive your first few doses of the drug. This is because Aldactone may cause problems with electrolyte levels, which can lead to nerve problems in people who have certain types of liver disease. Receiving the drug while in the hospital allows your doctor to watch closely for side effects.
- Pregnancy. It may not be safe to take Aldactone during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting Aldactone treatment.
- Breastfeeding. It isn’t known for certain whether Aldactone is safe to take while breastfeeding. That said, the drug isn’t known to pass into breast milk or cause side effects in a child who is breastfed. For more information about taking Aldactone while breastfeeding, talk with your doctor.
- Allergic reaction. If you’ve had an allergic reaction to Aldactone or any of its ingredients, your doctor will likely not prescribe Aldactone. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
Here are some frequently asked questions about Aldactone and possible interactions.
Is Aldactone a steroid? Does it interact with steroids?
No, Aldactone isn’t a steroid. And it isn’t known to interact with steroids.
Instead, Aldactone belongs to a drug class called aldosterone antagonists. It works by lowering the level of a steroid hormone called aldosterone. This hormone is made naturally by your body.
If you have questions about Aldactone and steroids, talk with your doctor or pharmacist.
You can take certain steps to help prevent interactions with Aldactone. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
- Let them know if you drink alcohol.
- Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
- Create a
medication list, which your doctor and pharmacist can help you fill out.
It’s also important to read the Aldactone label and other
If Aldactone doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with Aldactone by taking it exactly as your doctor prescribes.
Besides learning about interactions, you may want to find out more about Aldactone. These resources might help:
- Overview of Aldactone. For a general overview of Aldactone, you can see this article.
- Drug comparison. For information about how Aldactone compares with Entresto, read this article.
- Facts about your condition. To learn more about heart failure and high blood pressure, see our cardiovascular health hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.