Enalapril and Spironolactone: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Enalapril and Spironolactone unless specifically directed by your doctor.
How Enalapril interacts with Spironolactone
Both drugs reduce renal potassium excretion — ACE inhibition lowers aldosterone production while spironolactone blocks aldosterone receptors — causing additive hyperkalemia, especially in renal impairment.
What you should do
Monitor serum potassium and creatinine at baseline, within 1-2 weeks of initiation, then every 3-6 months. Avoid in eGFR <30 mL/min.
Key facts
Severity
Major — avoid combination
Mechanism
Both drugs reduce renal potassium excretion — ACE inhibition lowers aldosterone production while spironolactone blocks a...
Action
Monitor serum potassium and creatinine at baseline, within 1-2 weeks of initiation, then every 3-6 months. Avoid in eGFR...
Frequently asked questions
Can I take Enalapril and Spironolactone together?
No — this combination should generally be avoided. Monitor serum potassium and creatinine at baseline, within 1-2 weeks of initiation, then every 3-6 months. Avoid in eGFR <30 mL/min.
What is the severity of this interaction?
The interaction between Enalapril and Spironolactone is classified as Major — avoid combination. Both drugs reduce renal potassium excretion — ACE inhibition lowers aldosterone production while spironolactone blocks aldosterone receptors — causing additive hyperkalemia, especially in renal impairment.
What should I do if I'm prescribed both?
Monitor serum potassium and creatinine at baseline, within 1-2 weeks of initiation, then every 3-6 months. Avoid in eGFR <30 mL/min. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.