MAJOR — Use With Caution
FDA-documented interaction. Monitor potassium and renal function. May be intentionally used in heart failure with close monitoring.
Evidence level: STRONG
Spironolactone and enalapril both raise potassium levels. Taking them together significantly increases your risk of dangerously high potassium, which can affect your heart rhythm.
Same mechanism — aldosterone antagonist plus ACE inhibitor causes additive potassium retention. FDA labels warn about hyperkalemia.
Get regular potassium blood tests. Avoid potassium supplements and salt substitutes containing potassium chloride. Stay well hydrated.
Take Enalapril at the same time daily. Spironolactone follows its prescribed schedule. ACE inhibitors can be taken with or without food. If you develop a persistent dry cough, report it to your prescriber.
Higher risk for: those with renal impairment, hyperkalemia risk, concurrent potassium-sparing diuretics or potassium supplements, elderly, dehydrated patients, or those with bilateral renal artery stenosis.
Muscle weakness, irregular heartbeat, numbness, fatigue, nausea
Regular potassium and creatinine monitoring. Avoid potassium supplements. Start at low doses of both medications.
ACE inhibitor interactions often involve potassium levels or blood pressure effects. Ask your doctor about ARBs as alternatives, or adjust the timing of the interacting substance. Monitor potassium levels and blood pressure regularly.
Spironolactone and enalapril both raise potassium levels. Taking them together significantly increases your risk of dangerously high potassium, which can affect your heart rhythm.
Take Enalapril at the same time daily. Spironolactone follows its prescribed schedule. ACE inhibitors can be taken with or without food. If you develop a persistent dry cough, report it to your prescriber.
Muscle weakness, irregular heartbeat, numbness, fatigue, nausea
ACE inhibitor interactions often involve potassium levels or blood pressure effects. Ask your doctor about ARBs as alternatives, or adjust the timing of the interacting substance. Monitor potassium levels and blood pressure regularly.
Regular potassium and creatinine monitoring. Avoid potassium supplements. Start at low doses of both medications.
Or browse the full interaction database (121,000+ pairs).