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Spironolactone and ACEI or ARBs - safety advice

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Reminder for healthcare professionals:

  • concomitant use of spironolactone with ACEi or ARB is not routinely recommended because of the risks of severe hyperkalaemia, particularly in patients with marked renal impairment

  • use the lowest effective doses of spironolactone and ACEi or ARB if coadministration is considered essential

  • regularly monitor serum potassium levels and renal function

  • interrupt or discontinue treatment in the event of hyperkalaemia

Reference:

  • Medicines and Healthcare products Regulatory Agency (MHRA). Drug Safety Update February 2016.

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