Dangerous Drug Interaction: ACE Inhibitors-Spironolactone
benazepril (Lotensin)
captopril (Capoten)
enalapril (Vasotec)
fosinopril (Monopril)
lisinopril (Prinivil, Zestril)
moexipril (Univasc)
perindopril (Aceon)
quinapril (Accupril)
ramipril (Altace)
trandolapril (Mavik) |
spironolactone (Aldactone) |
| Brand names appear in parentheses above and are trademarks of their respective manufacturers/owners. |
Impact: Potential for elevated serum potassium levels.1
Mechanism of Interaction: Unknown.
Alternatives to Patient Management: Evaluate need for additional drug therapy. ACE inhibitors are recommended in diabetic patients for nephroprotection. Spironolactone increased survival in patients with severe CHF. Prior to initiation, obtain a potassium level with a serum creatinine and BUN to further evaluate use of these agents in combination.7
Monitoring/Precautions: Potassium levels greater than 5.0 mmol/L and serum creatinine concentrations greater than 2.5mg/dL should be monitored carefully due to risk of severe hyperkalemia and EKG changes.7
References: Follow this link for a complete list of references.
The above information serves only as a guide for use by qualified medical practitioners in understanding, handling and avoiding frequent and potentially dangerous drug interactions that occur in long-term care. This presentation is not intended to instruct a practitioner how to treat any medical condition, nor is it intended to replace a practitioner's best clinical judgment. AMDA expressly disclaims responsibility and liability for any adverse effects, damages or other consequences resulting from the use of any of the information contained in this presentation.
|