Spironolactone - DrugBank

ID Pharmacology Interactions References Trials Economics Properties Spectra Taxonomy

Targets (12)Enzymes (2)Transporters (3)

Targets (12)Enzymes (2)Transporters (3)Biointeractions (12)

Identification

Name

Spironolactone

Accession Number

DB00421 (APRD01234)

Type

Small Molecule

Groups

Approved

Description

A potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827)

Structure

MOL SDF 3D-SDF PDB SMILES InChI View 3D Structure

Synonyms

Espironolactona

Spironolactone

Spironolactonum

Spironolattone

External IDs

NSC-150399 / SC-9420

Product Ingredients

Not Available

Product Images

Approved Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Aldactone	Tablet, film coated	100 mg/1	Oral	G.D. Searle LLC Division of Pfizer Inc	1960-01-21	Not applicable	US
Aldactone	Tablet, film coated	50 mg/1	Oral	G.D. Searle LLC Division of Pfizer Inc	1960-01-21	Not applicable	US
Aldactone	Tablet, film coated	25 mg/1	Oral	G.D. Searle LLC Division of Pfizer Inc	1960-01-21	Not applicable	US
Aldactone 100 mg	Tablet	100 mg	Oral	Pfizer	1975-12-31	Not applicable	Canada
Aldactone 25 mg	Tablet	25 mg	Oral	Pfizer	1959-12-31	Not applicable	Canada
Ntp-spironolactone	Tablet	100 mg	Oral	Nt Pharma Canada Ltd	Not applicable	Not applicable	Canada
Ntp-spironolactone	Tablet	25 mg	Oral	Nt Pharma Canada Ltd	Not applicable	Not applicable	Canada
Spironolactone	Tablet, film coated	50 mg/1	Oral	Pd Rx Pharmaceuticals, Inc.	1960-01-21	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Greenstone, Llc	1960-01-21	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Greenstone, Llc	1960-01-21	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Greenstone, Llc	1960-01-21	Not applicable	US
Teva-spironolactone	Tablet	25 mg	Oral	Teva	1984-12-31	Not applicable	Canada
Teva-spironolactone	Tablet	100 mg	Oral	Teva	1984-12-31	Not applicable	Canada

Approved Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End
Spironolactone	Tablet, film coated	25 mg/1	Oral	Mc Kesson Contract Packaging	2011-12-07	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Mylan Pharmaceuticals	2002-01-22	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Blenheim Pharmacal, Inc.	2013-10-02	Not applicable	US
Spironolactone	Tablet	100 mg/1	Oral	Amneal Pharmaceuticals of New York Llc	2010-08-02	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Cardinal Health	2011-05-19	2016-03-02	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Amerincan Health Packaging	2010-04-14	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Remedy Repack	2014-03-11	2017-04-14	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Ncs Health Care Of Ky, Inc Dba Vangard Labs	2001-08-20	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Rebel Distributors	2007-01-03	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Preferreed Pharmaceuticals Inc.	2014-10-17	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Nucare Pharmaceuticals, Inc.	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Unit Dose Services	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Accord Healthcare Limited	2017-06-02	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Preferreed Pharmaceuticals Inc.	2016-10-17	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Unit Dose Services	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Preferreed Pharmaceuticals Inc.	2017-02-13	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	State of Florida DOH Central Pharmacy	2013-01-01	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	bryant ranch prepack	1986-07-23	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	St. Marys Medical Park Pharmacy	2013-05-22	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Actavis Pharma Company	2007-01-03	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Sun Pharmaceutical Industries Limited	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Proficient Rx LP	2013-02-01	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Aidarex Pharmaceuticals LLC	2013-02-01	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Mylan Institutional	2002-02-20	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Nucare Pharmaceuticals, Inc.	2013-02-01	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Physicians Total Care, Inc.	2004-03-09	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Accord Healthcare Limited	2017-06-02	Not applicable	US
Spironolactone	Tablet	50 mg/1	Oral	Mc Kesson Packaging Services A Buisness Unit Of Mc Kesson Corporation	2011-06-01	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Sandoz	1982-01-01	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Qualitest	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Aidarex Pharmaceuticals LLC	2006-08-29	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	State of Florida DOH Central Pharmacy	2009-07-01	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Jubilant Cadista Pharmaceuticals Inc.	2013-02-01	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Carilion Materials Management	2007-01-03	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Preferreed Pharmaceuticals Inc.	1994-03-25	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Blenheim Pharmacal, Inc.	2014-02-12	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Av Pak	2011-05-19	Not applicable	US
Spironolactone	Tablet	50 mg/1	Oral	A S Medication Solutions	2010-08-02	2016-10-20	US
Spironolactone	Tablet	25 mg/1	Oral	Remedy Repack	2013-05-28	2017-01-05	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Ncs Health Care Of Ky, Inc Dba Vangard Labs	2001-08-20	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2011-04-15	Not applicable	US
Spironolactone	Tablet	100 mg/1	Oral	Remedy Repack	2016-08-16	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	bryant ranch prepack	2007-01-03	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Pd Rx Pharmaceuticals, Inc.	2010-08-02	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Amneal Pharmaceuticals of New York Llc	2010-08-02	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Cardinal Health	2011-02-04	Not applicable	US
Spironolactone	Tablet	100 mg/1	Oral	Amneal Pharmaceuticals of New York Llc	2010-08-02	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	A S Medication Solutions	2013-02-01	2017-06-20	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Physicians Total Care, Inc.	1994-03-25	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	bryant ranch prepack	1986-07-23	Not applicable	US
Spironolactone	Tablet	50 mg/1	Oral	Mc Kesson Packaging Services A Buisness Unit Of Mc Kesson Corporation	2009-08-18	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Avera Mc Kennan Hospital	2015-03-24	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Mylan Pharmaceuticals	2002-01-22	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Rebel Distributors	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	State of Florida DOH Central Pharmacy	2009-07-01	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Jubilant Cadista Pharmaceuticals Inc.	2013-02-01	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Amerincan Health Packaging	2011-06-10	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Remedy Repack	2014-06-24	Not applicable	US
Spironolactone	Tablet	50 mg/1	Oral	Major	2009-11-02	2016-12-16	US
Spironolactone	Tablet	25 mg/1	Oral	Remedy Repack	2011-05-12	2016-11-30	US
Spironolactone	Tablet	25 mg/1	Oral	Preferreed Pharmaceuticals Inc.	2012-10-31	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Pd Rx Pharmaceuticals, Inc.	2006-08-29	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Sun Pharmaceutical Industries Limited	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Accord Healthcare Limited	2017-06-02	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	A S Medication Solutions	2010-08-02	2017-06-20	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Mylan Institutional	1996-12-23	Not applicable	US
Spironolactone	Tablet	100 mg/1	Oral	A S Medication Solutions	2010-08-02	2017-06-20	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Actavis Pharma Company	2007-01-03	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2007-01-03	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Remedy Repack	2017-06-29	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Northwind Pharmaceuticals	2014-09-15	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Cardinal Health	2011-06-01	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Amneal Pharmaceuticals of New York Llc	2010-08-02	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Remedy Repack	2011-10-07	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Qualitest	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Aidarex Pharmaceuticals LLC	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Cardinal Health	2011-02-04	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Dispensing Solutions, Inc.	2006-08-29	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Remedy Repack	2013-05-28	2017-01-04	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Ncs Health Care Of Ky, Inc Dba Vangard Labs	2001-08-20	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2007-01-03	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Proficient Rx LP	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Preferreed Pharmaceuticals Inc.	2017-02-13	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Proficient Rx LP	2013-02-01	Not applicable	US
Spironolactone	Tablet	50 mg/1	Oral	Amneal Pharmaceuticals of New York Llc	2010-08-02	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	A S Medication Solutions	2006-08-29	2017-06-20	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Mylan Institutional	2002-02-20	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Nucare Pharmaceuticals, Inc.	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Physicians Total Care, Inc.	2003-09-11	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Red Pharm Drug, Inc.	2013-02-01	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Mc Kesson Packaging Services A Buisness Unit Of Mc Kesson Corporation	2011-06-01	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	A S Medication Solutions	2006-08-29	2017-06-20	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Mylan Pharmaceuticals	1981-02-03	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Rebel Distributors	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	State of Florida DOH Central Pharmacy	2009-07-01	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Jubilant Cadista Pharmaceuticals Inc.	2013-02-01	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Amerincan Health Packaging	2011-06-10	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	bryant ranch prepack	1986-07-23	Not applicable	US
Spironolactone	Tablet	100 mg/1	Oral	Major	2009-11-02	2016-12-16	US
Spironolactone	Tablet	25 mg/1	Oral	A S Medication Solutions	1986-07-23	2017-06-20	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Ncs Health Care Of Ky, Inc Dba Vangard Labs	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Major	2009-11-02	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Sun Pharmaceutical Industries Limited	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Remedy Repack	2017-06-02	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Lake Erie Medical Dba Quality Care Produts Llc	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Actavis Pharma Company	2007-01-03	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Remedy Repack	2017-04-24	Not applicable	US
Spironolactone	Tablet, film coated	25 mg/1	Oral	Remedy Repack	2013-06-04	2016-10-13	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Cardinal Health	2011-02-04	Not applicable	US
Spironolactone	Tablet	50 mg/1	Oral	Amneal Pharmaceuticals of New York Llc	2010-08-02	Not applicable	US
Spironolactone	Tablet	25 mg/1	Oral	Unit Dose Services	1986-07-23	Not applicable	US
Spironolactone	Tablet, film coated	100 mg/1	Oral	Qualitest	2006-08-29	Not applicable	US
Spironolactone	Tablet, film coated	50 mg/1	Oral	Aidarex Pharmaceuticals LLC	2006-08-29	Not applicable	US

Approved Over the Counter Products

Not Available

Unapproved/Other Products

Not Available

International Brands

Name	Company
Osyrol	Not Available
Spiresis	Not Available
Spiretic	Not Available
Spiroctan	Not Available
Uractone	Not Available
Verospiron	Not Available
Xenalon	Not Available

Brand mixtures

Name	Labeller	Ingredients
Aldactazide	G.D. Searle LLC Division of Pfizer Inc	Hydrochlorothiazide Spironolactone
Aldactazide 25	Pfizer	Hydrochlorothiazide Spironolactone
Aldactazide 50	Pfizer	Hydrochlorothiazide Spironolactone
Apo-spirozide Tab	Apotex Corporation	Hydrochlorothiazide Spironolactone
Spironolactone and Hydrochlorothiazide	A S Medication Solutions	Hydrochlorothiazide Spironolactone
Teva-spironolactone/hctz	Teva	Hydrochlorothiazide Spironolactone

Categories

UNII

27O7W4T232

CAS number

52-01-7

Weight

Average: 416.573
Monoisotopic: 416.202130202

Chemical Formula

C₂₄H₃₂O₄S

InChI Key

LXMSZDCAJNLERA-ZHYRCANASA-N

InChI

InChI=1S/C24H32O4S/c1-14(25)29-19-13-15-12-16(26)4-8-22(15,2)17-5-9-23(3)18(21(17)19)6-10-24(23)11-7-20(27)28-24/h12,17-19,21H,4-11,13H2,1-3H3/t17-,18-,19+,21+,22-,23-,24+/m0/s1

IUPAC Name

(1'S,2R,2'R,9'R,10'R,11'S,15'S)-9'-(acetylsulfanyl)-2',15'-dimethylspiro[oxolane-2,14'-tetracyclo[8.7.0.0²,⁷.0¹¹,¹⁵]heptadecan]-6'-ene-5,5'-dione

SMILES

[H][C@@]12CC[C@@]3(CCC(=O)O3)[C@@]1(C)CC[C@@]1([H])[C@@]2([H])[C@@]([H])(CC2=CC(=O)CC[C@]12C)SC(C)=O

Pharmacology

Indication

Used primarily to treat low-renin hypertension, hypokalemia, and Conn's syndrome.

Structured Indications

Pharmacodynamics

Spironolactone is a synthetic 17-lactone steroid which is a renal competitive aldosterone antagonist in a class of pharmaceuticals called potassium-sparing diuretics. On its own, spironolactone is only a weak diuretic, but it can be combined with other diuretics. Due to its anti-androgen effect, it can also be used to treat hirsutism, and is a common component in hormone therapy for male-to-female transgendered people. Spironolactone inhibits the effect of aldosterone by competing for intracellular aldosterone receptor in the distal tubule cells. This increases the secretion of water and sodium, while decreasing the excretion of potassium. Spironolactone has a fairly slow onset of action, taking several days to develop and similarly the effect diminishes slowly.

Mechanism of action

Spironolactone is a specific pharmacologic antagonist of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule. Spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained. Spironolactone acts both as a diuretic and as an antihypertensive drug by this mechanism. It may be given alone or with other diuretic agents which act more proximally in the renal tubule. Aldosterone interacts with a cytoplasmic mineralocorticoid receptor to enhance the expression of the Na+, K+-ATPase and the Na+ channel involved in a Na+ K+ transport in the distal tubule . Spironolactone bind to this mineralcorticoid receptor, blocking the actions of aldosterone on gene expression. Aldosterone is a hormone; its primary function is to retain sodium and excrete potassium in the kidneys.

Target	Kind	Pharmacological action	Actions	Organism	UniProt ID
Mineralocorticoid receptor	Protein	yes	antagonist	Human	P08235	details
Androgen receptor	Protein	unknown	antagonist	Human	P10275	details
Progesterone receptor	Protein	unknown	agonist	Human	P06401	details
Glucocorticoid receptor	Protein	unknown	antagonist	Human	P04150	details
Cytochrome P450 11B2, mitochondrial	Protein	unknown	antagonist	Human	P19099	details
17alpha-hydroxylase	Protein	unknown	antagonist	Human	not applicable	details
17,20-desmolase	Protein	unknown	antagonist	Human	not applicable	details
3-oxo-5-alpha-steroid 4-dehydrogenase	Protein group	unknown	antagonist		not applicable	details
Sex hormone-binding globulin	Protein	unknown	binder	Human	P04278	details
Voltage-dependent calcium channel gamma-1 subunit	Protein	unknown	Not Available	Human	Q06432	details
Dihydrotestosterone receptor	Protein	unknown	Not Available	Human	not applicable	details
Nuclear receptor subfamily 1 group I member 2	Protein	unknown	Not Available	Human	O75469	details

Absorption

Fairly rapidly absorbed from the gastrointestinal tract. Food increases the bioavailability of unmetabolized spironolactone by almost 100%.

Volume of distribution

Not Available

Protein binding

Spironolactone and its metabolites are more than 90% bound to plasma proteins.

Metabolism

Rapidly and extensively metabolized. The metabolic pathway of spironolactone is complex and can be divided into two main routes: those in which the sulfur moiety is retained and those in which the sulfur moiety is removed by dethioacetylation. Spironolactone is transformed to a reactive metabolite that can inactivate adrenal and testicular cytochrome P450 enzymes. It also has anti-androgenic activity.

Route of elimination

The metabolites are excreted primarily in the urine and secondarily in bile.

Half life

10 minutes

Clearance

Not Available

Toxicity

The oral LD₅₀ of spironolactone is greater than 1,000 mg/kg in mice, rats, and rabbits. Acute overdosage of spironolactone may be manifested by drowsiness, mental confusion, maculopapular or erythematous rash, nausea, vomiting, dizziness, or diarrhea. Spironolactone has been shown to be a tumorigen in chronic toxicity studies in rats.

Affected organisms

Humans and other mammals

Pathways

Pathway	Category	SMPDB ID
Spironolactone Action Pathway	Drug action	SMP00134

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

Drug	Interaction	Drug group
Abiraterone	The therapeutic efficacy of Abiraterone can be decreased when used in combination with Spironolactone.	Approved
Acebutolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Acebutolol.	Approved
Aceclofenac	Aceclofenac may decrease the antihypertensive activities of Spironolactone.	Approved
Acetaminophen	The serum concentration of Acetaminophen can be increased when it is combined with Spironolactone.	Approved
Acetazolamide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Acetazolamide.	Approved, Vet Approved
Acetyldigitoxin	The therapeutic efficacy of Acetyldigitoxin can be decreased when used in combination with Spironolactone.	Approved
Acetylsalicylic acid	The serum concentration of Acetylsalicylic acid can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Adapalene	Adapalene may decrease the antihypertensive activities of Spironolactone.	Approved
Adrafinil	Spironolactone may decrease the vasoconstricting activities of Adrafinil.	Withdrawn
Afatinib	The serum concentration of Afatinib can be increased when it is combined with Spironolactone.	Approved
Aldesleukin	The risk or severity of adverse effects can be increased when Aldesleukin is combined with Spironolactone.	Approved
Aldosterone	The serum concentration of Aldosterone can be increased when it is combined with Spironolactone.	Experimental
Alfentanil	The risk or severity of adverse effects can be increased when Alfentanil is combined with Spironolactone.	Approved, Illicit
Aliskiren	The risk or severity of adverse effects can be increased when Spironolactone is combined with Aliskiren.	Approved, Investigational
Alitretinoin	The serum concentration of Alitretinoin can be increased when it is combined with Spironolactone.	Approved, Investigational
Alphacetylmethadol	The risk or severity of adverse effects can be increased when Alphacetylmethadol is combined with Spironolactone.	Experimental, Illicit
Ambrisentan	The serum concentration of Ambrisentan can be increased when it is combined with Spironolactone.	Approved, Investigational
Amibegron	Spironolactone may decrease the vasoconstricting activities of SR 58611.	Investigational
Amifostine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Amifostine.	Approved, Investigational
Amiloride	Amiloride may increase the hyperkalemic activities of Spironolactone.	Approved
Amiodarone	The risk or severity of adverse effects can be increased when Spironolactone is combined with Amiodarone.	Approved, Investigational
Amitriptyline	The serum concentration of Amitriptyline can be increased when it is combined with Spironolactone.	Approved
Amlodipine	The risk or severity of adverse effects can be increased when Amlodipine is combined with Spironolactone.	Approved
Ammonium chloride	The risk or severity of adverse effects can be increased when Spironolactone is combined with Ammonium chloride.	Approved, Vet Approved
Amobarbital	Amobarbital may increase the hypotensive activities of Spironolactone.	Approved, Illicit
Amodiaquine	The serum concentration of Amodiaquine can be increased when it is combined with Spironolactone.	Approved
Amphotericin B	The risk or severity of adverse effects can be increased when Spironolactone is combined with Amphotericin B.	Approved, Investigational
Amyl Nitrite	The risk or severity of adverse effects can be increased when Spironolactone is combined with Amyl Nitrite.	Approved
Andrographolide	HMPL-004 may decrease the antihypertensive activities of Spironolactone.	Investigational
Anisodamine	Spironolactone may decrease the vasoconstricting activities of Anisodamine.	Investigational
Antipyrine	Antipyrine may decrease the antihypertensive activities of Spironolactone.	Approved
Apixaban	The serum concentration of Apixaban can be increased when it is combined with Spironolactone.	Approved
Apocynin	Acetovanillone may decrease the antihypertensive activities of Spironolactone.	Investigational
Apomorphine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Apomorphine.	Approved, Investigational
Apraclonidine	Spironolactone may decrease the vasoconstricting activities of Apraclonidine.	Approved
Apremilast	Apremilast may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Arbutamine	Spironolactone may decrease the vasoconstricting activities of Arbutamine.	Approved
Ardeparin	Ardeparin may increase the hyperkalemic activities of Spironolactone.	Approved, Withdrawn
Arformoterol	Spironolactone may decrease the vasoconstricting activities of Arformoterol.	Approved, Investigational
Aripiprazole	Aripiprazole may increase the hypotensive activities of Spironolactone.	Approved, Investigational
Arotinolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Arotinolol.	Approved
Arsenic trioxide	The serum concentration of Arsenic trioxide can be increased when it is combined with Spironolactone.	Approved, Investigational
Atazanavir	The serum concentration of Atazanavir can be increased when it is combined with Spironolactone.	Approved, Investigational
Atenolol	The risk or severity of adverse effects can be increased when Atenolol is combined with Spironolactone.	Approved
Atorvastatin	The risk or severity of adverse effects can be increased when Atorvastatin is combined with Spironolactone.	Approved
Atracurium besylate	Spironolactone may increase the neuromuscular blocking activities of Atracurium besylate.	Approved
Axitinib	The serum concentration of Axitinib can be increased when it is combined with Spironolactone.	Approved, Investigational
Azapropazone	Azapropazone may decrease the antihypertensive activities of Spironolactone.	Withdrawn
Azelastine	Azelastine may decrease the antihypertensive activities of Spironolactone.	Approved
Azilsartan medoxomil	The risk or severity of adverse effects can be increased when Spironolactone is combined with Azilsartan medoxomil.	Approved
Balsalazide	Balsalazide may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Barbexaclone	Barbexaclone may increase the hypotensive activities of Spironolactone.	Experimental
Barbital	Barbital may increase the hypotensive activities of Spironolactone.	Illicit
Barnidipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Barnidipine.	Approved
Befunolol	Spironolactone may decrease the vasoconstricting activities of Befunolol.	Experimental
Bemiparin	Bemiparin may increase the hyperkalemic activities of Spironolactone.	Approved
Benazepril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Benazepril.	Approved, Investigational
Bendroflumethiazide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Bendroflumethiazide.	Approved
Benoxaprofen	Benoxaprofen may decrease the antihypertensive activities of Spironolactone.	Withdrawn
Bepridil	The risk or severity of adverse effects can be increased when Spironolactone is combined with Bepridil.	Approved, Withdrawn
Betamethasone	The serum concentration of Betamethasone can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Betaxolol	The risk or severity of adverse effects can be increased when Betaxolol is combined with Spironolactone.	Approved
Betulinic Acid	Betulinic Acid may decrease the antihypertensive activities of Spironolactone.	Investigational
Bezitramide	The risk or severity of adverse effects can be increased when Bezitramide is combined with Spironolactone.	Experimental, Illicit, Withdrawn
Bisoprolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Bisoprolol.	Approved
Bitolterol	Spironolactone may decrease the vasoconstricting activities of Bitolterol.	Withdrawn
Boceprevir	The serum concentration of Boceprevir can be increased when it is combined with Spironolactone.	Approved, Investigational
Bortezomib	The risk or severity of adverse effects can be increased when Spironolactone is combined with Bortezomib.	Approved, Investigational
Bosutinib	The serum concentration of Bosutinib can be increased when it is combined with Spironolactone.	Approved
Brentuximab vedotin	The serum concentration of Brentuximab vedotin can be increased when it is combined with Spironolactone.	Approved
Bretylium	The risk or severity of adverse effects can be increased when Spironolactone is combined with Bretylium.	Approved
Brimonidine	Spironolactone may decrease the vasoconstricting activities of Brimonidine.	Approved
Bromfenac	Bromfenac may decrease the antihypertensive activities of Spironolactone.	Approved
Bromocriptine	The serum concentration of Bromocriptine can be increased when it is combined with Spironolactone.	Approved, Investigational
Bucillamine	Bucillamine may decrease the antihypertensive activities of Spironolactone.	Investigational
Bumetanide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Bumetanide.	Approved
Bupivacaine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Bupivacaine.	Approved, Investigational
Buprenorphine	The risk or severity of adverse effects can be increased when Buprenorphine is combined with Spironolactone.	Approved, Illicit, Investigational, Vet Approved
Butorphanol	The risk or severity of adverse effects can be increased when Butorphanol is combined with Spironolactone.	Approved, Illicit, Vet Approved
Cabazitaxel	The serum concentration of Cabazitaxel can be increased when it is combined with Spironolactone.	Approved
Caffeine	The serum concentration of Caffeine can be increased when it is combined with Spironolactone.	Approved
Camptothecin	The serum concentration of Camptothecin can be increased when it is combined with Spironolactone.	Experimental
Canagliflozin	Canagliflozin may increase the hyperkalemic activities of Spironolactone.	Approved
Candesartan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Candesartan.	Approved
Candoxatril	Spironolactone may increase the hyperkalemic activities of Candoxatril.	Experimental
Captopril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Captopril.	Approved
Carbamazepine	The serum concentration of Carbamazepine can be increased when it is combined with Spironolactone.	Approved, Investigational
Carbetocin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Carbetocin.	Approved
Carfentanil	The risk or severity of adverse effects can be increased when Carfentanil is combined with Spironolactone.	Illicit, Vet Approved
Carfilzomib	The serum concentration of Carfilzomib can be increased when it is combined with Spironolactone.	Approved
Carprofen	Carprofen may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved, Withdrawn
Carteolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Carteolol.	Approved
Carvedilol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Carvedilol.	Approved, Investigational
Castanospermine	Castanospermine may decrease the antihypertensive activities of Spironolactone.	Experimental
Celecoxib	Celecoxib may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Ceritinib	The serum concentration of Ceritinib can be increased when it is combined with Spironolactone.	Approved
Cerivastatin	The serum concentration of Cerivastatin can be increased when it is combined with Spironolactone.	Withdrawn
Certoparin	Certoparin may increase the hyperkalemic activities of Spironolactone.	Approved
Chloroquine	Chloroquine may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved
Chlorothiazide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Chlorothiazide.	Approved, Vet Approved
Chlorpromazine	The serum concentration of Chlorpromazine can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Chlorthalidone	The risk or severity of adverse effects can be increased when Chlorthalidone is combined with Spironolactone.	Approved
Cholestyramine	The risk or severity of adverse effects can be increased when Cholestyramine is combined with Spironolactone.	Approved
Choline magnesium trisalicylate	Trisalicylate-choline may decrease the antihypertensive activities of Spironolactone.	Approved
Cilazapril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Cilazapril.	Approved
Cilnidipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Cilnidipine.	Approved
Cimetidine	The serum concentration of Cimetidine can be increased when it is combined with Spironolactone.	Approved
Ciprofloxacin	Spironolactone may increase the arrhythmogenic activities of Ciprofloxacin.	Approved, Investigational
Ciprofloxacin	The serum concentration of Ciprofloxacin can be increased when it is combined with Spironolactone.	Approved, Investigational
Cirazoline	Spironolactone may decrease the vasoconstricting activities of Cirazoline.	Experimental
Cisplatin	The serum concentration of Cisplatin can be increased when it is combined with Spironolactone.	Approved
Citalopram	The serum concentration of Citalopram can be increased when it is combined with Spironolactone.	Approved
Clarithromycin	The serum concentration of Clarithromycin can be increased when it is combined with Spironolactone.	Approved
Clenbuterol	Spironolactone may decrease the vasoconstricting activities of Clenbuterol.	Approved, Vet Approved
Clevidipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Clevidipine.	Approved
Clobazam	The serum concentration of Clobazam can be increased when it is combined with Spironolactone.	Approved, Illicit
Clofarabine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Clofarabine.	Approved, Investigational
Clomifene	The serum concentration of Clomifene can be increased when it is combined with Spironolactone.	Approved, Investigational
Clomipramine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Clomipramine.	Approved, Vet Approved
Clonidine	Spironolactone may decrease the vasoconstricting activities of Clonidine.	Approved
Clonixin	Clonixin may decrease the antihypertensive activities of Spironolactone.	Approved
Clopidogrel	The serum concentration of Clopidogrel can be increased when it is combined with Spironolactone.	Approved, Nutraceutical
Clozapine	The serum concentration of Clozapine can be increased when it is combined with Spironolactone.	Approved
Cobimetinib	The serum concentration of Cobimetinib can be increased when it is combined with Spironolactone.	Approved
Codeine	The risk or severity of adverse effects can be increased when Codeine is combined with Spironolactone.	Approved, Illicit
Colchicine	The serum concentration of Colchicine can be increased when it is combined with Spironolactone.	Approved
Conivaptan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Conivaptan.	Approved, Investigational
Conjugated estrogens	The serum concentration of Conjugated Equine Estrogens can be increased when it is combined with Spironolactone.	Approved
Crizotinib	The serum concentration of Crizotinib can be increased when it is combined with Spironolactone.	Approved
Curcumin	Curcumin may decrease the antihypertensive activities of Spironolactone.	Investigational
Cyclosporine	Spironolactone may increase the hyperkalemic activities of Cyclosporine.	Approved, Investigational, Vet Approved
Cyclosporine	The serum concentration of Cyclosporine can be increased when it is combined with Spironolactone.	Approved, Investigational, Vet Approved
Dabigatran etexilate	The serum concentration of the active metabolites of Dabigatran etexilate can be increased when Dabigatran etexilate is used in combination with Spironolactone.	Approved
Dabrafenib	The serum concentration of Dabrafenib can be increased when it is combined with Spironolactone.	Approved
Dactinomycin	The serum concentration of Dactinomycin can be increased when it is combined with Spironolactone.	Approved
Dalteparin	Dalteparin may increase the hyperkalemic activities of Spironolactone.	Approved
Dapagliflozin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Dapagliflozin.	Approved
Dasatinib	The serum concentration of Dasatinib can be increased when it is combined with Spironolactone.	Approved, Investigational
Daunorubicin	The serum concentration of Daunorubicin can be increased when it is combined with Spironolactone.	Approved
Debrisoquin	The serum concentration of Debrisoquin can be increased when it is combined with Spironolactone.	Approved
Desflurane	The risk or severity of adverse effects can be increased when Spironolactone is combined with Desflurane.	Approved
Deslanoside	The therapeutic efficacy of Deslanoside can be decreased when used in combination with Spironolactone.	Approved
Dexamethasone	The serum concentration of Dexamethasone can be increased when it is combined with Spironolactone.	Approved, Investigational, Vet Approved
Dexmedetomidine	Spironolactone may decrease the vasoconstricting activities of Dexmedetomidine.	Approved, Vet Approved
Dextromoramide	The risk or severity of adverse effects can be increased when Dextromoramide is combined with Spironolactone.	Experimental, Illicit
Dextropropoxyphene	The risk or severity of adverse effects can be increased when Dextropropoxyphene is combined with Spironolactone.	Approved, Illicit, Withdrawn
Dezocine	The risk or severity of adverse effects can be increased when Dezocine is combined with Spironolactone.	Approved
Diazepam	The serum concentration of Diazepam can be increased when it is combined with Spironolactone.	Approved, Illicit, Vet Approved
Diclofenac	Diclofenac may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved
Diclofenamide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Diclofenamide.	Approved
Diethylstilbestrol	The serum concentration of Diethylstilbestrol can be increased when it is combined with Spironolactone.	Approved
Diflunisal	Diflunisal may decrease the antihypertensive activities of Spironolactone.	Approved
Digitoxin	The serum concentration of Digitoxin can be increased when it is combined with Spironolactone.	Approved
Digoxin	The serum concentration of Digoxin can be increased when it is combined with Spironolactone.	Approved
Dihydrocodeine	The risk or severity of adverse effects can be increased when Dihydrocodeine is combined with Spironolactone.	Approved, Illicit
Dihydroetorphine	The risk or severity of adverse effects can be increased when Dihydroetorphine is combined with Spironolactone.	Experimental, Illicit
Dihydromorphine	The risk or severity of adverse effects can be increased when Dihydromorphine is combined with Spironolactone.	Experimental, Illicit
Dihydrotestosterone	The serum concentration of Dihydrotestosterone can be increased when it is combined with Spironolactone.	Illicit
Diltiazem	The risk or severity of adverse effects can be increased when Diltiazem is combined with Spironolactone.	Approved
Dinutuximab	The risk or severity of adverse effects can be increased when Spironolactone is combined with Dinutuximab.	Approved
Diphenoxylate	The risk or severity of adverse effects can be increased when Diphenoxylate is combined with Spironolactone.	Approved, Illicit
Dipivefrin	Spironolactone may decrease the vasoconstricting activities of Dipivefrin.	Approved
Dipyridamole	The risk or severity of adverse effects can be increased when Spironolactone is combined with Dipyridamole.	Approved
Dobutamine	Spironolactone may decrease the vasoconstricting activities of Dobutamine.	Approved
Docetaxel	The serum concentration of Docetaxel can be increased when it is combined with Spironolactone.	Approved, Investigational
Domperidone	The serum concentration of Domperidone can be increased when it is combined with Spironolactone.	Approved, Investigational, Vet Approved
Doxazosin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Doxazosin.	Approved
Doxorubicin	The serum concentration of Doxorubicin can be increased when it is combined with Spironolactone.	Approved, Investigational
Drospirenone	Drospirenone may increase the hyperkalemic activities of Spironolactone.	Approved
Droxicam	Droxicam may decrease the antihypertensive activities of Spironolactone.	Approved
Droxidopa	Spironolactone may decrease the vasoconstricting activities of Droxidopa.	Approved, Investigational
Duloxetine	Spironolactone may increase the orthostatic hypotensive activities of Duloxetine.	Approved
Duvelisib	Duvelisib may decrease the antihypertensive activities of Spironolactone.	Investigational
E-6201	E6201 may decrease the antihypertensive activities of Spironolactone.	Investigational
Ebselen	Ebselen may decrease the antihypertensive activities of Spironolactone.	Investigational
Edoxaban	The serum concentration of Edoxaban can be increased when it is combined with Spironolactone.	Approved
Efonidipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Efonidipine.	Approved
Eletriptan	The serum concentration of Eletriptan can be increased when it is combined with Spironolactone.	Approved, Investigational
Empagliflozin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Empagliflozin.	Approved
Enalapril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Enalapril.	Approved, Vet Approved
Enalaprilat	Spironolactone may increase the hyperkalemic activities of Enalaprilat.	Approved
Enoxaparin	Enoxaparin may increase the hyperkalemic activities of Spironolactone.	Approved
Ephedrine	Spironolactone may decrease the vasoconstricting activities of Ephedrine.	Approved
Epinastine	The serum concentration of Epinastine can be increased when it is combined with Spironolactone.	Approved, Investigational
Epinephrine	Spironolactone may decrease the vasoconstricting activities of Epinephrine.	Approved, Vet Approved
Epirizole	Epirizole may decrease the antihypertensive activities of Spironolactone.	Approved
Eplerenone	Eplerenone may increase the hyperkalemic activities of Spironolactone.	Approved
Epoprostenol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Epoprostenol.	Approved
Eprosartan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Eprosartan.	Approved
Ergotamine	Spironolactone may decrease the vasoconstricting activities of Ergotamine.	Approved
Erlotinib	The serum concentration of Erlotinib can be increased when it is combined with Spironolactone.	Approved, Investigational
Erythromycin	The serum concentration of Erythromycin can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Esmolol	The risk or severity of adverse effects can be increased when Esmolol is combined with Spironolactone.	Approved
Estradiol	The serum concentration of Estradiol can be increased when it is combined with Spironolactone.	Approved, Investigational, Vet Approved
Estriol	The serum concentration of Estriol can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Estrone	The serum concentration of Estrone can be increased when it is combined with Spironolactone.	Approved
Etacrynic acid	The risk or severity of adverse effects can be increased when Spironolactone is combined with Etacrynic acid.	Approved
Etanercept	Etanercept may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Ethinyl Estradiol	The serum concentration of Ethinyl Estradiol can be increased when it is combined with Spironolactone.	Approved
Ethylmorphine	The risk or severity of adverse effects can be increased when Ethylmorphine is combined with Spironolactone.	Approved, Illicit
Etilefrine	Spironolactone may decrease the vasoconstricting activities of Etilefrine.	Withdrawn
Etodolac	Etodolac may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational, Vet Approved
Etofenamate	Etofenamate may decrease the antihypertensive activities of Spironolactone.	Approved
Etoposide	The serum concentration of Etoposide can be increased when it is combined with Spironolactone.	Approved
Etoricoxib	Etoricoxib may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Etorphine	The risk or severity of adverse effects can be increased when Etorphine is combined with Spironolactone.	Illicit, Vet Approved
Everolimus	The serum concentration of Everolimus can be increased when it is combined with Spironolactone.	Approved
Ezetimibe	The serum concentration of Ezetimibe can be increased when it is combined with Spironolactone.	Approved
Felodipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Felodipine.	Approved, Investigational
Fenbufen	Fenbufen may decrease the antihypertensive activities of Spironolactone.	Approved
Fenoldopam	The risk or severity of adverse effects can be increased when Spironolactone is combined with Fenoldopam.	Approved
Fenoprofen	Fenoprofen may decrease the antihypertensive activities of Spironolactone.	Approved
Fenoterol	Spironolactone may decrease the vasoconstricting activities of Fenoterol.	Approved
Fentanyl	The risk or severity of adverse effects can be increased when Fentanyl is combined with Spironolactone.	Approved, Illicit, Investigational, Vet Approved
Fesoterodine	The serum concentration of Fesoterodine can be increased when it is combined with Spironolactone.	Approved
Fexofenadine	The serum concentration of Fexofenadine can be increased when it is combined with Spironolactone.	Approved
Fidaxomicin	The serum concentration of Fidaxomicin can be increased when it is combined with Spironolactone.	Approved
Fimasartan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Fimasartan.	Approved
Floctafenine	Floctafenine may decrease the antihypertensive activities of Spironolactone.	Approved, Withdrawn
Flurbiprofen	Flurbiprofen may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Fluticasone furoate	The serum concentration of Fluticasone furoate can be increased when it is combined with Spironolactone.	Approved
Forasartan	Forasartan may increase the hyperkalemic activities of Spironolactone.	Experimental
Formoterol	Spironolactone may decrease the vasoconstricting activities of Formoterol.	Approved, Investigational
Fosinopril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Fosinopril.	Approved
Furosemide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Furosemide.	Approved, Vet Approved
Gefitinib	The serum concentration of Gefitinib can be increased when it is combined with Spironolactone.	Approved, Investigational
Gemcitabine	The serum concentration of Gemcitabine can be increased when it is combined with Spironolactone.	Approved
Grazoprevir	The serum concentration of Grazoprevir can be increased when it is combined with Spironolactone.	Approved
Grepafloxacin	The serum concentration of Grepafloxacin can be increased when it is combined with Spironolactone.	Withdrawn
Guanabenz	Spironolactone may decrease the vasoconstricting activities of Guanabenz.	Approved
Guanfacine	Spironolactone may decrease the vasoconstricting activities of Guanfacine.	Approved, Investigational
Haloperidol	The serum concentration of Haloperidol can be increased when it is combined with Spironolactone.	Approved
Halothane	The risk or severity of adverse effects can be increased when Spironolactone is combined with Halothane.	Approved, Vet Approved
Heparin	Heparin may increase the hyperkalemic activities of Spironolactone.	Approved, Investigational
Heroin	The risk or severity of adverse effects can be increased when Heroin is combined with Spironolactone.	Approved, Illicit
Hexobarbital	Hexobarbital may increase the hypotensive activities of Spironolactone.	Approved
Hexoprenaline	Spironolactone may decrease the vasoconstricting activities of Hexoprenaline.	Approved, Withdrawn
Higenamine	Spironolactone may decrease the vasoconstricting activities of Higenamine.	Investigational
Hydralazine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Hydralazine.	Approved
Hydrochlorothiazide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Hydrochlorothiazide.	Approved, Vet Approved
Hydrocodone	The risk or severity of adverse effects can be increased when Hydrocodone is combined with Spironolactone.	Approved, Illicit
Hydrocortisone	The serum concentration of Hydrocortisone can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Hydroflumethiazide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Hydroflumethiazide.	Approved
Hydromorphone	The risk or severity of adverse effects can be increased when Hydromorphone is combined with Spironolactone.	Approved, Illicit
Ibuprofen	The serum concentration of Ibuprofen can be increased when it is combined with Spironolactone.	Approved
Ibuproxam	Ibuproxam may decrease the antihypertensive activities of Spironolactone.	Withdrawn
Icatibant	Icatibant may decrease the antihypertensive activities of Spironolactone.	Approved
Idelalisib	The serum concentration of Idelalisib can be increased when it is combined with Spironolactone.	Approved
Iloprost	The risk or severity of adverse effects can be increased when Spironolactone is combined with Iloprost.	Approved, Investigational
Imatinib	The serum concentration of Imatinib can be increased when it is combined with Spironolactone.	Approved
Imidapril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Imidapril.	Investigational
Imipramine	The serum concentration of Imipramine can be increased when it is combined with Spironolactone.	Approved
Indacaterol	The serum concentration of Indacaterol can be increased when it is combined with Spironolactone.	Approved
Indapamide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Indapamide.	Approved
Indinavir	The serum concentration of Indinavir can be increased when it is combined with Spironolactone.	Approved
Indomethacin	The serum concentration of Indomethacin can be increased when it is combined with Spironolactone.	Approved, Investigational
Indoprofen	Indoprofen may decrease the antihypertensive activities of Spironolactone.	Withdrawn
Indoramin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Indoramin.	Withdrawn
Irbesartan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Irbesartan.	Approved, Investigational
Irinotecan	The serum concentration of Irinotecan can be increased when it is combined with Spironolactone.	Approved, Investigational
Isocarboxazid	The risk or severity of adverse effects can be increased when Spironolactone is combined with Isocarboxazid.	Approved
Isoetarine	Spironolactone may decrease the vasoconstricting activities of Isoetarine.	Approved
Isoflurane	The risk or severity of adverse effects can be increased when Spironolactone is combined with Isoflurane.	Approved, Vet Approved
Isoprenaline	Spironolactone may decrease the vasoconstricting activities of Isoprenaline.	Approved
Isosorbide Dinitrate	The risk or severity of adverse effects can be increased when Spironolactone is combined with Isosorbide Dinitrate.	Approved
Isosorbide Mononitrate	The risk or severity of adverse effects can be increased when Spironolactone is combined with Isosorbide Mononitrate.	Approved
Isoxicam	Isoxicam may decrease the antihypertensive activities of Spironolactone.	Withdrawn
Isoxsuprine	Spironolactone may decrease the vasoconstricting activities of Isoxsuprine.	Approved, Withdrawn
Isradipine	The risk or severity of adverse effects can be increased when Isradipine is combined with Spironolactone.	Approved
Ivermectin	The serum concentration of Ivermectin can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Kebuzone	Kebuzone may decrease the antihypertensive activities of Spironolactone.	Experimental
Ketazolam	The serum concentration of Ketazolam can be increased when it is combined with Spironolactone.	Approved
Ketobemidone	The risk or severity of adverse effects can be increased when Ketobemidone is combined with Spironolactone.	Approved
Ketoconazole	The serum concentration of Ketoconazole can be increased when it is combined with Spironolactone.	Approved, Investigational
Ketoprofen	Ketoprofen may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved
Ketorolac	Ketorolac may decrease the antihypertensive activities of Spironolactone.	Approved
Labetalol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Labetalol.	Approved
Lacidipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Lacidipine.	Approved
Lamivudine	The serum concentration of Lamivudine can be increased when it is combined with Spironolactone.	Approved, Investigational
Lamotrigine	The serum concentration of Lamotrigine can be increased when it is combined with Spironolactone.	Approved, Investigational
Lansoprazole	The serum concentration of Lansoprazole can be increased when it is combined with Spironolactone.	Approved, Investigational
Ledipasvir	The serum concentration of Ledipasvir can be increased when it is combined with Spironolactone.	Approved
Leflunomide	Leflunomide may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Lenalidomide	The serum concentration of Lenalidomide can be increased when it is combined with Spironolactone.	Approved
Lenvatinib	The serum concentration of Lenvatinib can be increased when it is combined with Spironolactone.	Approved
Lercanidipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Lercanidipine.	Approved, Investigational
Levetiracetam	The serum concentration of Levetiracetam can be increased when it is combined with Spironolactone.	Approved, Investigational
Levobunolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Levobunolol.	Approved
Levobupivacaine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Levobupivacaine.	Approved
Levodopa	Spironolactone may increase the orthostatic hypotensive activities of Levodopa.	Approved
Levofloxacin	The serum concentration of Levofloxacin can be increased when it is combined with Spironolactone.	Approved, Investigational
Levomethadyl Acetate	The risk or severity of adverse effects can be increased when Levomethadyl Acetate is combined with Spironolactone.	Approved
Levomilnacipran	The serum concentration of Levomilnacipran can be increased when it is combined with Spironolactone.	Approved
Levorphanol	The risk or severity of adverse effects can be increased when Levorphanol is combined with Spironolactone.	Approved
Levosimendan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Levosimendan.	Approved, Investigational
Linagliptin	The serum concentration of Linagliptin can be increased when it is combined with Spironolactone.	Approved
Lisinopril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Lisinopril.	Approved, Investigational
Lisofylline	Lisofylline may decrease the antihypertensive activities of Spironolactone.	Investigational
Lofentanil	The risk or severity of adverse effects can be increased when Lofentanil is combined with Spironolactone.	Illicit
Lofexidine	Spironolactone may decrease the vasoconstricting activities of Lofexidine.	Approved, Investigational
Loperamide	The serum concentration of Loperamide can be increased when it is combined with Spironolactone.	Approved
Lornoxicam	Lornoxicam may decrease the antihypertensive activities of Spironolactone.	Approved
Losartan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Losartan.	Approved
Loxoprofen	Loxoprofen may decrease the antihypertensive activities of Spironolactone.	Approved
Lumiracoxib	Lumiracoxib may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Magnesium salicylate	Magnesium salicylate may decrease the antihypertensive activities of Spironolactone.	Approved
Mannitol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Mannitol.	Approved, Investigational
Masoprocol	Masoprocol may decrease the antihypertensive activities of Spironolactone.	Approved
Mecamylamine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Mecamylamine.	Approved
Meclofenamic acid	Meclofenamic acid may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved
Mefenamic acid	Mefenamic acid may decrease the antihypertensive activities of Spironolactone.	Approved
Meloxicam	Meloxicam may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved
Mephentermine	Spironolactone may decrease the vasoconstricting activities of Mephentermine.	Approved
Mesalazine	Mesalazine may decrease the antihypertensive activities of Spironolactone.	Approved
Metamizole	Metamizole may decrease the antihypertensive activities of Spironolactone.	Withdrawn
Metaraminol	Spironolactone may decrease the vasoconstricting activities of Metaraminol.	Approved, Investigational
Methadone	The risk or severity of adverse effects can be increased when Methadone is combined with Spironolactone.	Approved
Methadyl Acetate	The risk or severity of adverse effects can be increased when Methadyl Acetate is combined with Spironolactone.	Approved, Illicit
Methazolamide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Methazolamide.	Approved
Methohexital	Methohexital may increase the hypotensive activities of Spironolactone.	Approved
Methotrexate	The serum concentration of Methotrexate can be increased when it is combined with Spironolactone.	Approved
Methoxamine	Spironolactone may decrease the vasoconstricting activities of Methoxamine.	Approved
Methyclothiazide	The risk or severity of adverse effects can be increased when Methyclothiazide is combined with Spironolactone.	Approved
Methyldopa	Spironolactone may decrease the vasoconstricting activities of Methyldopa.	Approved
Methylphenobarbital	Methylphenobarbital may increase the hypotensive activities of Spironolactone.	Approved
Methylprednisolone	The serum concentration of Methylprednisolone can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Metipranolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Metipranolol.	Approved
Metolazone	The risk or severity of adverse effects can be increased when Spironolactone is combined with Metolazone.	Approved
Metoprolol	The risk or severity of adverse effects can be increased when Metoprolol is combined with Spironolactone.	Approved, Investigational
Midazolam	The serum concentration of Midazolam can be increased when it is combined with Spironolactone.	Approved, Illicit
Midodrine	Spironolactone may decrease the vasoconstricting activities of Midodrine.	Approved
Minoxidil	The risk or severity of adverse effects can be increased when Minoxidil is combined with Spironolactone.	Approved
Mirabegron	Spironolactone may decrease the vasoconstricting activities of Mirabegron.	Approved
Mitotane	The therapeutic efficacy of Mitotane can be decreased when used in combination with Spironolactone.	Approved
Mitoxantrone	The serum concentration of Mitoxantrone can be increased when it is combined with Spironolactone.	Approved, Investigational
Mivacurium	Spironolactone may increase the neuromuscular blocking activities of Mivacurium.	Approved
Mizoribine	Mizoribine may decrease the antihypertensive activities of Spironolactone.	Investigational
Moexipril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Moexipril.	Approved
Morphine	The risk or severity of adverse effects can be increased when Morphine is combined with Spironolactone.	Approved, Investigational
Moxonidine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Moxonidine.	Approved
Mycophenolate mofetil	The serum concentration of Mycophenolate mofetil can be increased when it is combined with Spironolactone.	Approved, Investigational
Mycophenolic acid	Mycophenolic acid may decrease the antihypertensive activities of Spironolactone.	Approved
Nabilone	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nabilone.	Approved, Investigational
Nabumetone	Nabumetone may decrease the antihypertensive activities of Spironolactone.	Approved
Nadolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nadolol.	Approved
Nadroparin	Nadroparin may increase the hyperkalemic activities of Spironolactone.	Approved
Nafamostat	Nafamostat may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Naftifine	Naftifine may decrease the antihypertensive activities of Spironolactone.	Approved
Nalbuphine	The risk or severity of adverse effects can be increased when Nalbuphine is combined with Spironolactone.	Approved
Naloxegol	The serum concentration of Naloxegol can be increased when it is combined with Spironolactone.	Approved
Naloxone	The serum concentration of Naloxone can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Naphazoline	Spironolactone may decrease the vasoconstricting activities of Naphazoline.	Approved
Naproxen	Naproxen may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved
NCX 4016	NCX 4016 may decrease the antihypertensive activities of Spironolactone.	Investigational
Nebivolol	Spironolactone may decrease the vasoconstricting activities of Nebivolol.	Approved, Investigational
Nelfinavir	The serum concentration of Nelfinavir can be increased when it is combined with Spironolactone.	Approved
Nepafenac	Nepafenac may decrease the antihypertensive activities of Spironolactone.	Approved
Nesiritide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nesiritide.	Approved, Investigational
Nicardipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nicardipine.	Approved
Nicorandil	Nicorandil may increase the hypotensive activities of Spironolactone.	Approved
Nifedipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nifedipine.	Approved
Niflumic Acid	Niflumic Acid may decrease the antihypertensive activities of Spironolactone.	Approved
Nilotinib	The serum concentration of Nilotinib can be increased when it is combined with Spironolactone.	Approved, Investigational
Nilvadipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nilvadipine.	Approved
Nimesulide	Nimesulide may decrease the antihypertensive activities of Spironolactone.	Approved, Withdrawn
Nimodipine	The risk or severity of adverse effects can be increased when Nimodipine is combined with Spironolactone.	Approved
Nintedanib	The serum concentration of Nintedanib can be increased when it is combined with Spironolactone.	Approved
Nisoldipine	The risk or severity of adverse effects can be increased when Nisoldipine is combined with Spironolactone.	Approved
Nitrendipine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nitrendipine.	Approved
Nitric Oxide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nitric Oxide.	Approved
Nitroaspirin	Nitroaspirin may decrease the antihypertensive activities of Spironolactone.	Investigational
Nitrofurantoin	Nitrofurantoin may increase the hyperkalemic activities of Spironolactone.	Approved, Vet Approved
Nitroglycerin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Nitroglycerin.	Approved, Investigational
Nitroprusside	The risk or severity of adverse effects can be increased when Nitroprusside is combined with Spironolactone.	Approved
Nizatidine	The serum concentration of Nizatidine can be increased when it is combined with Spironolactone.	Approved
Norepinephrine	Spironolactone may decrease the vasoconstricting activities of Norepinephrine.	Approved
Normethadone	The risk or severity of adverse effects can be increased when Normethadone is combined with Spironolactone.	Approved, Illicit
Obinutuzumab	The risk or severity of adverse effects can be increased when Spironolactone is combined with Obinutuzumab.	Approved
Olanzapine	The serum concentration of Olanzapine can be increased when it is combined with Spironolactone.	Approved, Investigational
Oleandrin	The therapeutic efficacy of Anvirzel can be decreased when used in combination with Spironolactone.	Experimental
Olmesartan	The risk or severity of adverse effects can be increased when Olmesartan is combined with Spironolactone.	Approved, Investigational
Olodaterol	Spironolactone may decrease the vasoconstricting activities of Olodaterol.	Approved
Olopatadine	Olopatadine may decrease the antihypertensive activities of Spironolactone.	Approved
Olsalazine	Olsalazine may decrease the antihypertensive activities of Spironolactone.	Approved
Omapatrilat	Spironolactone may increase the hyperkalemic activities of Omapatrilat.	Investigational
Ombitasvir	The serum concentration of Ombitasvir can be increased when it is combined with Spironolactone.	Approved
Opium	The risk or severity of adverse effects can be increased when Opium is combined with Spironolactone.	Approved, Illicit
Orciprenaline	Spironolactone may decrease the vasoconstricting activities of Orciprenaline.	Approved
Osimertinib	The serum concentration of Osimertinib can be increased when it is combined with Spironolactone.	Approved
Ouabain	The therapeutic efficacy of Ouabain can be decreased when used in combination with Spironolactone.	Approved
Oxaprozin	Oxaprozin may decrease the antihypertensive activities of Spironolactone.	Approved
Oxprenolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Oxprenolol.	Approved
Oxycodone	The risk or severity of adverse effects can be increased when Oxycodone is combined with Spironolactone.	Approved, Illicit, Investigational
Oxymetazoline	Spironolactone may decrease the vasoconstricting activities of Oxymetazoline.	Approved
Oxymorphone	The risk or severity of adverse effects can be increased when Oxymorphone is combined with Spironolactone.	Approved, Investigational, Vet Approved
Oxyphenbutazone	Oxyphenbutazone may decrease the antihypertensive activities of Spironolactone.	Withdrawn
Paclitaxel	The serum concentration of Paclitaxel can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Panobinostat	The serum concentration of Panobinostat can be increased when it is combined with Spironolactone.	Approved, Investigational
Papaverine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Papaverine.	Approved
Parecoxib	Parecoxib may decrease the antihypertensive activities of Spironolactone.	Approved
Parnaparin	Parnaparin may increase the hyperkalemic activities of Spironolactone.	Approved
Pazopanib	The serum concentration of Pazopanib can be increased when it is combined with Spironolactone.	Approved
Penbutolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Penbutolol.	Approved, Investigational
Pentazocine	The risk or severity of adverse effects can be increased when Pentazocine is combined with Spironolactone.	Approved, Vet Approved
Pentobarbital	Pentobarbital may increase the hypotensive activities of Spironolactone.	Approved, Vet Approved
Perindopril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Perindopril.	Approved
Pethidine	The risk or severity of adverse effects can be increased when Pethidine is combined with Spironolactone.	Approved
Phenelzine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Phenelzine.	Approved
Phenobarbital	The serum concentration of Phenobarbital can be increased when it is combined with Spironolactone.	Approved
Phenoxybenzamine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Phenoxybenzamine.	Approved
Phentolamine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Phentolamine.	Approved
Phenylbutazone	Phenylbutazone may decrease the antihypertensive activities of Spironolactone.	Approved, Vet Approved
Phenylephrine	Spironolactone may decrease the vasoconstricting activities of Phenylephrine.	Approved
Phenylpropanolamine	Spironolactone may decrease the vasoconstricting activities of Phenylpropanolamine.	Approved, Vet Approved, Withdrawn
Phenytoin	The serum concentration of Phenytoin can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Pimecrolimus	Pimecrolimus may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Pindolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Pindolol.	Approved
Pipamperone	The risk or severity of adverse effects can be increased when Spironolactone is combined with Pipamperone.	Approved
Pirbuterol	Spironolactone may decrease the vasoconstricting activities of Pirbuterol.	Approved
Pirfenidone	Pirfenidone may decrease the antihypertensive activities of Spironolactone.	Investigational
Piritramide	The risk or severity of adverse effects can be increased when Piritramide is combined with Spironolactone.	Investigational
Piroxicam	Piroxicam may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Pitavastatin	The serum concentration of Pitavastatin can be increased when it is combined with Spironolactone.	Approved
Pomalidomide	The serum concentration of Pomalidomide can be increased when it is combined with Spironolactone.	Approved
Ponatinib	The serum concentration of Ponatinib can be increased when it is combined with Spironolactone.	Approved
Pramipexole	The risk or severity of adverse effects can be increased when Spironolactone is combined with Pramipexole.	Approved, Investigational
Pravastatin	The serum concentration of Pravastatin can be increased when it is combined with Spironolactone.	Approved
Prazosin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Prazosin.	Approved
Prednisolone	The serum concentration of Prednisolone can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Prednisone	The serum concentration of Prednisone can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Primidone	Primidone may increase the hypotensive activities of Spironolactone.	Approved, Vet Approved
Procaterol	Spironolactone may decrease the vasoconstricting activities of Procaterol.	Approved
Progesterone	The serum concentration of Progesterone can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Propacetamol	Propacetamol may decrease the antihypertensive activities of Spironolactone.	Approved
Propofol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Propofol.	Approved, Investigational, Vet Approved
Propranolol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Propranolol.	Approved, Investigational
Prucalopride	The serum concentration of Prucalopride can be increased when it is combined with Spironolactone.	Approved
Pseudoephedrine	Spironolactone may decrease the vasoconstricting activities of Pseudoephedrine.	Approved
PTC299	PTC299 may decrease the antihypertensive activities of Spironolactone.	Investigational
Quetiapine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Quetiapine.	Approved
Quinapril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Quinapril.	Approved, Investigational
Quinidine	The therapeutic efficacy of Quinidine can be decreased when used in combination with Spironolactone.	Approved
Quinine	The serum concentration of Quinine can be increased when it is combined with Spironolactone.	Approved
Ramipril	The risk or severity of adverse effects can be increased when Ramipril is combined with Spironolactone.	Approved
Ranitidine	The serum concentration of Ranitidine can be increased when it is combined with Spironolactone.	Approved
Ranolazine	The serum concentration of Ranolazine can be increased when it is combined with Spironolactone.	Approved, Investigational
Rapacuronium	Spironolactone may increase the neuromuscular blocking activities of Rapacuronium.	Withdrawn
Rasagiline	The risk or severity of adverse effects can be increased when Spironolactone is combined with Rasagiline.	Approved
Remifentanil	The risk or severity of adverse effects can be increased when Remifentanil is combined with Spironolactone.	Approved
Rescinnamine	Spironolactone may increase the hyperkalemic activities of Rescinnamine.	Approved
Reserpine	The risk or severity of adverse effects can be increased when Reserpine is combined with Spironolactone.	Approved
Resveratrol	Resveratrol may decrease the antihypertensive activities of Spironolactone.	Experimental, Investigational
Reviparin	Reviparin may increase the hyperkalemic activities of Spironolactone.	Approved
Rifampicin	The serum concentration of Rifampicin can be increased when it is combined with Spironolactone.	Approved
Rifaximin	The serum concentration of Rifaximin can be increased when it is combined with Spironolactone.	Approved, Investigational
Rilmenidine	Spironolactone may decrease the vasoconstricting activities of Rilmenidine.	Investigational
Riociguat	The risk or severity of adverse effects can be increased when Spironolactone is combined with Riociguat.	Approved
Risperidone	Spironolactone may increase the hypotensive activities of Risperidone.	Approved, Investigational
Ritobegron	Spironolactone may decrease the vasoconstricting activities of Ritobegron.	Investigational
Ritodrine	Spironolactone may decrease the vasoconstricting activities of Ritodrine.	Approved
Ritonavir	The serum concentration of Ritonavir can be increased when it is combined with Spironolactone.	Approved, Investigational
Rivaroxaban	The serum concentration of Rivaroxaban can be increased when it is combined with Spironolactone.	Approved
Rofecoxib	Rofecoxib may decrease the antihypertensive activities of Spironolactone.	Investigational, Withdrawn
Romidepsin	The serum concentration of Romidepsin can be increased when it is combined with Spironolactone.	Approved, Investigational
Ropinirole	The risk or severity of adverse effects can be increased when Spironolactone is combined with Ropinirole.	Approved, Investigational
Ropivacaine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Ropivacaine.	Approved
Rotigotine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Rotigotine.	Approved
Sacubitril	Sacubitril may increase the hyperkalemic activities of Spironolactone.	Approved
Salbutamol	Spironolactone may decrease the vasoconstricting activities of Salbutamol.	Approved, Vet Approved
Salicylamide	Salicylamide may decrease the antihypertensive activities of Spironolactone.	Approved
Salicylic acid	The serum concentration of Salicylic acid can be increased when it is combined with Spironolactone.	Approved, Vet Approved
Salmeterol	Spironolactone may decrease the vasoconstricting activities of Salmeterol.	Approved
Salsalate	Salsalate may decrease the antihypertensive activities of Spironolactone.	Approved
Saprisartan	Saprisartan may increase the hyperkalemic activities of Spironolactone.	Experimental
Saquinavir	The serum concentration of Saquinavir can be increased when it is combined with Spironolactone.	Approved, Investigational
Secobarbital	Secobarbital may increase the hypotensive activities of Spironolactone.	Approved, Vet Approved
Selegiline	The risk or severity of adverse effects can be increased when Spironolactone is combined with Selegiline.	Approved, Investigational, Vet Approved
Selexipag	The serum concentration of Selexipag can be increased when it is combined with Spironolactone.	Approved
Sevoflurane	The risk or severity of adverse effects can be increased when Spironolactone is combined with Sevoflurane.	Approved, Vet Approved
Silodosin	The serum concentration of Silodosin can be increased when it is combined with Spironolactone.	Approved
Simeprevir	The serum concentration of Simeprevir can be increased when it is combined with Spironolactone.	Approved
Sitagliptin	The serum concentration of Sitagliptin can be increased when it is combined with Spironolactone.	Approved, Investigational
Sodium Nitrite	The risk or severity of adverse effects can be increased when Spironolactone is combined with Sodium Nitrite.	Approved
Sofosbuvir	The serum concentration of Sofosbuvir can be increased when it is combined with Spironolactone.	Approved
Solabegron	Spironolactone may decrease the vasoconstricting activities of Solabegron.	Investigational
Sorafenib	The serum concentration of Sorafenib can be increased when it is combined with Spironolactone.	Approved, Investigational
Sotalol	The risk or severity of adverse effects can be increased when Spironolactone is combined with Sotalol.	Approved
Sparfloxacin	The serum concentration of Sparfloxacin can be increased when it is combined with Spironolactone.	Approved
Sphingosine	The serum concentration of Sphingosine can be increased when it is combined with Spironolactone.	Experimental
Spirapril	Spironolactone may increase the hyperkalemic activities of Spirapril.	Approved
SRT501	SRT501 may decrease the antihypertensive activities of Spironolactone.	Investigational
Streptokinase	The risk or severity of adverse effects can be increased when Spironolactone is combined with Streptokinase.	Approved
Sufentanil	The risk or severity of adverse effects can be increased when Sufentanil is combined with Spironolactone.	Approved, Investigational
Sulfasalazine	Sulfasalazine may decrease the antihypertensive activities of Spironolactone.	Approved
Sulindac	Sulindac may decrease the antihypertensive activities of Spironolactone.	Approved
Suprofen	Suprofen may decrease the antihypertensive activities of Spironolactone.	Approved, Withdrawn
Synephrine	Spironolactone may decrease the vasoconstricting activities of Synephrine.	Experimental
Tacrolimus	Spironolactone may increase the hyperkalemic activities of Tacrolimus.	Approved, Investigational
Tacrolimus	The serum concentration of Tacrolimus can be increased when it is combined with Spironolactone.	Approved, Investigational
Tamoxifen	The serum concentration of Tamoxifen can be increased when it is combined with Spironolactone.	Approved
Tamsulosin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Tamsulosin.	Approved, Investigational
Tapentadol	The risk or severity of adverse effects can be increased when Tapentadol is combined with Spironolactone.	Approved
Tasosartan	Tasosartan may increase the hyperkalemic activities of Spironolactone.	Approved
Taurocholic Acid	The serum concentration of Taurocholic Acid can be increased when it is combined with Spironolactone.	Experimental
Technetium Tc-99m sestamibi	The serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Spironolactone.	Approved
Telaprevir	The serum concentration of Telaprevir can be increased when it is combined with Spironolactone.	Withdrawn
Telmisartan	The risk or severity of adverse effects can be increased when Spironolactone is combined with Telmisartan.	Approved, Investigational
Temocapril	Spironolactone may increase the hyperkalemic activities of Temocapril.	Experimental, Investigational
Temsirolimus	The serum concentration of Temsirolimus can be increased when it is combined with Spironolactone.	Approved
Tenoxicam	Tenoxicam may decrease the antihypertensive activities of Spironolactone.	Approved
Terazosin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Terazosin.	Approved
Terbutaline	Spironolactone may decrease the vasoconstricting activities of Terbutaline.	Approved
Teriflunomide	Teriflunomide may decrease the antihypertensive activities of Spironolactone.	Approved
Thalidomide	The risk or severity of adverse effects can be increased when Spironolactone is combined with Thalidomide.	Approved, Investigational, Withdrawn
Thiamylal	Thiamylal may increase the hypotensive activities of Spironolactone.	Approved, Vet Approved
Thiopental	Thiopental may increase the hypotensive activities of Spironolactone.	Approved, Vet Approved
Thioridazine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Thioridazine.	Withdrawn
Tiaprofenic acid	Tiaprofenic acid may decrease the antihypertensive activities of Spironolactone.	Approved
Ticagrelor	The serum concentration of Ticagrelor can be increased when it is combined with Spironolactone.	Approved
Timolol	The risk or severity of adverse effects can be increased when Timolol is combined with Spironolactone.	Approved
Tinoridine	Tinoridine may decrease the antihypertensive activities of Spironolactone.	Investigational
Tinzaparin	Tinzaparin may increase the hyperkalemic activities of Spironolactone.	Approved
Tizanidine	Spironolactone may decrease the vasoconstricting activities of Tizanidine.	Approved
Tolazoline	The risk or severity of adverse effects can be increased when Spironolactone is combined with Tolazoline.	Approved, Vet Approved
Tolcapone	The risk or severity of adverse effects can be increased when Spironolactone is combined with Tolcapone.	Approved, Withdrawn
Tolfenamic Acid	Tolfenamic Acid may decrease the antihypertensive activities of Spironolactone.	Approved
Tolmetin	Tolmetin may decrease the antihypertensive activities of Spironolactone.	Approved
Tolvaptan	Tolvaptan may increase the hyperkalemic activities of Spironolactone.	Approved
Topotecan	The serum concentration of Topotecan can be increased when it is combined with Spironolactone.	Approved, Investigational
Torasemide	The risk or severity of adverse effects can be increased when Torasemide is combined with Spironolactone.	Approved
Toremifene	The serum concentration of Toremifene can be increased when it is combined with Spironolactone.	Approved, Investigational
Tramadol	The risk or severity of adverse effects can be increased when Tramadol is combined with Spironolactone.	Approved, Investigational
Trandolapril	The risk or severity of adverse effects can be increased when Spironolactone is combined with Trandolapril.	Approved
Tranilast	Tranilast may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational
Tranylcypromine	The risk or severity of adverse effects can be increased when Spironolactone is combined with Tranylcypromine.	Approved
Trastuzumab emtansine	The serum concentration of Trastuzumab emtansine can be increased when it is combined with Spironolactone.	Approved
Tretinoin	The risk or severity of adverse effects can be increased when Spironolactone is combined with Tretinoin.	Approved, Investigational, Nutraceutical
Triamterene	Triamterene may increase the hyperkalemic activities of Spironolactone.	Approved
Trimethoprim	Trimethoprim may increase the hyperkalemic activities of Spironolactone.	Approved, Vet Approved
Tulobuterol	Spironolactone may decrease the vasoconstricting activities of Tulobuterol.	Investigational
Ulipristal	The serum concentration of Ulipristal can be increased when it is combined with Spironolactone.	Approved
Umeclidinium	The serum concentration of Umeclidinium can be increased when it is combined with Spironolactone.	Approved
Valdecoxib	Valdecoxib may decrease the antihypertensive activities of Spironolactone.	Investigational, Withdrawn
Valsartan	The risk or severity of adverse effects can be increased when Valsartan is combined with Spironolactone.	Approved, Investigational
Vecuronium	The serum concentration of Vecuronium can be increased when it is combined with Spironolactone.	Approved
Venetoclax	The serum concentration of Venetoclax can be increased when it is combined with Spironolactone.	Approved
Venlafaxine	The serum concentration of Venlafaxine can be increased when it is combined with Spironolactone.	Approved
Verapamil	The risk or severity of adverse effects can be increased when Spironolactone is combined with Verapamil.	Approved
Vinblastine	The serum concentration of Vinblastine can be increased when it is combined with Spironolactone.	Approved
Vincristine	The serum concentration of Vincristine can be increased when it is combined with Spironolactone.	Approved, Investigational
Vismodegib	The serum concentration of Vismodegib can be increased when it is combined with Spironolactone.	Approved
Zaltoprofen	Zaltoprofen may decrease the antihypertensive activities of Spironolactone.	Approved
Zidovudine	The serum concentration of Zidovudine can be increased when it is combined with Spironolactone.	Approved
Zileuton	Zileuton may decrease the antihypertensive activities of Spironolactone.	Approved, Investigational, Withdrawn
Zomepirac	Zomepirac may decrease the antihypertensive activities of Spironolactone.	Withdrawn

Food Interactions

Avoid alcohol.
Food increases the bioavailability of spironolactone by almost 100%.
Spironolactone may decrease the excretion of potassium. Salt substitutes containing potassium increase the risk of hyperkalemia.

References

Synthesis Reference

Giuseppe Bernini, "Process for preparing micronized spironolactone." U.S. Patent US4332721, issued July, 1975.

US4332721

General References

Berardesca E, Gabba P, Ucci G, Borroni G, Rabbiosi G: Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris. Int J Tissue React. 1988;10(2):115-9. [PubMed:2972662 ]
Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999 Sep 2;341(10):709-17. [PubMed:10471456 ]
Wandelt-Freerksen E: [Aldactone in the treatment of sarcoidosis of the lungs (author's transl)]. Z Erkr Atmungsorgane. 1977 Jul;149(1):156-9. [PubMed:607621 ]

External Links

Resource	Link
Human Metabolome Database (HMDB)	HMDB14565
KEGG Drug	D00443
KEGG Compound	C07310
PubChem Compound	5833
PubChem Substance	46508525
ChemSpider	5628
BindingDB	50228080
ChEBI	9241
ChEMBL	CHEMBL1393
Therapeutic Targets Database	DAP000297
PharmGKB	PA451483
IUPHAR	2875
Guide to Pharmacology	2875
HET	SNL
Drug Product Database	7408
RxList	http://www.rxlist.com/cgi/generic/spiron.htm
Drugs.com	http://www.drugs.com/spironolactone.html
PDRhealth	http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/ald1010.shtml
Wikipedia	Spironolactone

ATC Codes

C03DA01 — Spironolactone

AHFS Codes

24:32.20

PDB Entries

Not Available

FDA label

Download (395 KB)

MSDS

Download (72.6 KB)

Clinical Trials

Phase	Status	Purpose	Conditions	Count
0	Completed	Treatment	Polycystic Ovaries Syndrome	1
1	Completed	Not Available	Healthy Volunteers	1
1	Completed	Basic Science	Healthy Volunteers	1
1	Completed	Treatment	Healthy Volunteers	1
1	Completed	Treatment	Heart Failure, Unspecified	1
1	Completed	Treatment	High Blood Pressure	1
1	Not Yet Recruiting	Diagnostic	Cardiomyopathy With Unknown Etiology	1
1	Recruiting	Other	Polycystic Ovaries Syndrome	1
1	Terminated	Basic Science	Type 2 Diabetic Nephropathy	1
1, 2	Completed	Treatment	Central Serous Chorioretinitis	1
1, 2	Recruiting	Treatment	AML	1
1, 2	Recruiting	Treatment	Pulmonary Arterial Hypertension (PAH)	1
2	Active Not Recruiting	Supportive Care	Dermatologic Complications / Neoplasms, Malignant	1
2	Active Not Recruiting	Treatment	End-Stage Renal Disease (ESRD)	1
2	Completed	Prevention	ACTH / Cortisol Resistance / Glucocorticoid therapy / Mineralcorticoid / Negative Feedback	1
2	Completed	Prevention	Cutaneous Atrophy Due to Corticosteroids	1
2	Completed	Prevention	Heart Failure, Unspecified	1
2	Completed	Treatment	Acanthosis Nigricans / Polycystic Ovaries Syndrome	1
2	Completed	Treatment	Cardiovascular Disease (CVD) / Chronic Kidney Disease (CKD)	1
2	Completed	Treatment	Chronic Kidney Disease (CKD) / Hyperkalemia / Hypertensive	1
2	Completed	Treatment	Congenital Heart Disease (CHD) / Endomyocardial Fibrosis / Heart Failure, Unspecified	1
2	Completed	Treatment	Female Pattern Hair Loss	1
2	Completed	Treatment	Heart Failure, Unspecified	2
2	Completed	Treatment	Hypertension,Essential	1
2	Completed	Treatment	Puberty, Precocious	1
2	Recruiting	Prevention	Cardiovascular Disease (CVD) / Diabetes / Hypertensive	1
2	Recruiting	Treatment	Albuminuria / Chronic Kidney Disease (CKD)	1
2	Recruiting	Treatment	Cancers	1
2	Recruiting	Treatment	Hyperkalemia / Resistant Hypertension	1
2	Recruiting	Treatment	Hypertensive	1
2	Suspended	Treatment	Transplant, Kidney	1
2	Terminated	Treatment	Hypertensive	1
2	Unknown Status	Treatment	End Stage Renal Disease / Hemodialysis	1
2	Withdrawn	Treatment	Acute Heart Failure (AHF)	1
2, 3	Completed	Prevention	Diabetic Nephropathies / Glomerulonephritis / Kidney Diseases / Proteinuria	1
2, 3	Completed	Prevention	Nonvalvular Atrial Fibrillation	1
2, 3	Recruiting	Diagnostic	Diabetic Nephropathies / Retinopathy, Diabetic	1
2, 3	Recruiting	Prevention	Cancers / Critically Ill	1
2, 3	Recruiting	Treatment	Chronic Lung Disease of Prematurity / Chronic Lung Diseases	1
2, 3	Recruiting	Treatment	Heart Failure, Unspecified	1
3	Active Not Recruiting	Treatment	Duchenne's Muscular Dystrophy (DMD)	1
3	Active Not Recruiting	Treatment	Glucose tolerance impaired / Heart Failure, Unspecified / Type 2 Diabetes Mellitus	1
3	Active Not Recruiting	Treatment	Nonvalvular Atrial Fibrillation	1
3	Completed	Prevention	End Stage Renal Disease (ESRD)	1
3	Completed	Prevention	Heart Failure, Unspecified	1
3	Completed	Treatment	Arterial Hypertension / Diabetes Mellitus (DM) / Hypertension, Resistant to Conventional Therapy	1
3	Completed	Treatment	Cardiovascular Disease (CVD) / Congestive Heart Failure (CHF) / Heart Diseases	1
3	Completed	Treatment	Congestive Heart Failure (CHF) / Diastolic Heart Failure	1
3	Completed	Treatment	Heart Failure, Unspecified	1
3	Completed	Treatment	Hypertension,Essential	1
3	Completed	Treatment	Myocardial Infarction (MI)	1
3	Not Yet Recruiting	Prevention	Acute Kidney Injury (AKI)	1
3	Not Yet Recruiting	Prevention	Endstage Renal Disease	1
3	Not Yet Recruiting	Treatment	ST Elevation Myocardial Infarction	1
3	Recruiting	Treatment	End Stage Renal Failure on Dialysis	1
4	Active Not Recruiting	Diagnostic	Heart Failure, Unspecified / Nonischemic Dilated Cardiomyopathy	1
4	Active Not Recruiting	Treatment	Cardio-Renal Syndrome / Renal Insufficiency,Chronic	1
4	Active Not Recruiting	Treatment	Hypertension, Resistant to Conventional Therapy	1
4	Active Not Recruiting	Treatment	Nonvalvular Atrial Fibrillation	1
4	Completed	Diagnostic	Heart Failure, Unspecified	1
4	Completed	Prevention	Anthracycline Induced Cardiotoxicity	1
4	Completed	Prevention	End-stage Renal Failure (ESRF)	1
4	Completed	Prevention	Hypertensive	1
4	Completed	Treatment	Arterial Elasticity / Arterial Stiffness	1
4	Completed	Treatment	Ascites / Liver Cirrhosis	1
4	Completed	Treatment	Chronic Stable Heart Failure	2
4	Completed	Treatment	Diabetes Mellitus (DM) / Hypertension, Resistant to Conventional Therapy	1
4	Completed	Treatment	Diabetes Mellitus (DM) / Type 2 Diabetes Mellitus	1
4	Completed	Treatment	Diabetic Nephropathies	1
4	Completed	Treatment	Diastolic Heart Failure	1
4	Completed	Treatment	Heart Failure, Unspecified / Ventricular Dysfunction, Left	1
4	Completed	Treatment	Hypertensive	2
4	Completed	Treatment	Kidney Failure,Chronic	1
4	Enrolling by Invitation	Prevention	Disorder Related to Renal Transplantation	1
4	Not Yet Recruiting	Treatment	Fibrosis / Hypertrophic Cardiomyopathy	1
4	Not Yet Recruiting	Treatment	Heart Failure With Preserved Ejection Fraction (HFpEF)	1
4	Not Yet Recruiting	Treatment	Liver Cirrhosis / Portal Hypertension	1
4	Recruiting	Prevention	Blood Pressures / Hypertensive / Strokes	1
4	Recruiting	Treatment	Atherosclerosis	1
4	Recruiting	Treatment	Heart Failure, Unspecified	1
4	Recruiting	Treatment	Hypertension Resistant To Conventional Therapy	1
4	Recruiting	Treatment	Pulmonary Hypertension (PH)	1
4	Recruiting	Treatment	Transplantation, Liver	1
4	Suspended	Treatment	Alcoholism / Cardiomyopathy, Alcoholic	1
4	Terminated	Prevention	Patients With Fungic Infections	1
4	Unknown Status	Treatment	Diabetic Nephropathies	1
4	Unknown Status	Treatment	Hypertensive	3
4	Unknown Status	Treatment	Hypertrophic Cardiomyopathy / Myocardial Fibrosis	1
4	Unknown Status	Treatment	Kidney Failure,Chronic	1
4	Unknown Status	Treatment	Liver Cirrhosis / Portal Hypertension	1
4	Unknown Status	Treatment	Osteoarthritis of the Knees	1
4	Unknown Status	Treatment	Renal Failure	1
4	Unknown Status	Treatment	Hemodialysis-dependent patients	1
4	Withdrawn	Treatment	Congestive Heart Failure (CHF) / End Stage Renal Disease (ESRD)	1
4	Withdrawn	Treatment	End Stage Renal Disease (ESRD) / Hemodialysis-dependent patients	1
4	Withdrawn	Treatment	Female Androgenetic Alopecia	1
4	Withdrawn	Treatment	Heart Failure, Unspecified	1
Not Available	Completed	Not Available	Fractures, Bone / Type 2 Diabetes Mellitus	1
Not Available	Completed	Diagnostic	Cardiovascular Disease (CVD)	1
Not Available	Completed	Prevention	BMI >30 kg/m2 / Insulin Resistance	1
Not Available	Completed	Prevention	Cardiovascular Disease (CVD) / Coronary Heart Disease (CHD) / Heart Diseases	1
Not Available	Completed	Treatment	ADPKD	1
Not Available	Completed	Treatment	Chronic Kidney Disease (CKD) / Proteinuria	1
Not Available	Completed	Treatment	Congenital Disorders	1
Not Available	Completed	Treatment	Congestive Heart Failure (CHF)	1
Not Available	Completed	Treatment	Diabetic Nephropathies	1
Not Available	Completed	Treatment	Hyperaldosteronism / Obstructive Sleep Apnea (OSA) / Resistant Hypertension	1
Not Available	Completed	Treatment	Hypertension,Essential	1
Not Available	Completed	Treatment	Hypokalemia Caused by Thiazide Diuretics / Idiopathic Hypercalciuria	1
Not Available	Completed	Treatment	Major Depressive Disorder (MDD)	1
Not Available	Completed	Treatment	Polycystic Ovaries Syndrome	1
Not Available	Completed	Treatment	Type 2 Diabetes Mellitus / Vascular Diseases	1
Not Available	Recruiting	Not Available	Alport Syndrome / Familial Benign Hematuria / Hereditary Kidney Disease / Pediatric Kidney Disease / Thin Basement Membrane Disease	1
Not Available	Recruiting	Basic Science	BMI >30 kg/m2 / Hyperandrogenemia / Polycystic Ovaries Syndrome	1
Not Available	Recruiting	Basic Science	Primary Aldosteronism	1
Not Available	Recruiting	Treatment	Acute Decompensated Heart Failure (ADHF)	1
Not Available	Recruiting	Treatment	Diabetes, Diabetes Mellitus Type 1	1
Not Available	Terminated	Treatment	Congestive Heart Failure (CHF)	1
Not Available	Unknown Status	Prevention	Acute Kidney Injury (AKI) / Acute Renal Injury / Kidney Injuries, Acute	1
Not Available	Unknown Status	Prevention	Diabetes Mellitus (DM) / Endocrine System Diseases / Glucose Metabolism Disorders / Metabolic Diseases	1
Not Available	Unknown Status	Treatment	Nonvalvular Atrial Fibrillation	1
Not Available	Withdrawn	Treatment	Congestive Heart Failure (CHF)	2
Not Available	Withdrawn	Treatment	Diastolic Heart Failure	1
Not Available	Withdrawn	Treatment	Hypertensive	1
Not Available	Withdrawn	Treatment	Pulmonary Hypertension (PH) / Right Heart Failure	1

Pharmacoeconomics

Manufacturers

Gd searle llc
Actavis elizabeth llc
Amneal pharmaceuticals
Ascot hosp pharmaceuticals inc div travenol laboratories inc
Ivax pharmaceuticals inc
Lederle laboratories div american cyanamid co
Mutual pharmaceutical co inc
Mylan pharmaceuticals inc
Purepac pharmaceutical co
Sandoz inc
Superpharm corp
Upsher smith laboratories inc
Vangard laboratories inc div midway medical co
Vintage pharmaceuticals llc
Warner chilcott div warner lambert co
Watson laboratories inc

Packagers

Actavis Group
Advanced Pharmaceutical Services Inc.
Amerisource Health Services Corp.
A-S Medication Solutions LLC
Cardinal Health
Caremark LLC
Comprehensive Consultant Services Inc.
Dept Health Central Pharmacy
DHHS Program Support Center Supply Service Center
Direct Dispensing Inc.
Dispensing Solutions
Diversified Healthcare Services Inc.
GD Searle LLC
Greenstone LLC
Guna Inc.
H and H Laboratories
Heartland Repack Services LLC
Innoviant Pharmacy Inc.
Lake Erie Medical and Surgical Supply
Liberty Pharmaceuticals
Major Pharmaceuticals
Mckesson Corp.
Medisca Inc.
Murfreesboro Pharmaceutical Nursing Supply
Mutual Pharmaceutical Co.
Mylan
Neighborcare Repackaging Inc.
Neuman Distributors Inc.
Nucare Pharmaceuticals Inc.
Palmetto Pharmaceuticals Inc.
PD-Rx Pharmaceuticals Inc.
Pfizer Inc.
Pharmaceutical Utilization Management Program VA Inc.
Pharmacia Inc.
Pharmedix
Physicians Total Care Inc.
Preferred Pharmaceuticals Inc.
Prepackage Specialists
Prepak Systems Inc.
Professional Co.
Qualitest
Rebel Distributors Corp.
Remedy Repack
Resource Optimization and Innovation LLC
Richmond Pharmacy
Sandhills Packaging Inc.
Sandoz
Southwood Pharmaceuticals
UDL Laboratories
Vangard Labs Inc.
Vintage Pharmaceuticals Inc.

Dosage forms

Form	Route	Strength
Tablet	Oral	100 mg
Tablet	Oral	25 mg
Tablet	Oral	100 mg/1
Tablet	Oral	25 mg/1
Tablet	Oral	50 mg/1
Tablet, film coated	Oral	100 mg/1
Tablet, film coated	Oral	25 mg/1
Tablet, film coated	Oral	50 mg/1
Tablet	Oral
Tablet, film coated	Oral

Prices

Unit description	Cost	Unit
Spironolactone powder	12.56USD	g
Aldactone 100 mg tablet	2.14USD	tablet
Aldactazide 50-50 mg tablet	2.02USD	tablet
Aldactazide 50-50 tablet	1.92USD	tablet
Aldactone 50 mg tablet	1.84USD	tablet
Spironolactone 100 mg tablet	1.45USD	tablet
Aldactazide 25-25 mg tablet	1.26USD	tablet
Aldactazide 25-25 tablet	1.04USD	tablet
Spironolactone 50 mg tablet	0.83USD	tablet
Aldactone 25 mg tablet	0.8USD	tablet
Spironolactone-HCTZ 25-25 mg tablet	0.57USD	tablet
Spironolactone 25 mg tablet	0.5USD	tablet
Novo-Spiroton 100 mg Tablet	0.25USD	tablet
Novo-Spiroton 25 mg Tablet	0.11USD	tablet

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Not Available

Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	134.5 °C	PhysProp
water solubility	22 mg/L (at 25 °C)	YALKOWSKY,SH & DANNENFELSER,RM (1992)
logP	2.78	HANSCH,C ET AL. (1995)
logS	-4.28	ADME Research, USCD

Predicted Properties

Property	Value	Source
Water Solubility	0.00198 mg/mL	ALOGPS
logP	3.1	ALOGPS
logP	3.64	ChemAxon
logS	-5.3	ALOGPS
pKa (Strongest Acidic)	18.01	ChemAxon
pKa (Strongest Basic)	-4.9	ChemAxon
Physiological Charge	0	ChemAxon
Hydrogen Acceptor Count	3	ChemAxon
Hydrogen Donor Count	0	ChemAxon
Polar Surface Area	60.44 Å²	ChemAxon
Rotatable Bond Count	2	ChemAxon
Refractivity	113.5 m³·mol^-1	ChemAxon
Polarizability	46.03 Å³	ChemAxon
Number of Rings	5	ChemAxon
Bioavailability	1	ChemAxon
Rule of Five	Yes	ChemAxon
Ghose Filter	Yes	ChemAxon
Veber's Rule	Yes	ChemAxon
MDDR-like Rule	Yes	ChemAxon

Predicted ADMET features

Property	Value	Probability
Human Intestinal Absorption	+	0.9912
Blood Brain Barrier	+	0.932
Caco-2 permeable	+	0.5432
P-glycoprotein substrate	Substrate	0.5691
P-glycoprotein inhibitor I	Inhibitor	0.6807
P-glycoprotein inhibitor II	Inhibitor	0.8388
Renal organic cation transporter	Non-inhibitor	0.727
CYP450 2C9 substrate	Non-substrate	0.7897
CYP450 2D6 substrate	Non-substrate	0.9116
CYP450 3A4 substrate	Substrate	0.6638
CYP450 1A2 substrate	Non-inhibitor	0.9045
CYP450 2C9 inhibitor	Non-inhibitor	0.9071
CYP450 2D6 inhibitor	Non-inhibitor	0.9276
CYP450 2C19 inhibitor	Non-inhibitor	0.9025
CYP450 3A4 inhibitor	Non-inhibitor	0.8309
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.8681
Ames test	Non AMES toxic	0.9158
Carcinogenicity	Non-carcinogens	0.9288
Biodegradation	Not ready biodegradable	0.9696
Rat acute toxicity	2.0150 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.9427
hERG inhibition (predictor II)	Non-inhibitor	0.7002

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum Type	Description	Splash Key
LC-MS/MS	LC-MS/MS Spectrum - LC-ESI-ITFT , positive	splash10-014i-0000900000-5e2e1944e45fcef225d1	View in MoNA
LC-MS/MS	LC-MS/MS Spectrum - LC-ESI-ITFT , positive	splash10-014i-0000900000-406c100eed5b6cdc3286	View in MoNA
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 10V, Positive	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 20V, Positive	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 40V, Positive	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 10V, Negative	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 20V, Negative	Not Available
Predicted LC-MS/MS	Predicted LC-MS/MS Spectrum - 40V, Negative	Not Available
MS	Mass Spectrum (Electron Ionization)	splash10-0006-9836000000-9f600bd39c3b914c0b17	View in MoNA

Taxonomy

Description

This compound belongs to the class of organic compounds known as spironolactones and derivatives. These are steroid lactones with a structure based on the spironolactone skeleton.

Kingdom

Organic compounds

Super Class

Lipids and lipid-like molecules

Class

Steroids and steroid derivatives

Sub Class

Steroid lactones

Direct Parent

Spironolactones and derivatives

Alternative Parents

3-oxo delta-4-steroids / Delta-4-steroids / Cyclohexenones / Gamma butyrolactones / Tetrahydrofurans / Thioesters / Carboxylic acid esters / Carbothioic S-esters / Sulfenyl compounds / Oxacyclic compounds

Substituents

Spironolactone / 3-oxo-delta-4-steroid / 3-oxosteroid / Oxosteroid / Delta-4-steroid / Cyclohexenone / Gamma butyrolactone / Tetrahydrofuran / Carboxylic acid ester / Carbothioic s-ester

Molecular Framework

Aliphatic heteropolycyclic compounds

External Descriptors

thioester, 3-oxo steroid, methyl ketone, oxaspiro compound, steroid lactone (CHEBI:9241 ) / Pregnane and derivatives [Fig] (C07310 )

Targets

Details

1. Mineralocorticoid receptor

Kind: Protein
Organism: Human
Pharmacological action: yes
Actions: antagonist

General Function:: Zinc ion binding
Specific Function:: Receptor for both mineralocorticoids (MC) such as aldosterone and glucocorticoids (GC) such as corticosterone or cortisol. Binds to mineralocorticoid response elements (MRE) and transactivates target genes. The effect of MC is to increase ion and water transport and thus raise extracellular fluid volume and blood pressure and lower potassium levels.
Gene Name:: NR3C2
Uniprot ID:: P08235
Molecular Weight:: 107066.575 Da

References

Sitruk-Ware R: Progestogens in hormonal replacement therapy: new molecules, risks, and benefits. Menopause. 2002 Jan-Feb;9(1):6-15. [PubMed:11791081 ]
Rogerson FM, Yao YZ, Smith BJ, Dimopoulos N, Fuller PJ: Determinants of spironolactone binding specificity in the mineralocorticoid receptor. J Mol Endocrinol. 2003 Dec;31(3):573-82. [PubMed:14664717 ]
Gertner RA, Klein JD, Bailey JL, Kim DU, Luo XH, Bagnasco SM, Sands JM: Aldosterone decreases UT-A1 urea transporter expression via the mineralocorticoid receptor. J Am Soc Nephrol. 2004 Mar;15(3):558-65. [PubMed:14978157 ]
Frishman WH, Stier CT Jr: Aldosterone and aldosterone antagonism in systemic hypertension. Curr Hypertens Rep. 2004 Jun;6(3):195-200. [PubMed:15128471 ]
Rogerson FM, Yao Y, Smith BJ, Fuller PJ: Differences in the determinants of eplerenone, spironolactone and aldosterone binding to the mineralocorticoid receptor. Clin Exp Pharmacol Physiol. 2004 Oct;31(10):704-9. [PubMed:15554912 ]
Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]
Sica DA: Pharmacokinetics and pharmacodynamics of mineralocorticoid blocking agents and their effects on potassium homeostasis. Heart Fail Rev. 2005 Jan;10(1):23-9. [PubMed:15947888 ]
Rossi G, Boscaro M, Ronconi V, Funder JW: Aldosterone as a cardiovascular risk factor. Trends Endocrinol Metab. 2005 Apr;16(3):104-7. [PubMed:15808807 ]

Details

2. Androgen receptor

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: antagonist

General Function:: Zinc ion binding
Specific Function:: Steroid hormone receptors are ligand-activated transcription factors that regulate eukaryotic gene expression and affect cellular proliferation and differentiation in target tissues. Transcription factor activity is modulated by bound coactivator and corepressor proteins. Transcription activation is down-regulated by NR0B2. Activated, but not phosphorylated, by HIPK3 and ZIPK/DAPK3.
Gene Name:: AR
Uniprot ID:: P10275
Molecular Weight:: 98987.9 Da

References

Ye P, Yamashita T, Pollock DM, Sasano H, Rainey WE: Contrasting effects of eplerenone and spironolactone on adrenal cell steroidogenesis. Horm Metab Res. 2009 Jan;41(1):35-9. doi: 10.1055/s-0028-1087188. Epub 2008 Sep 25. [PubMed:18819053 ]

Details

3. Progesterone receptor

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: agonist

General Function:: Zinc ion binding
Specific Function:: The steroid hormones and their receptors are involved in the regulation of eukaryotic gene expression and affect cellular proliferation and differentiation in target tissues. Progesterone receptor isoform B (PRB) is involved activation of c-SRC/MAPK signaling on hormone stimulation.Isoform A: inactive in stimulating c-Src/MAPK signaling on hormone stimulation.Isoform 4: Increases mitochondrial ...
Gene Name:: PGR
Uniprot ID:: P06401
Molecular Weight:: 98979.96 Da

References

Fagart J, Hillisch A, Huyet J, Barfacker L, Fay M, Pleiss U, Pook E, Schafer S, Rafestin-Oblin ME, Kolkhof P: A new mode of mineralocorticoid receptor antagonism by a potent and selective nonsteroidal molecule. J Biol Chem. 2010 Sep 24;285(39):29932-40. doi: 10.1074/jbc.M110.131342. Epub 2010 Jul 22. [PubMed:20650892 ]

Details

4. Glucocorticoid receptor

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: antagonist

General Function:: Zinc ion binding
Specific Function:: Receptor for glucocorticoids (GC). Has a dual mode of action: as a transcription factor that binds to glucocorticoid response elements (GRE), both for nuclear and mitochondrial DNA, and as a modulator of other transcription factors. Affects inflammatory responses, cellular proliferation and differentiation in target tissues. Could act as a coactivator for STAT5-dependent transcription upon grow...
Gene Name:: NR3C1
Uniprot ID:: P04150
Molecular Weight:: 85658.57 Da

References

Fagart J, Hillisch A, Huyet J, Barfacker L, Fay M, Pleiss U, Pook E, Schafer S, Rafestin-Oblin ME, Kolkhof P: A new mode of mineralocorticoid receptor antagonism by a potent and selective nonsteroidal molecule. J Biol Chem. 2010 Sep 24;285(39):29932-40. doi: 10.1074/jbc.M110.131342. Epub 2010 Jul 22. [PubMed:20650892 ]

Details

5. Cytochrome P450 11B2, mitochondrial

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: antagonist

General Function:: Steroid 11-beta-monooxygenase activity
Specific Function:: Preferentially catalyzes the conversion of 11-deoxycorticosterone to aldosterone via corticosterone and 18-hydroxycorticosterone.
Gene Name:: CYP11B2
Uniprot ID:: P19099
Molecular Weight:: 57559.62 Da

References

Cheng SC, Suzuki K, Sadee W, Harding BW: Effects of spironolactone, canrenone and canrenoate-K on cytochrome P450, and 11beta- and 18-hydroxylation in bovine and human adrenal cortical mitochondria. Endocrinology. 1976 Oct;99(4):1097-106. [PubMed:976190 ]

6. 17alpha-hydroxylase

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: antagonist

References

Authors unspecified: Spironolactone and endocrine dysfunction. Ann Intern Med. 1976 Nov;85(5):630-6. [PubMed:984618 ]
Desai; Meena P.; Vijayalakshmi Bhatia & P.S.N. Menon (2001). Pediatric Endocrine Disorders. Orient Blackswan. [ISBN:978-81-250-2025-7 ]

7. 17,20-desmolase

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: antagonist

References

Authors unspecified: Spironolactone and endocrine dysfunction. Ann Intern Med. 1976 Nov;85(5):630-6. [PubMed:984618 ]
Desai; Meena P.; Vijayalakshmi Bhatia & P.S.N. Menon (2001). Pediatric Endocrine Disorders. Orient Blackswan. [ISBN:978-81-250-2025-7 ]

Details

8. 3-oxo-5-alpha-steroid 4-dehydrogenase (Protein Group)

Kind: Protein group
Organism
Pharmacological action: unknown
Actions: antagonist

General Function:: Electron carrier activity
Specific Function:: Converts testosterone into 5-alpha-dihydrotestosterone and progesterone or corticosterone into their corresponding 5-alpha-3-oxosteroids. It plays a central role in sexual differentiation and androgen physiology.

Components:

Name	UniProt ID	Details
3-oxo-5-alpha-steroid 4-dehydrogenase 1	P18405	Details
3-oxo-5-alpha-steroid 4-dehydrogenase 2	P31213	Details
Polyprenol reductase	Q9H8P0	Details

References

Corvol P, Michaud A, Menard J, Freifeld M, Mahoudeau J: Antiandrogenic effect of spirolactones: mechanism of action. Endocrinology. 1975 Jul;97(1):52-8. [PubMed:166833 ]

Details

9. Sex hormone-binding globulin

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: binder

General Function:: Androgen binding
Specific Function:: Functions as an androgen transport protein, but may also be involved in receptor mediated processes. Each dimer binds one molecule of steroid. Specific for 5-alpha-dihydrotestosterone, testosterone, and 17-beta-estradiol. Regulates the plasma metabolic clearance rate of steroid hormones by controlling their plasma concentration.
Gene Name:: SHBG
Uniprot ID:: P04278
Molecular Weight:: 43778.755 Da

References

Braunstein GD: Clinical practice. Gynecomastia. N Engl J Med. 2007 Sep 20;357(12):1229-37. [PubMed:17881754 ]

Details

10. Voltage-dependent calcium channel gamma-1 subunit

Kind: Protein
Organism: Human
Pharmacological action: unknown

General Function:: Voltage-gated calcium channel activity
Specific Function:: This protein is a subunit of the dihydropyridine (DHP) sensitive calcium channel. Plays a role in excitation-contraction coupling. The skeletal muscle DHP-sensitive Ca(2+) channel may function only as a multiple subunit complex.
Gene Name:: CACNG1
Uniprot ID:: Q06432
Molecular Weight:: 25028.105 Da

References

Sorrentino R, Autore G, Cirino G, d'Emmanuele de Villa Bianca R, Calignano A, Vanasia M, Alfieri C, Sorrentino L, Pinto A: Effect of spironolactone and its metabolites on contractile property of isolated rat aorta rings. J Cardiovasc Pharmacol. 2000 Aug;36(2):230-5. [PubMed:10942165 ]
Melander A, Danielson K, Schersten B, Thulin T, Wahlin E: Enhancement by food of canrenone bioavailability from spironolactone. Clin Pharmacol Ther. 1977 Jul;22(1):100-3. [PubMed:872489 ]

11. Dihydrotestosterone receptor

Kind: Protein
Organism: Human
Pharmacological action: unknown

References

Berardesca E, Gabba P, Ucci G, Borroni G, Rabbiosi G: Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris. Int J Tissue React. 1988;10(2):115-9. [PubMed:2972662 ]

Details

12. Nuclear receptor subfamily 1 group I member 2

Kind: Protein
Organism: Human
Pharmacological action: unknown

General Function:: Zinc ion binding
Specific Function:: Nuclear receptor that binds and is activated by variety of endogenous and xenobiotic compounds. Transcription factor that activates the transcription of multiple genes involved in the metabolism and secretion of potentially harmful xenobiotics, drugs and endogenous compounds. Activated by the antibiotic rifampicin and various plant metabolites, such as hyperforin, guggulipid, colupulone, and is...
Gene Name:: NR1I2
Uniprot ID:: O75469
Molecular Weight:: 49761.245 Da

References

Kretschmer XC, Baldwin WS: CAR and PXR: xenosensors of endocrine disrupters? Chem Biol Interact. 2005 Aug 15;155(3):111-28. [PubMed:16054614 ]

Enzymes

Details

1. Cytochrome P450 2C8

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: inhibitor

General Function:: Steroid hydroxylase activity
Specific Function:: Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. In the epoxidation of arachidonic acid it generates only 14,15- and 11,12-cis-epoxyeicosatrienoic acids. It is the principal enzyme...
Gene Name:: CYP2C8
Uniprot ID:: P10632
Molecular Weight:: 55824.275 Da

References

Walsky RL, Gaman EA, Obach RS: Examination of 209 drugs for inhibition of cytochrome P450 2C8. J Clin Pharmacol. 2005 Jan;45(1):68-78. [PubMed:15601807 ]
Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]

Details

2. Cytochrome P450 11B1, mitochondrial

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: inhibitorinducer

General Function:: Steroid 11-beta-monooxygenase activity
Specific Function:: Has steroid 11-beta-hydroxylase activity. In addition to this activity, the 18 or 19-hydroxylation of steroids and the aromatization of androstendione to estrone have also been ascribed to cytochrome P450 XIB.
Gene Name:: CYP11B1
Uniprot ID:: P15538
Molecular Weight:: 57572.44 Da

References

Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
Cheng SC, Suzuki K, Sadee W, Harding BW: Effects of spironolactone, canrenone and canrenoate-K on cytochrome P450, and 11beta- and 18-hydroxylation in bovine and human adrenal cortical mitochondria. Endocrinology. 1976 Oct;99(4):1097-106. [PubMed:976190 ]

Transporters

Details

1. Canalicular multispecific organic anion transporter 1

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: inducer

General Function:: Organic anion transmembrane transporter activity
Specific Function:: Mediates hepatobiliary excretion of numerous organic anions. May function as a cellular cisplatin transporter.
Gene Name:: ABCC2
Uniprot ID:: Q92887
Molecular Weight:: 174205.64 Da

References

Johnson DR, Klaassen CD: Regulation of rat multidrug resistance protein 2 by classes of prototypical microsomal enzyme inducers that activate distinct transcription pathways. Toxicol Sci. 2002 Jun;67(2):182-9. [PubMed:12011477 ]

Details

2. Multidrug resistance protein 1

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: inhibitor

General Function:: Xenobiotic-transporting atpase activity
Specific Function:: Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name:: ABCB1
Uniprot ID:: P08183
Molecular Weight:: 141477.255 Da

References

Wang E, Lew K, Barecki M, Casciano CN, Clement RP, Johnson WW: Quantitative distinctions of active site molecular recognition by P-glycoprotein and cytochrome P450 3A4. Chem Res Toxicol. 2001 Dec;14(12):1596-603. [PubMed:11743742 ]

Details

3. Solute carrier organic anion transporter family member 1A2

Kind: Protein
Organism: Human
Pharmacological action: unknown
Actions: inhibitor

General Function:: Sodium-independent organic anion transmembrane transporter activity
Specific Function:: Mediates the Na(+)-independent transport of organic anions such as sulfobromophthalein (BSP) and conjugated (taurocholate) and unconjugated (cholate) bile acids (By similarity). Selectively inhibited by the grapefruit juice component naringin.
Gene Name:: SLCO1A2
Uniprot ID:: P46721
Molecular Weight:: 74144.105 Da

References

Kanai N, Lu R, Bao Y, Wolkoff AW, Schuster VL: Transient expression of oatp organic anion transporter in mammalian cells: identification of candidate substrates. Am J Physiol. 1996 Feb;270(2 Pt 2):F319-25. [PubMed:8779893 ]

Drug created on June 13, 2005 07:24 / Updated on July 07, 2017 02:57

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Structure for DB00421 (Spironolactone)

Targets

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Components:

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Enzymes

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Transporters

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