Spironolactone and Lithium Interaction
Drug interaction information between Spironolactone and Lithium.
Spironolactone and Lithium have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Spironolactone and Lithium. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Spironolactone makes it harder for the kidneys to remove lithium from the body. This can cause lithium to build up to dangerous levels.
What To Do
Your doctor should check your lithium blood levels regularly while you are taking both medications.
FDA Label Information
Lithium: Increased risk of lithium toxicity ( 7.2 ). Examples of drugs that can increase potassium include: ACE inhibitors angiotensin receptor blockers non-steroidal anti-inflammatory drugs (NSAIDs) heparin and low molecular weight heparin trimethoprim 7.2 Lithium Like other diuretics, spironolactone reduces the renal clearance of lithium, thus increasing the risk of lithium toxicity. Monitor lithium levels periodically when spironolactone is co-administered [see Clinical Pharmacology (12.3) ] .
Spironolactone Also Interacts With
- Trimethoprim moderate
- Heparin moderate
- Amlodipine/Benazepril moderate
- Benazepril moderate
- Lovastatin moderate
Lithium Also Interacts With
- Amlodipine/Benazepril major
- Risperidone major
- Amiloride moderate
- Amiodarone moderate
- Amlodipine/Valsartan moderate
Frequently Asked Questions
Can I take Spironolactone and Lithium together?
This is a moderate interaction. Your doctor should check your lithium blood levels regularly while you are taking both medications.
How serious is the interaction between Spironolactone and Lithium?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Spironolactone and Lithium interact?
Spironolactone makes it harder for the kidneys to remove lithium from the body. This can cause lithium to build up to dangerous levels.
Understanding the Spironolactone and Lithium Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Spironolactone belongs to the Potassium-Sparing Diuretic / Aldosterone Antagonist class and Lithium belongs to the Mood Stabilizer class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Spironolactone makes it harder for the kidneys to remove lithium from the body. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Spironolactone has 23 total documented interactions on file in this dataset, and Lithium has 90. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should check your lithium blood levels regularly while you are taking both medications. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Spironolactone or Lithium based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.