Spironolactone and Trimethoprim Interaction

Drug interaction information between Spironolactone and Trimethoprim.

Spironolactone and Trimethoprim have a documented moderate interaction in FDA labeling.

FDA drug labeling documents a moderate-severity interaction between Spironolactone and Trimethoprim. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.

Drug A

Spironolactone

Potassium-Sparing Diuretic / Aldosterone Antagonist

Drug B

Trimethoprim

Dihydrofolate Reductase Inhibitor

How They Interact

Both of these medications can cause your body to hold onto potassium. Taking them together increases the risk of having too much potassium in your blood.

FDA Label Information

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.

Spironolactone Also Interacts With

View all Spironolactone interactions →

Frequently Asked Questions

What SPL severity band is on file for Spironolactone + Trimethoprim?

Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.

Which drug in this pair has the larger labeled-interaction portfolio?

Spironolactone has 23 labeled pairs on file vs Trimethoprim's 22. In the moderate band specifically: Spironolactone has 9 (also Lithium, Heparin, Amlodipine/Benazepril, Benazepril); Trimethoprim has 3 (also Prenatal Multivitamin, Spironolactone).

What mechanism field is on file for Spironolactone and Trimethoprim?

Both of these medications can cause your body to hold onto potassium. Taking them together increases the risk of having too much potassium in your blood.

Trimethoprim carries more major-labeled pairs than Spironolactone

SPL source-record counts only. This page's band is moderate · classes on file: Spironolactone (Potassium-Sparing Diuretic / Aldosterone Antagonist); Trimethoprim (Dihydrofolate Reductase Inhibitor).

Trimethoprim has 1 major-labeled pair vs Spironolactone's 0. This page itself is in the moderate band, not the major band.

Spironolactone

0 major · 9 moderate · 14 minor · 23 total

Trimethoprim

1 major · 3 moderate · 18 minor · 22 total

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.