Trimethoprim and Spironolactone Interaction

Drug interaction information between Trimethoprim and Spironolactone.

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

FDA drug labeling documents a moderate-severity interaction between Trimethoprim and Spironolactone. 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

Trimethoprim

Dihydrofolate Reductase Inhibitor

Drug B

Spironolactone

Potassium-Sparing Diuretic / Aldosterone Antagonist

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 Trimethoprim + Spironolactone?

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: Trimethoprim has 3 (also Prenatal Multivitamin, Spironolactone); Spironolactone has 9 (also Lithium, Heparin, Amlodipine/Benazepril, Benazepril).

What mechanism field is on file for Trimethoprim and Spironolactone?

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: Trimethoprim (Dihydrofolate Reductase Inhibitor); Spironolactone (Potassium-Sparing Diuretic / Aldosterone Antagonist).

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

Trimethoprim

1 major · 3 moderate · 18 minor · 22 total

Spironolactone

0 major · 9 moderate · 14 minor · 23 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.