Spironolactone should NOT be given with the following pharmacological agent: ACE inhibitors

Spironolactone should NOT be given with the following pharmacological agent:
a) Chlorothiazide
b) b-blocker
c) ACE inhibitors
d) Amlodipine
Correct Answer - C
Unlike most other diuretics, K±sparing diuretics reduce urinary excretion of K+ and can
cause mild, moderate, or even life-threatening hyperkalemia.
The risk of this complication is greatly increased by renal disease (in which maximal K+
excretion may be reduced) or by the use of other drugs that reduce or inhibit renin (beta
blockers, NSAIDs, aliskiren) or angiotensin II activity (angiotensin- converting enzyme
inhibitors, angiotensin receptor inhibitors).
Since most other diuretic agents lead to K+ losses, hyperkalemia is more common when
K±sparing diuretics are used as the sole diuretic agent, especially in patients with renal
insufficiency.
Ref: Ives H.E. (2012). Chapter 15. Diuretic Agents. In B.G. Katzung, S.B. Masters, A.J.
Trevor (Eds), Basic & Clinical Pharmacology, 12e