Drug Interactions between spironolactone and tacrolimus

Talk to your doctor before using tacrolimus together with spironolactone. Combining these medications may increase the risk of hyperkalemia (high blood potassium), which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia while taking these medications if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. Regular or long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk. It is important that you maintain adequate fluid intake during treatment with these medications. In addition, talk to your doctor to see if you should limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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