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Can You Take Lisinopril and Spironolactone Together?

Combining lisinopril and spironolactone can raise potassium to dangerous levels -- named directly on both drugs' FDA labels.

Use cautionEvidence: High

What the interaction means

Lisinopril's FDA label states: "Lisinopril attenuates potassium loss caused by thiazide-type diuretics. Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) can increase the risk of hyperkalemia. Therefore, if concomitant use of such agents is indicated, monitor the patient's serum potassium frequently." Spironolactone's own label corroborates this from the other side: "Concomitant administration of spironolactone tablets with potassium supplementation or drugs that can increase potassium may lead to severe hyperkalemia... Check serum potassium levels when ACE inhibitor or ARB therapy is altered in patients receiving spironolactone tablets," listing ACE inhibitors (lisinopril's class) among the examples.

Why it may happen

Lisinopril (an ACE inhibitor) reduces potassium excretion, and spironolactone (a potassium-sparing diuretic) also retains potassium -- the combined effect can push serum potassium to dangerously high levels (hyperkalemia).

Practical context

Both labels direct frequent serum potassium monitoring during concomitant use rather than an outright avoidance -- this combination is sometimes used intentionally under medical supervision (e.g., in heart failure management), but requires active monitoring, not casual co-use.

What the sources say

Lisinopril Tablets — FDA Prescribing Information — Prinston Pharmaceutical Inc. (via DailyMed, U.S. National Library of Medicine)Spironolactone Tablets — FDA Prescribing Information — Sun Pharmaceutical Industries, Inc. (via DailyMed, U.S. National Library of Medicine)

Last reviewed 2026-08-23

Medical information disclaimer: this information is general and educational. It does not diagnose conditions, prescribe treatment, or determine whether a combination is safe for you personally. Follow your prescription label and ask a pharmacist or clinician before starting, stopping, or combining products. Full disclaimer.

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