Potassium-sparing diuretics (drug interactions)

Definition: An alternative diuretic used to avoid the potassium loss common with loop and thiazide diuretics.

Interactions:Arginine, magnesium, potassium, white willow, zinc, ACE inhibitors, digoxin

Potassium

Effect: Likely Harmful Interaction

Potassium-sparing diuretics cause the kidneys to hold potassium in the body. Persons taking these medications generally should not take potassium supplements because potassium levels might rise too high.

Treatments that combine thiazide diuretics (which cause potassium loss) and potassium-sparing diuretics can affect potassium levels unpredictably. Persons taking such a combination medication should not take potassium except on the advice of a physician.

Magnesium

Effect: Possible Harmful Interaction

Preliminary evidence from animal studies suggests that the potassium-sparing diuretic amiloride might cause the body to retain magnesium also, along with potassium. Therefore, taking magnesium supplements might conceivably present the risk of excessive magnesium levels.

Arginine

Effect: Possible Harmful Interaction

Based on experience with intravenous arginine, it is possible that the use of high-dose oral arginine might alter potassium levels in the body, especially in people with severe liver disease. This is a potential concern for persons who take potassium-sparing diuretics.

White Willow

Effect: Possible Negative Interaction

The herb white willow contains substances that are similar to aspirin. On this basis, it might not be advisable to combine white willow with potassium-sparing diuretics.

Zinc

Effect: Possible Harmful Interaction

The potassium-sparing diuretic amiloride was found to significantly reduce zinc excretion from the body. This means that if one takes zinc supplements at the same time as amiloride, zinc accumulation could occur. This could lead to toxic side effects. However, the potassium-sparing diuretic triamterene does not seem to cause this problem.

Other Interactions

Patients taking ACE inhibitors should avoid potassium-sparing diuretics as they may cause hypokalemia or high protein levels. Similarly, patients should avoid consuming potassium-rich foods or salt substitutes. Potassium-sparing diuretics should not be taken with digoxin as it may lead to fatal arrhythmias.

Bibliography

Corliss, Julie. “Tips for Taking Diuretic Medications.” Harvard Health, 25 Sept. 2019, www.health.harvard.edu/heart-health/tips-for-taking-diuretic-medications. Accessed 17 Aug. 2023.

“List of Potassium-Sparing Diuretics.” Drugs.com, 10 Aug. 2023, www.drugs.com/drug-class/potassium-sparing-diuretics.html. Accessed 17 Aug. 2023.

Reyes, A. J., et al. “Urinary Zinc Excretion, Diuretics, Zinc Deficiency, and Some Side-Effects of Diuretics.” South African Journal of Medical Sciences 64 (1983): 936-941.

Wester, P. O. “Urinary Zinc Excretion During Treatment with Different Diuretics.” Acta Medica Scandinavica 208 (1980): 209-212.