Moderate
Probable
الوصف
NSAIDs reduce the natriuretic and diuretic efficacy of spironolactone, potentially leading to sodium retention and worsening edema or hypertension.
الآلية
Spironolactone's diuretic effect is partially prostaglandin-dependent; naproxen-mediated prostaglandin inhibition attenuates this mechanism and promotes sodium reabsorption.
الأهمية السريرية
The interaction may be particularly significant in patients with heart failure or hepatic cirrhosis where diuretic response is already reduced.
التدبير
Avoid NSAIDs in patients taking spironolactone for heart failure or liver disease; monitor weight, edema, and renal function.