Major
Probable
Açıklama
Spironolactone increases renal lithium reabsorption by promoting distal tubular sodium retention, leading to lithium toxicity.
Mekanizma
Spironolactone antagonizes aldosterone-mediated distal tubular sodium excretion; the resulting sodium retention reduces compensatory proximal tubular sodium (and lithium) reabsorption variably, but overall lithium levels tend to rise.
Klinik Önemi
Lithium toxicity has been documented with spironolactone co-administration; the direction and magnitude of interaction is variable.
Yönetim
Monitor lithium levels within 1 week of spironolactone initiation or dose change; adjust lithium dose based on levels.