Minor
Alprazolam × Spironolactone
Benzodiazepines. Short-to-medium-acting anxiolytics×Potassium-sparing diuretics (mineralocorticoid receptor antagonists)
Mechanism
No direct interaction. Mild additive hypotension and fall risk in older patients during hypovolaemia or on starting the combination.
Symptoms
Possible mild morning hypotension and sedation. In older patients: fall risk.
Management
No dose adjustment needed. In older patients, start alprazolam at 0.125 mg at bedtime. In dehydration or acute illness, temporarily stop spironolactone.