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Can I take Eplerenone and Lixiana together?

Drug interaction guide

Taking eplerenone and Lixiana (edoxaban) together may increase your risk of bleeding. While eplerenone is a diuretic (water tablet) and Lixiana is a blood thinner, they do not have a direct chemical interaction. However, eplerenone can sometimes affect kidney function or potassium levels, which can indirectly influence how your body handles blood thinners. Additionally, if eplerenone causes dehydration, it could lead to a higher concentration of Lixiana in your blood, making bleeding more likely.

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Why this happens

There is no direct metabolic interaction between these drugs. However, eplerenone can cause changes in kidney function (renal impairment) or electrolyte imbalances. Since Lixiana is partially cleared by the kidneys, any significant drop in kidney function caused by eplerenone could lead to Lixiana building up in the system, increasing the anticoagulant effect.

You can usually take these medicines together, but you should be monitored by your doctor. Ensure you have regular blood tests to check your kidney function and potassium levels. Seek medical advice immediately if you notice signs of unusual bleeding, such as unexplained bruising, blood in your urine or stools, or nosebleeds that take a long time to stop.

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High potassium levels (hyperkalaemia)

Eplerenone can cause dangerously high levels of potassium in your blood. You must avoid using potassium supplements or salt substitutes containing potassium (such as Lo-Salt) while taking this medicine.

Kidney disease

You must not take eplerenone if you have severe kidney disease, as this significantly increases the risk of life-threatening potassium build-up.

Bleeding risk

Lixiana thins your blood. You must seek immediate medical help if you have a serious fall (especially a head injury) or experience signs of internal bleeding, such as black tarry stools or coughing up blood.

Surgery and dental work

You must inform your surgeon or dentist that you are taking Lixiana before any procedure, as you may need to stop taking it temporarily to prevent dangerous bleeding.

Pregnancy and breastfeeding

Do not take Lixiana if you are pregnant or breastfeeding, as it may cause serious harm to the baby. Use effective contraception while taking it.

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Alcohol can increase the risk of dizziness or fainting with eplerenone. With Lixiana, alcohol can increase the risk of stomach irritation and bleeding.

Grapefruit juice

Do not drink grapefruit juice while taking eplerenone. Grapefruit juice can increase the amount of eplerenone in your blood, which significantly increases the risk of side effects.

Salt substitutes (containing potassium)

Avoid using salt substitutes that contain potassium (such as Lo-Salt) or foods very high in potassium (such as bananas, spinach, or coconut water). Eplerenone increases potassium levels in your body; adding more through your diet can lead to dangerously high potassium levels (hyperkalaemia).

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Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.

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Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 25 Jan 2026 | Originally published
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