Potassium supplementation, either in the form of medication or as a diet rich in potassium, should not ordinarily be given in association with Spironolactone therapy. Excessive potassium intake may cause hyperkalemia in patients receiving Spironolactone. Spironolactone should not be administered concurrently with other potassium-sparing diuretics. Spironolactone, when used with ACE inhibitors or indomethacin, even in the presence of a diuretic, has been associated with severe hyperkalemia. Extreme caution should be exercised when Spironolactone is given concomitantly with these drugs. Spironolactone should be used with caution in patients with impaired hepatic function because minor alterations of fluid and electrolyte balance may precipitate hepatic coma. Lithium generally should not be given with diuretics.