Tylenol (acetaminophen) can safely be taken with Aldactone (spironolactone) as there is no listed or reported interaction between the two medications. It is recommended however, that spironolactone be taken consistently with respect to food.
Food intake with spironolactone can increase absorption of the drug by up to 90%. To ensure consistent dosing, be sure to take spironolactone the same way each day.
Tylenol can sometimes cause GI upset, which can often be reduced by taking it with food. If your intake of Tylenol adjusts your food intake around the same time you take spironolactone, be aware that this may affect how the medication is absorbed.