Spironolactone
Hypertension, Edema ... show more
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
NO
Pharmaceutical Class
Aldosterone Antagonist
Controlled Drug Substance
NO
Spironolactone
Learn more about this medicine -
Click HereSummary
Spironolactone is used to ease fluid buildup in the body caused by conditions like heart failure, liver disease, or kidney problems. It also helps lower high blood pressure and is used for certain types of high blood pressure related to the adrenal glands.
Spironolactone works by blocking a hormone that makes your body hold onto salt and lose potassium. This action helps lower blood pressure and reduces swelling. It also helps your body keep potassium, an important mineral.
The dosage of Spironolactone varies depending on what it's treating. For heart problems and high blood pressure, the dose might start low and be adjusted based on your response. For swelling from liver disease, the dose starts higher and can be increased. It's usually taken orally.
Common side effects of Spironolactone include high potassium levels, low blood pressure, and kidney problems. It can also cause imbalances in other salts in your body and high blood sugar. In men, it might cause breast growth.
Spironolactone can raise your potassium levels, especially if you have kidney problems or take other medicines that also raise potassium. You shouldn't take it if you have high potassium, Addison's disease, or are taking a similar medicine called eplerenone. Pregnant women also shouldn't take it.
Indications and Purpose
What is Spironolactone used for?
Spironolactone is indicated for treating conditions such as heart failure, hypertension, edema associated with liver or kidney disease, and hyperaldosteronism. It is also used in combination with other medications for certain cases of precocious puberty and myasthenia gravis, and to treat abnormal facial hair in some female patients.
How does Spironolactone work?
Spironolactone works by blocking the action of aldosterone, a hormone that causes the kidneys to retain sodium and water. By inhibiting aldosterone, Spironolactone promotes the excretion of excess sodium and water while retaining potassium, helping to reduce blood pressure and fluid retention.
Is Spironolactone effective?
Spironolactone has been shown to be effective in reducing mortality in patients with heart failure, as demonstrated in the Randomized Spironolactone Evaluation Study. It also effectively manages hypertension and edema by promoting the excretion of excess water and sodium while retaining potassium. These benefits have been observed in controlled clinical trials.
How does one know if Spironolactone is working?
The benefit of Spironolactone is evaluated through regular monitoring of blood pressure, potassium levels, and renal function. Patients should also report any side effects or changes in symptoms to their doctor. Regular follow-up appointments help ensure the medication is working effectively and safely.
Directions for Use
What is the usual dose of Spironolactone?
For adults, the usual daily dose of Spironolactone varies depending on the condition being treated. For heart failure, the starting dose is typically 25 mg once daily, which may be increased to 50 mg if tolerated. For hypertension, the dose ranges from 25 to 100 mg per day. For edema, the dose can range from 25 to 200 mg daily. For children, the initial daily dosage is 1-3 mg per kg of body weight, given in divided doses. Always follow your doctor's specific dosage instructions.
How do I take Spironolactone?
Spironolactone can be taken with or without food, but it should be taken consistently in the same manner each time. Avoid potassium-rich foods and salt substitutes containing potassium to prevent hyperkalemia. Follow your doctor's dietary recommendations, including any advice on a reduced-sodium diet.
For how long do I take Spironolactone?
Spironolactone is often used as a long-term treatment for conditions like heart failure, hypertension, and edema. The duration of use depends on the specific condition being treated and the patient's response to the medication. It is important to continue taking Spironolactone even if you feel well and not to stop without consulting your doctor.
How long does it take for Spironolactone to start working?
Spironolactone may take about 2 weeks or longer to show its full effect. However, some patients may notice improvements in symptoms like swelling or blood pressure within a few days. It's important to continue taking the medication as prescribed, even if you don't see immediate results.
How should I store Spironolactone?
Store Spironolactone in its original container, tightly closed, at room temperature away from excess heat and moisture. Keep it out of reach of children. Do not store it in the bathroom. For disposal, use a medicine take-back program if available, and avoid flushing it down the toilet.
Warnings and Precautions
Who should avoid taking Spironolactone?
Important warnings for Spironolactone include the risk of hyperkalemia, especially in patients with impaired renal function or those taking potassium supplements. It is contraindicated in patients with Addison's disease, hyperkalemia, and those using eplerenone. Regular monitoring of potassium levels and renal function is essential to prevent serious complications.
Can I take Spironolactone with other prescription drugs?
Significant drug interactions with Spironolactone include those with potassium supplements, ACE inhibitors, angiotensin receptor blockers, NSAIDs, and lithium. These can increase the risk of hyperkalemia or reduce the effectiveness of Spironolactone. Always inform your doctor of all medications you are taking to avoid potential interactions.
Can I take Spironolactone with vitamins or supplements?
Spironolactone can interact with potassium supplements and potassium-rich foods, increasing the risk of hyperkalemia. Avoid using potassium-containing salt substitutes and discuss any vitamin or supplement use with your doctor to prevent potential interactions.
Can Spironolactone be taken safely while pregnant?
Spironolactone is not recommended during pregnancy due to potential risks to the male fetus, as it may affect sex differentiation. There is limited data from human studies, but animal studies have shown potential risks. Pregnant women should discuss the risks and benefits with their doctor before using this medication.
Can Spironolactone be taken safely while breastfeeding?
Spironolactone is not present in breast milk, but its active metabolite, canrenone, is found in low amounts. While short-term exposure has not shown adverse effects in infants, the long-term effects are unknown. Consult your doctor to weigh the benefits of breastfeeding against the need for Spironolactone.
Is Spironolactone safe for the elderly?
Elderly patients taking Spironolactone should be monitored closely due to the increased risk of adverse reactions, particularly if they have impaired renal function. It's important to start with the lowest effective dose and adjust as needed. Regular monitoring of renal function and potassium levels is recommended to prevent complications like hyperkalemia.
Is it safe to exercise while taking Spironolactone?
Spironolactone does not specifically limit the ability to exercise. However, side effects like dizziness, fatigue, or muscle cramps may affect physical activity. If you experience these symptoms, consult your doctor for advice on managing them and safely continuing your exercise routine.
Is it safe to drink alcohol while taking Spironolactone?
Drinking alcohol while taking Spironolactone may cause dizziness, lightheadedness, and fainting, especially when getting up quickly from a lying position. It's important to talk to your doctor about alcohol consumption while on this medication to ensure safety and avoid any adverse effects.
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