Spironolactone
Ascites, Hypertension ... show more
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DRUG STATUS
Approvals
US(FDA), UK(BNF)
Essential Medicine
YES
Teratogenicity
Unlisted
Pharmaceutical Class
Aldosterone Antagonist
Spironolactone
Know 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 the treatment of heart failure, hypertension, and edema associated with liver cirrhosis or nephrotic syndrome. It is also used for managing primary hyperaldosteronism, both as a preoperative treatment and for long-term maintenance in patients not undergoing surgery.
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 sodium and water while retaining potassium, helping to reduce fluid buildup and lower blood pressure.
Is Spironolactone effective?
Clinical studies, such as the Randomized Spironolactone Evaluation Study, have shown that Spironolactone effectively reduces mortality and hospitalization in patients with heart failure. It also lowers blood pressure in patients with hypertension. These benefits are attributed to its action as an aldosterone antagonist, which helps manage fluid balance and blood pressure.
How does one know if Spironolactone is working?
The benefit of Spironolactone is evaluated through regular monitoring of blood pressure, serum potassium levels, and kidney function. For heart failure patients, improvements in symptoms and reduced hospitalizations are indicators of effectiveness. Regular follow-up with a healthcare provider is essential to assess the drug's impact and adjust treatment as needed.
Directions for Use
What is the usual dose of Spironolactone?
The usual daily dose for adults varies based on the condition being treated. For heart failure, the initial dose is typically 25 mg once daily, which can be adjusted based on tolerance and clinical response. For hypertension, the dose ranges from 25 to 100 mg daily. For edema, the dose can range from 25 to 200 mg daily. For primary hyperaldosteronism, doses can be as high as 400 mg daily. Spironolactone is not recommended for children as safety and effectiveness have not been established.
How do I take Spironolactone?
Spironolactone can be taken with or without food, but it should be taken consistently in relation to meals. Avoid potassium-rich foods and supplements, as they can increase the risk of hyperkalemia. Always follow your doctor's instructions regarding dosage and dietary restrictions.
For how long do I take Spironolactone?
The duration of use for Spironolactone depends on the condition being treated. For chronic conditions like heart failure or hypertension, it may be used long-term as part of ongoing management. For short-term conditions like preoperative treatment of hyperaldosteronism, it may be used for a limited period. Always follow your doctor's guidance on duration.
How long does it take for Spironolactone to start working?
Spironolactone may start to work within a few days, but it can take several weeks to see the full effects, especially for conditions like hypertension. For heart failure and edema, improvements may be noticed sooner. Always follow your doctor's guidance and attend regular check-ups to monitor progress.
How should I store Spironolactone?
Store Spironolactone at room temperature, between 20°C to 25°C (68°F to 77°F). Protect it from light and moisture. Keep it in a tight, light-resistant, child-resistant container. Ensure it is kept out of reach of children and pets to prevent accidental ingestion.
Warnings and Precautions
Who should avoid taking Spironolactone?
Spironolactone is contraindicated in patients with hyperkalemia, Addison's disease, and those using eplerenone. It can cause hyperkalemia, especially in patients with impaired renal function or those taking potassium supplements. Monitor serum potassium levels regularly. Be cautious of hypotension and worsening renal function, particularly in salt-depleted patients or those on certain medications.
Can I take Spironolactone with other prescription drugs?
Spironolactone can interact with drugs that increase potassium levels, such as ACE inhibitors, angiotensin receptor blockers, and NSAIDs, leading to severe hyperkalemia. It also reduces the clearance of lithium, increasing the risk of toxicity. Monitor potassium levels and adjust dosages of interacting drugs as necessary.
Can I take Spironolactone with vitamins or supplements?
Spironolactone can interact with potassium supplements and salt substitutes containing potassium, increasing the risk of hyperkalemia. It's important to avoid these supplements unless directed by a healthcare provider. Always inform your doctor about any supplements you are taking to avoid potential interactions.
Can Spironolactone be taken safely while pregnant?
Spironolactone is not recommended during pregnancy due to potential risks to the male fetus, such as feminization. Animal studies have shown adverse effects on fetal development. Pregnant women should consult their healthcare provider for alternative treatments and discuss potential risks.
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, long-term effects are unknown. Consider the benefits of breastfeeding and consult your healthcare provider for personalized advice.
Is Spironolactone safe for the elderly?
Elderly patients are more likely to have decreased renal function, which can increase the risk of adverse reactions to Spironolactone. It's important to monitor renal function closely in older adults. Dosage adjustments may be necessary based on kidney function and overall health status. Always consult a healthcare provider for personalized advice.
Is it safe to exercise while taking Spironolactone?
Spironolactone does not directly limit the ability to exercise. However, it can cause side effects like dizziness or fatigue, which might affect physical performance. If you experience these symptoms, it may be wise to avoid strenuous activities and consult your doctor for advice on managing these side effects.
Is it safe to drink alcohol while taking Spironolactone?
From all available and reliable information, there is no confirmed data on this. Please consult a doctor for personalized advice.
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