Spironolactone

Uses of Spironolactone

Spironolactone is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

Spironolactone is used to treat heart failure, high blood pressure (hypertension), or hypokalemia (low potassium levels in the blood).

Spironolactone also treats fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome.

Spironolactone is also used to diagnose or treat a condition in which you have too much aldosterone in your body. Aldosterone is a hormone produced by your adrenal glands to help regulate the salt and water balance in your body.

Precautions and Warnings

You should not use spironolactone if you are allergic to it, or if you have:

• Addison’s disease (an adrenal gland disorder);
• high levels of potassium in your blood (hyperkalemia);
• if you are unable to urinate; or
• if you are also taking eplerenone.

To make sure spironolactone is safe for you, tell your doctor if you have:

• an electrolyte imbalance (such as low levels of calcium, magnesium, or sodium in your blood);
• kidney disease;
• liver disease; or
• heart disease.

Tell your doctor if you are pregnant or plan to become pregnant. Having congestive heart failure, cirrhosis, or uncontrolled high blood pressure during pregnancy may lead to medical problems in the mother or the baby. Your doctor should decide whether you take spironolactone if you are pregnant.

It may not be safe to breastfeed while using spironolactone. Ask your doctor about any risk.

Dosage

How much spironolactone you need to take depends on why you’re taking it. Your dose may need to be changed a few times before you find the dose that’s right for you.

The usual dose for adults is:

• heart failure – 25mg once a day as a starting dose. Depending on how well it works for you, the dose can be from 25mg every other day to 50mg once a day
• build-up of fluid caused by liver disease (ascites) – between 100mg and 400mg a day
• oedema caused by heart failure – 100mg a day as a starting dose. Depending on well it works for you, the dose can be between 25mg and 200mg a day
• nephrotic syndrome (a condition caused by kidney disease) – between 100mg and 200mg a day
• high aldosterone levels – 400mg a day as a starting dose, for a few days to a few weeks, to check if high aldosterone levels are the cause of your symptoms. Once confirmed, the long-term dose can be between 100mg and 400mg a day
• high blood pressure (hypertension) – 25mg a day

Doses are usually lower for people over 65 years as they may be more likely to get side effects.

For babies and children, your child’s doctor will use your child’s weight or age to work out the right dose.

Side Effects:

Common side effects:

• Low blood pressure (see below)
• High potassium level (see below)
• Enlarged breasts in men (gynecomastia)
• Dizziness