GENERIC NAME: spironolactone

BRAND NAME: Aldactone

DRUG CLASS AND MECHANISM: One of the main functions of the kidneys is to retain salt (sodium chloride) and water. In patients with heart failure and cirrhosis, increased levels of a hormone produced by the adrenal glands, called aldosterone, causes salt and fluid retention by the kidneys. Spironolactone inhibits the action of aldosterone causing the kidneys to excrete salt and fluid while retaining potassium. Therefore, spironolactone is classified as a potassium-sparing medication that promotes the output of urine (diuretic).

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Tablets (25mg, 50mg, and 100mg).

STORAGE: Should be stored at room temperature.

PRESCRIBED FOR: Spironolactone is used as a diuretic to remove the excess fluid caused by congestive heart failure, cirrhosis of the liver, and kidney disease. It can also be used to treat elevated blood pressure in combination with other drugs and in resistant cases of low potassium (hypokalemia). Spironolactone is also used to counteract the effects of excessive adrenal aldosterone production. Aldosterone overproduction can occur from a tumor in the adrenal gland, or when enlarged adrenal glands produce an excessive amount of aldosterone.

DOSING: May be taken with or without food.

DRUG INTERACTIONS: Spironolactone can lower blood sodium levels while raising flood potassium levels. Excessively high blood potassium levels can lead to potentially life-threatening heart rhythm abnormalities. Therefore, spironolactone usually is not administered with other agents that can raise blood potassium levels, such as potassium supplements, ACE inhibitors, indometacin (Indocin), or other potassium-sparing diuretics. Spironolactone can cause elevation of blood digoxin (Lanoxin) levels, requiring adjustment of the digoxin dosage.

SIDE EFFECTS: Enlargement of the breasts (gynecomastia) is a not infrequent side effect. Rare side effects include diarrhea, cramps, drowsiness, rash, impotence, irregular menstrual periods, and irregular hair growth.

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Last Editorial Review: 12/31/1997