spironolactone, Aldactone

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Fluid and electrolytes imbalance (for example, low sodium, low magnesium, and high potassium) may occur, so patients should be monitored carefully. Enlargement of the male breasts (gynecomastia) may also occur and is related to dose and duration of therapy. It usually reverses upon discontinuation of spironolactone.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 25, 50, and 100 mg

STORAGE: Spironolactone should be stored at room temperature, below 25 C (77 F).

DOSING: Spironolactone may be taken with or without food. The dosage range is 25-400 mg daily in single or divided doses.

  • The initial dose for treating edema in adults is 100 mg daily as a single dose or divided doses. The dose may be adjusted after 5 days based on response. The recommended dose range is 25 to 200 mg daily. The initial dose should be continued for at least 5 days before increasing the dose. If there is no adequate response after 5 days, a second diuretic may be added.
  • The dose for treating high blood pressure (hypertension) is 50 to 100 mg daily in single or divided doses.
  • The dose for treating hypokalemia is 25 to 100 mg daily.

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

Medically Reviewed by a Doctor on 4/14/2015
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