Aldactone (spironolactone)

  • 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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What brand names are available for spironolactone?

Aldactone

Is spironolactone available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for spironolactone?

Yes

What are the uses for spironolactone?

  • Aldactone removes excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease.
  • It also can be used in combination with other drugs to treat elevated blood pressure, and for treating diuretic-induced low potassium (hypokalemia).
  • Aldactone also is used to counteract the effects of excessive adrenal aldosterone production (hyperaldosteronism). Aldosterone overproduction can occur from a tumor in the adrenal gland or enlarged adrenal glands (hyperplasia of the adrenal glands).

What are the side effects of spironolactone?

Common side effects of Aldactone include:

Enlargement of the male breasts (gynecomastia) may also occur and is related to dose and duration of therapy. It usually reverses upon discontinuation of Aldactone.

Possible serious side effects of Aldactone include:

  • Liver dysfunction
  • Kidney failure
  • Anaphylaxis
  • Abnormal heart rhythm
  • Low platelets
  • Low white blood cells
  • Toxic epidermal necrolysis
  • Vasculitis
  • Risk of tumors in animal studies

Fluid and electrolytes imbalance (for example, low sodium, low magnesium, and high potassium) may occur, so patients should be monitored carefully.

What is the dosage for spironolactone?

  • Aldactone 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.

Which drugs or supplements interact with spironolactone?

:

  • Aldactone 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, Aldactone 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.
  • Aldactone can cause elevation of blood digoxin (Lanoxin) to toxic levels, requiring adjustment of the digoxin dosage.

Is spironolactone safe to take if I'm pregnant or breastfeeding?

:

  • There are no adequate studies in pregnant women. Aldactone may be harmful if used for treating gestational hypertension (high blood pressure during pregnancy).
  • An active metabolite of Aldactone is secreted in breast milk. To avoid adverse effects in the newborn, mothers should avoid breastfeeding while taking Aldactone.

What else should I know about spironolactone?

What preparations of spironolactone are available?

Tablets: 25, 50, and 100 mg

How should I keep spironolactone stored?

Aldactone should be stored at room temperature, below 25 C (77 F).

Reference: FDA Prescribing Information

Summary

Aldactone (spironolactone) is classified as a potassium-sparing diuretic. It is prescribed for the treatment of congestive heart failure, cirrhosis of the liver, and kidney disease. It can also be used in combination with other drugs to treat diuretic induced low potassium and high blood pressure. Side effects include:

Drug interactions, dosage, and pregnancy and breastfeeding safety information should be reviewed prior to taking any medication.

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Reviewed on 9/23/2016
References
Reference: FDA Prescribing Information

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