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Aldactone (spironolactone): Side Effects (Weight Gain) & Uses

July 19, 2021

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What is spironolactone, and how does it work (mechanism of action)?

Aldactone (spironolactone) is a potassium-sparing diuretic that 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 diuretic-induced low potassium (hypokalemia) and high blood pressure. Aldactone also is used to counteract the effects of excessive adrenal aldosterone production (hyperaldosteronism) that can occur from a tumor in the adrenal gland or enlarged adrenal glands (hyperplasia of the adrenal glands).

Aldactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule. Aldactone causes increased amounts of sodium and water to be excreted, while potassium is retained. Aldactone acts both as a diuretic and as an antihypertensive drug by this mechanism. It may be given alone or with other diuretic agents that act more proximally in the renal tubule.

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:

Headache
Diarrhea
Cramps
Drowsiness
Rash
Nausea
Vomiting
Impotence
Irregular menstrual periods
Irregular hair growth

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.

QUESTION

In the U.S., 1 in every 4 deaths is caused by heart disease.
See Answer

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.