Spironol

Spironolactone is a prescription medication used to treat high blood pressure and fluid retention caused by various conditions. It is also used to treat low potassium levels and to diagnose and treat primary hyperaldosteronism, a condition in which the body produces too much of the hormone aldosterone.

This medication belongs to a group of drugs called diuretics ("water pills"). Specifically, it is a "potassium-sparing" diuretic known as an "aldosterone antagonist". By blocking aldosterone, spironolactone helps the body get rid of excess fluid  by increasing the amount of salt and water the kidneys remove from the blood, while still keeping potassium in the body. 

This medication comes in tablet form and is usually taken once or twice daily. Spironolactone can be taken with or without food.

Common side effects of spironolactone include headache, nausea, and tiredness. Spironolactone may cause drowsiness. Do not drive or operate heavy machinery until you know how it affects you.

Spironolactone is a prescription medication used to treat high blood pressure and fluid retention caused by various conditions. It is also used to treat low potassium levels and to diagnose and treat primary hyperaldosteronism, a condition in which the body produces too much of the hormone aldosterone.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Take spironolactone exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The spironolactone dose your doctor recommends will be based on:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

For the diagnosis of hyperaldosteronism the daily dosage is 400 mg for either 4 days or 4 weeks.

For the treatment of hyperaldosteronism the dose ranges from 100 mg to 400 mg daily.

For the treatment of fluid retention, the recommended starting dose is 100 mg daily, but may range from 25 to 200 mg daily.

The recommended starting dose for the treatment of high blood pressure is 50 mg to 100 mg daily.

The recommendation for treating hypokalemia is 25 to 100 mg.

WARNING

Spironolactone has been shown to be a tumorigen in chronic toxicity studies in rats. Unnecessary use of this drug should be avoided.

Serious side effects can occur including:

• electrolyte imbalance. This medication may affect electrolytes including sodium and potassium. Your doctor will check these levels using a blood test. Warning signs of electrolyte imbalance include:
  • dry mouth
  • thirst
  • weakness
  • lack of energy
  • drowsiness
  • restlessness
  • muscle pains or cramps
  • muscle fatigue
  • low blood pressure
  • decreased urination
  • fast heart rate
  • nausea and vomiting
• worsening of kidney disease
• breast enlargement in men

This medication may cause drowsiness or dizziness. Do not drive or operate heavy machinery until you know how it affects you.

Do not take spironolactone if you:

• are allergic to spironolactone or any other ingredients in spironolactone
• are not able to produce urine
• have severe kidney disease
• have high potassium levels

Serious side effects may occur. See "Drug Precautions" section.

Common side effects include:

• diarrhea
• cramping
• nausea
• vomiting
• impotence
• irregular menstruation
• bleeding after menopause
• fever
• rash
• confusion
• headache
• drowsiness
• tiredness

This is not a complete list of spironolactone side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace) and others
• other medications for high blood pressure
• "loop diuretics" such as furosemide (Lasix) or torsemide (Demadex) and others
• nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin, Nuprin) or naproxen (Aleve) and salicylates
• corticosteroids such as prednisone, hydrocortisone (Cortef), and dexamethasone (Decadron, Dexone, Hexadrol)
• lithium (Eskalith, Lithobid)
• potassium products including potassium chloride (K-Dur, Klor-Con, Micro-K), potassium citrate (Urocit-K, Polycitra-K), potassium gluconate, potassium phosphate (Neutra-Phos-K, K-Phos)
• salt substitutes that contain potassium
• alcohol
• narcotics
• barbiturates such as amobarbital (Amytal), butalbital (Fioricet, Fiorinal), phenobarbital (Luminal) and others
• digoxin

This is not a complete list of spironolactone drug interactions. Ask your doctor or pharmacist for more information.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Spironolactone falls into category C. In animals studies, pregnant animals were given this medication and had some babies born with problems. There are no well-controlled studies that have been done in humans with spironolactone, though. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

The active metabolite of spironolactone has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from spironolactone, a choice should be made whether to stop nursing or to stop use of spironolactone. The importance of the drug to the mother should be considered.

Spironolactone can be taken with or without food.

Because spironolactone increases urination, it is best taken in the morning to avoid having to get up in the night to urinate. 

If you take spironolactone more than once a day, take your last dose by late afternoon.

This medication may affect electrolytes including sodium and potassium. Your doctor will check these levels using a blood test.

• Warning signs of electrolyte imbalance include dry mouth, thirst, lack of energy, muscle pains or cramps, fast heart rate, and nausea and vomiting