Spironolactone

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Aldactone, Spiractin

Drug group:

Potassium-sparing diuretic

Prescription needed?

Yes

What does it do?

Spironolactone is used in the treatment of:

• Oedema (fluid retention) - from congestive heart failure, cirrhosis of the liver, or nephrotic syndrome (a kidney disorder)
• Hypertension (high blood pressure) - especially in Conn’s syndrome (benign tumour of the adrenal glands)

How does it work?

Spironolactone is a slow acting potassium-sparing diuretic

How should it be used?

• Avoid high potassium foods and salt substitutes containing potassium
• If you have been prescribed spironolactone and you have kidney failure, you will need careful monitoring as you are especially at risk of potassium retention

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

25–400mg taken once daily, usually in the morning

How quickly will it start to work?

Within 1–3 days, but full effect in 2 weeks 
                            

How long will the effects last?

2–3 days                   

When should I stop using it?

Do not stop the drug without consulting your doctor   
                              

Is it safe for prolonged use?

Long-term use is avoided if possible, especially in younger patients.

Blood tests may be needed to monitor kidney function and potassium levels.                            

What are the possible side effects?

The following have been reported:

• More common: nausea, vomiting, high potassium levels (muscle weakness, numbness)
• Less common: headache, lethargy, drowsiness, irregular menstruation, breast enlargement/tenderness (in men), erectile dysfunction
• Report to your doctor before taking your next dose if you experience: rash, symptoms of high potassium levels

Unlike other diuretics, spironolactone does not worsen gout or diabetes.

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney problems, porphyria, Addison’s disease, metabolic disorders
• Other medicines: ACE inhibitors, NSAIDs, angiotensin II blockers, ciclosporin, tacrolimus, potassium salts, lithium, digoxin
• Pregnancy and breast-feeding: Not usually prescribed, discuss with your doctor
• Children: Reduced dose necessary
• Over 60: Reduced dose may be necessary, increased risk of side effects
• Driving and hazardous work: Caution, the drug may occasionally cause drowsiness
• Alcohol: No known problems