Spironolactone effects. Spironolactone: Understanding Its Effects, Side Effects, and Usage
What are the common side effects of spironolactone. How should spironolactone be taken to minimize side effects. When should you seek medical attention while taking spironolactone. What are the serious side effects and allergic reactions associated with spironolactone.
Common Side Effects of Spironolactone: What to Expect
Spironolactone, like many medications, can cause side effects in some individuals. These effects are often more pronounced when first starting the medication and tend to improve as the body adjusts. Understanding these common side effects can help patients better manage their treatment and know when to seek medical advice.
Dizziness: A Common Initial Side Effect
Feeling dizzy is a frequent side effect experienced by those taking spironolactone. How can you manage this symptom? If you feel dizzy upon standing, try getting up slowly or remain seated until the sensation passes. In cases of severe dizziness, lying down can prevent fainting. It’s crucial to avoid driving, cycling, or operating machinery while experiencing dizziness. Typically, this side effect subsides within a few days. However, if it persists, consulting your doctor is advisable.
Nausea and Vomiting: Coping Strategies
Nausea and vomiting can occur when taking spironolactone. To mitigate these effects, consider taking the medication with or just after a meal. Sticking to simple, non-spicy foods may also help. If vomiting occurs, staying hydrated is crucial – take small, frequent sips of water. For those on contraceptive pills, be aware that vomiting may affect the pill’s effectiveness. Like dizziness, this side effect usually improves after a few days. If it persists, your doctor may recommend anti-nausea medication.
Muscle Cramps: When to Be Concerned
Unusual muscle or leg cramps not related to physical activity may occur while taking spironolactone. If you experience such cramps, it’s important to inform your doctor. They may recommend a blood test to determine the underlying cause.
Fatigue and Low Energy: Management Techniques
Feeling tired or low in energy is another common side effect of spironolactone. How can you combat this fatigue? Regular exercise, maintaining a healthy diet, and establishing a consistent sleep pattern can help boost energy levels. If fatigue persists or worsens, it’s important to discuss this with your healthcare provider.
Breast-Related Side Effects
Some individuals may experience breast pain or enlargement while taking spironolactone. This can affect both women and men. If these symptoms are bothersome, it’s important to discuss them with your doctor.
Serious Side Effects: When to Seek Immediate Medical Attention
While less common, spironolactone can occasionally cause serious side effects that require prompt medical attention. Being aware of these potential complications is crucial for patient safety.
Liver Problems: Recognizing the Signs
Yellowing of the eyes or skin (jaundice) can indicate liver problems. This may be less noticeable on darker skin tones. If you observe these symptoms, it’s essential to contact your doctor or seek medical help immediately.
Electrolyte Imbalances: Symptoms to Watch For
Spironolactone can affect potassium levels in the body. What are the signs of elevated potassium levels? A slow or irregular heartbeat, tingling sensations, muscle weakness, or shortness of breath may indicate high potassium levels. These symptoms warrant immediate medical attention.
Dehydration and Kidney Function Issues
Changes in urination patterns, such as decreased urine output or dark, strong-smelling urine, along with increased thirst or dizziness, may signal dehydration. Similarly, symptoms like diarrhea, reduced urination, nausea, vomiting, drowsiness, or confusion could indicate kidney function problems. In either case, prompt medical evaluation is necessary.
Allergic Reactions: Recognizing Anaphylaxis
While rare, it’s possible to have a severe allergic reaction (anaphylaxis) to spironolactone. What are the signs of a serious allergic reaction? Symptoms may include skin rashes (itchy, red, swollen, blistered, or peeling skin), wheezing, chest tightness, difficulty breathing or talking, and swelling of the mouth, face, lips, tongue, or throat. If you experience these symptoms, seek emergency medical care immediately.
Proper Usage of Spironolactone: Maximizing Benefits and Minimizing Risks
Understanding how to take spironolactone correctly can help maximize its benefits while minimizing potential side effects. Here are some key points to consider:
- Take the medication as directed by your doctor, typically by mouth.
- If stomach upset occurs, taking it with food or milk may help.
- For those using it as a diuretic, taking the dose early in the day (before 6 p.m.) can help prevent nighttime urination.
- If using the liquid form, shake the bottle well before each dose and use a special measuring device to ensure accurate dosing.
Consistency is key when taking spironolactone. Whether you choose to take it with or without food, it’s important to maintain the same routine with each dose.
Interactions and Precautions: What Patients Should Know
Spironolactone can interact with other medications and substances. What are some important interactions to be aware of? It’s crucial to inform your healthcare provider about all medications, supplements, and herbal products you’re using. Certain drugs, such as other potassium-sparing diuretics, ACE inhibitors, and potassium supplements, can interact with spironolactone and potentially lead to dangerous potassium levels.
Alcohol Consumption
How does alcohol interact with spironolactone? Alcohol can increase the risk of certain side effects, such as dizziness and dehydration. It’s advisable to limit or avoid alcohol consumption while taking this medication.
Pregnancy and Breastfeeding Considerations
Is spironolactone safe during pregnancy or while breastfeeding? Spironolactone is generally not recommended during pregnancy due to potential risks to the developing fetus. For breastfeeding mothers, it’s important to discuss the risks and benefits with your healthcare provider, as small amounts of the drug can pass into breast milk.
Long-Term Use of Spironolactone: What to Expect
For many conditions, spironolactone may be prescribed for long-term use. What should patients know about extended use of this medication? Regular monitoring is typically required to assess kidney function, electrolyte levels, and overall response to the treatment.
Regular Check-ups and Blood Tests
Your doctor may schedule periodic blood tests to check potassium levels and kidney function. These tests are crucial for ensuring the medication is working effectively and safely.
Adjusting to Long-Term Treatment
Many side effects associated with spironolactone tend to diminish over time as the body adjusts to the medication. However, it’s important to maintain open communication with your healthcare provider about any persistent or new side effects that develop during long-term use.
Alternative Treatments and Complementary Approaches
While spironolactone is effective for many conditions, some patients may explore alternative or complementary treatments. What options might be available?
Lifestyle Modifications
Depending on the condition being treated, lifestyle changes may complement or, in some cases, replace medication. These might include dietary modifications, stress reduction techniques, or specific exercise regimens.
Alternative Medications
For some conditions, alternative medications may be available. These could include different types of diuretics, hormonal treatments, or other classes of drugs. The choice of treatment should always be made in consultation with a healthcare provider.
Patient Experiences and Support: Navigating Treatment with Spironolactone
Understanding the experiences of other patients can provide valuable insights and support for those starting or continuing treatment with spironolactone. How can patients connect with others and find support?
Support Groups and Online Communities
Many patients find comfort and practical advice in support groups or online communities dedicated to their specific condition or medication use. These platforms can offer a space to share experiences, coping strategies, and encouragement.
Working with Healthcare Providers
Maintaining open communication with your healthcare team is crucial. Regular check-ins, asking questions, and discussing concerns can help ensure that your treatment plan is optimized for your individual needs.
In conclusion, while spironolactone can be an effective treatment for various conditions, it’s important for patients to be well-informed about its effects, potential side effects, and proper usage. By understanding these aspects and maintaining regular communication with healthcare providers, patients can maximize the benefits of spironolactone while minimizing risks. Remember, individual experiences may vary, and any concerns should be promptly discussed with a medical professional.
Side effects of spironolactone – NHS
Like all medicines, spironolactone can cause side effects, although not everyone gets them.
Side effects often happen when you first start taking spironolactone and get better as your body gets used to the medicine.
Common side effects
These common side effects of spironolactone happen in more than 1 in 100 people. There are things you can do to help cope with them:
Feeling dizzy
If spironolactone makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so that you do not faint, then sit until you feel better. Do not drive, cycle or use tools or machines while you’re feeling dizzy.
This side effect usually wears off after a few days.
Talk to your doctor if it carries on for longer.
Feeling or being sick
Take spironolactone with or just after a meal. It may help if you stick to simple meals and do not eat rich or spicy food. If you’re being sick, take small, frequent sips of water so you do not get dehydrated (ask your doctor how much fluid you can drink).
If you take contraceptive pills and you’re being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.
This side effect usually wears off after a few days. Talk to your doctor about taking an anti-sickness medicine if it carries on for longer.
Muscle or leg cramps
If you get unusual muscle cramps that are not from exercise or physical work, talk to your doctor. You may need a blood test to check what is causing it.
Feeling tired or low in energy
Do not drive, cycle or use tools or machinery while you’re feeling tired.
Some ways to increase your energy levels include exercise, eating a healthy diet and making sure you have a regular sleep pattern. There are self-help tips you can try to improve your energy levels.
If you are still feeling tired and low in energy, and this bothers you, or if it’s getting worse, talk to your doctor.
Breast pain and breast enlargement, including in men
If this bothers you, talk to your doctor.
Serious side effects
Some people have serious side effects after taking spironolactone.
Tell your doctor or contact 111 straight away if:
- the whites of your eyes turn yellow, or your skin turns yellow, although this may be less obvious on brown or black skin – these can be signs of liver problems
- you get a slow or irregular heartbeat, tingling feeling, muscle weakness or shortness of breath – these can be signs of potassium levels being too high
- you’re peeing less that usual or have dark, strong smelling pee, feel thirsty or feel dizzy or light-headed – these can be signs of dehydration
- you have diarrhoea, are peeing less than usual, are feeling or being sick, and feel drowsy or confused – these can be signs of loss of kidney function
Go to 111.
nhs.uk or call 111.
Serious allergic reaction
It’s possible to have a serious allergic reaction (anaphylaxis) to spironolactone.
Immediate action required: Call 999 or go to A&E now if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you’re wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
Other side effects
These are not all the side effects of spironolactone.:focal(979x532:981x534)/020922-spironolactone-acne-lead-2000-cdfc667714f84866b4c0bcafe9642708.jpg)
For a full list see the leaflet inside your medicines packet.
Information:
You can report any suspected side effect using the Yellow Card safety scheme.
Visit Yellow Card for further information.
Page last reviewed: 6 July 2022
Next review due: 6 July 2025
Spironolactone Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Uses
How to use Spironolactone
Take this medication by mouth, as directed by your doctor. If stomach upset occurs, take it with food or milk. It is best to take your dose early in the day (before 6 p.m.) to prevent having to get up during the night to urinate. Consult your doctor or pharmacist if you have any questions.
If you are using the liquid form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
You may take the liquid form of this medication with or without food, but it is important to choose one way and take it the same way with every dose.
Dosage is based on your medical condition and response to therapy. In children, the dosage is also based on body weight.
Take this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day as directed. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.
Take this medication exactly as prescribed. Do not increase your dose, take it more often than prescribed, or stop using this medicine without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped.
Inform your doctor if your condition worsens (such as if you notice an increase in your routine blood pressure readings).
Side Effects
Drowsiness, dizziness, lightheadedness, stomach upset, diarrhea, nausea, vomiting, or headache may occur.
To minimize lightheadedness, get up slowly when rising from a seated or lying position. If any of these effects last or get worse, notify your doctor or pharmacist promptly.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: nausea/vomiting that doesn’t stop, increased thirst, signs of kidney problems (such as change in the amount of urine), mental/mood changes, unusual fatigue/weakness, muscle spasms, menstrual period changes, breast pain, breast enlargement (gynecomastia) in men, sexual function problems, signs of infection (such as sore throat that doesn’t go away, fever), severe stomach/abdominal pain, vomit that looks like coffee grounds, dark urine, yellowing of the eyes/skin, easy bruising/bleeding.
This medication may lead to high levels of potassium, especially in patients with kidney problems.
If not treated, very high potassium levels can be fatal. Tell your doctor right away if you notice any of the following serious side effects: slow/irregular heartbeat, muscle weakness.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking spironolactone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, untreated mineral imbalance (such as high potassium, low sodium), decreased adrenal gland function (Addison’s disease).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This medication may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist. Limit foods high in potassium such as bananas, tomatoes, potatoes, and low-salt milk. Consult your doctor or pharmacist for more details, including recommendations.
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy.
Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Older adults may be more sensitive to the side effects of this drug, especially the effects on potassium (see Side Effects section).
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
This medication passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.
Interactions
See also Precautions section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: lithium, drugs that may increase the level of potassium in the blood (such as amiloride, cyclosporine, eplerenone, tacrolimus, triamterene, birth control pills containing drospirenone).
Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
This medication may interfere with certain laboratory tests (including digoxin or cortisol levels), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
Does Spironolactone interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away.
US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Do not share this medication with others.
Lab and/or medical tests (such as kidney/liver function, blood mineral levels such as potassium) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
If you are taking this medication for high blood pressure, lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.
Have your blood pressure checked regularly while taking this medication. Discuss with your doctor and learn how to monitor your own blood pressure. Inform your doctor of your blood pressure readings.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose.
Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Images
spironolactone 100 mg tablet
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This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
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This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
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This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
Color: whiteShape: roundImprint: 660
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 100 mg tablet
Color: light peachShape: roundImprint: AF
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
Color: whiteShape: roundImprint: 852 logo
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
Color: light orangeShape: ovalImprint: AE
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
Color: whiteShape: roundImprint: MP 542
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
Color: whiteShape: roundImprint: M 146
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
Color: whiteShape: roundImprint: AN 511
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
Color: brownShape: roundImprint: TL 217
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 100 mg tablet
Color: brownShape: roundImprint: TL 218
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 100 mg tablet
Color: beigeShape: roundImprint: AN 515
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
Color: brownShape: roundImprint: TL 216
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 100 mg tablet
Color: whiteShape: roundImprint: 662
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
Color: light orangeShape: ovalImprint: G 5012
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
Color: whiteShape: roundImprint: MP 35
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 100 mg tablet
Color: whiteShape: ovalImprint: MP 303
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
Color: yellowShape: roundImprint: AN 514
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 25 mg tablet
Color: light yellowShape: roundImprint: G 5011
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
Color: whiteShape: ovalImprint: 661
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 50 mg tablet
Color: whiteShape: roundImprint: M 243
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 100 mg tablet
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This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
spironolactone 100 mg tablet
Color: peachShape: roundImprint: G 5013
This medicine is a white, round, scored, coated, tablet imprinted with “854” and “logo”.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals.
The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
💊 Composition of the preparation Spironolactone ✅ Use of the preparation Spironolactone Keep for yourself Search for analogues Interaction Description of the active ingredients of the preparation Spironolactone The scientific information provided is general and cannot be used to make decisions. Update date: 2020.05.21 Marketing authorization holder: ATOLL, OOO Manufactured:OZON, OOO (Russia) ATX code: C03DA01 (Spironolactone) Active substance: Rec.INN WHO registered Dosage form
Release form, packaging and composition |
25 mg: 10, 20, 30, 40, 50, 60, 80 or 100 pcs.
It is a competitive aldosterone antagonist in terms of its effect on the distal nephron (competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permeases in the aldosterone-dependent region of the collecting ducts and distal tubules), increases the excretion of Na + , Cl – and water and reduces the excretion of K + and urea, reduces the titratable acidity of urine. Increased diuresis causes a hypotensive effect, which is unstable. The hypotensive effect does not depend on the level of renin in the blood plasma and does not appear in normal blood pressure.
| D35.0 | Benign neoplasm of adrenal gland |
| E26 | Hyperaldosteronism |
| E28.2 | Polycystic ovary syndrome |
| E87.6 | Hypokalemia |
| I10 | Essential [primary] hypertension |
I15. 2 | Hypertension secondary to endocrine disorders |
| I50.0 | Congestive heart failure |
| K74 | Fibrosis and cirrhosis of the liver |
| N04 | Nephrotic syndrome |
| N94.3 | Premenstrual tension syndrome |
| O12 | Pregnancy-induced edema and proteinuria without hypertension |
| O14 | Preeclampsia |
| R60 | Edema, not elsewhere classified |
| Y54.4 | Loop diuretics |
Y54. 5 | Other diuretics |
| Z03 | Medical observation and evaluation for suspected disease or condition |
Dosage regimen
The method of administration and dosing regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed.
Installed individually depending on the severity of water and electrolyte metabolism disorders and hormonal status.
With edematous syndrome – 100-200 mg / day (less often – 300 mg / day) in 2-3 doses (usually in combination with a “loop” or / and thiazide diuretic) daily for 14-21 days. Dose adjustment should be carried out taking into account the values of the concentration of potassium in the plasma.:max_bytes(150000):strip_icc()/spironolactone-for-weight-loss-4178700_color4-5c26575b46e0fb000125c5e4.png)
If necessary, courses are repeated every 10-14 days. With severe hyperaldosteronism and reduced plasma potassium – 300 mg / day in 2-3 doses.
Side effects
From the digestive system: nausea, vomiting, abdominal pain, gastritis, ulceration and bleeding in the gastrointestinal tract, intestinal colic, diarrhea or constipation.
From the side of the central nervous system: dizziness, drowsiness, lethargy, headache, lethargy, ataxia.
From the side of metabolism: increased urea concentration, hypercreatininemia, hyperuricemia, impaired water-salt metabolism and acid-base balance (metabolic hypochloremic acidosis or alkalosis).
From the side of the hematopoietic system: megaloblastosis, agranulocytosis, thrombocytopenia.
From the endocrine system: with prolonged use – gynecomastia, erectile dysfunction in men; in women – dysmenorrhea, amenorrhea, metrorrhagia in menopause, hirsutism, coarsening of the voice, soreness of the mammary glands, breast carcinoma.
Allergic reactions: urticaria, maculopapular and erythematous rashes, drug fever, pruritus.
Other: muscle spasms, reduced potency.
Contraindications
Addison’s disease, hyperkalemia, hypercalcemia, hyponatremia, chronic renal failure, anuria, liver failure, diabetes mellitus with confirmed or suspected chronic renal failure, diabetic nephropathy, first trimester of pregnancy, metabolic acidosis, menstrual irregularity or increase mammary glands, hypersensitivity to spironolactone.
Use in pregnancy and lactation
There are no data on the negative impact of spironolactone on pregnancy and fetal development. However, in the first trimester of pregnancy, the use is contraindicated, in the II and III trimesters, it can be used according to indications.
If it is necessary to use during lactation, it should be borne in mind that the spironolactone metabolite canrenone is excreted in breast milk in small amounts.
Use in hepatic dysfunction
Contraindicated in liver failure. Use with caution in decompensated liver cirrhosis.
Use in disorders of kidney function
Contraindicated in chronic renal failure, anuria, diabetic nephropathy.
Use in elderly patients
Use with caution in elderly patients.
Precautions
Use with caution in AV blockade (possibility of increased due to the development of hyperkalemia), decompensated liver cirrhosis, surgical interventions, taking drugs that cause gynecomastia, when taking local and general anesthetics, in elderly patients.
While taking spironolactone, do not prescribe drugs containing potassium, as well as other diuretics that cause potassium retention in the body. The use of spironolactone with carbenoxolone, which causes sodium retention, should be avoided.
During the period of treatment, periodic determination of the content of electrolytes and urea in the blood should be carried out.
When using spironolactone in combination with other diuretic or antihypertensive drugs, it is recommended to reduce the dose of the latter. When using spironolactone simultaneously with digoxin, it may be necessary to reduce both the loading and maintenance doses of the latter.
Drug interactions
When used simultaneously with antihypertensive drugs, the hypotensive effect of spironolactone is potentiated.
With simultaneous use with ACE inhibitors, hyperkalemia may develop (especially in patients with impaired renal function), because. ACE inhibitors reduce the content of aldosterone, which leads to a retention of potassium in the body against the background of limiting the excretion of potassium.
When used simultaneously with potassium preparations, other potassium-sparing diuretics, table salt substitutes and dietary supplements containing potassium, hyperkalemia may develop.
When used simultaneously with salicylates, the diuretic effect of spironolactone decreases due to blockade of canrenone excretion by the kidneys.
Indomethacin and mefenamic acid inhibit renal excretion of canrenone.
With simultaneous use, the hypoprothrombinemic effect of oral anticoagulants decreases.
Co-administration with digitoxin can either increase or decrease the effects of digitoxin.
Co-administration of spironolactone inhibits renal excretion of digoxin and likely reduces its volume of distribution. This may cause an increase in the concentration of digoxin in the blood plasma.
When used simultaneously with candesartan, losartan, eprosartan, there is a risk of hyperkalemia.
Cases of hypochloremic alkalosis have been described when co-administered with cholestyramine.
With simultaneous use with lithium carbonate, an increase in the concentration of lithium in the blood plasma is possible.
When used simultaneously with norepinephrine, it is possible to reduce the sensitivity of vessels to norepinephrine.
With simultaneous use, the effect of triptorelin, buserelin, gonadorelin is enhanced.
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Spironolactone . Description of the drug in the reference book Vidal.
What pills, mechanism, side effects, dosage
Publication date: 03/14/2023
THERE ARE CONTRAINDICATIONS POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED.High blood pressureFor the heart and blood vesselsEdemaPills
Author of the article
Ripatti Yuliya Igorevna,
Diploma of Pharmaceutical Education: 105924 3510926, reg. number 32018
All authors
Contents of the article
- Spironolactone: mechanism of action
- Spironolactone: what pills are for
- Spironolactone: dosage
- Spironolactone: contraindications
- Spironolactone or Veroshpiron: which is better
- Spironolactone or Indapamide: which is better
- Executive summary
- Ask a subject matter expert
90 347 Spironolactone: side effects
In 2021, the first comprehensive analysis of global hypertension trends was conducted.
The statistics turned out to be disappointing: over the past 30 years, the number of hypertensive patients among adults aged 30 to 79 has increased from 650 million to 1.28 million people. Nearly half of the patients examined were unaware of the disease. Arterial hypertension or high blood pressure syndrome is a pathological condition that significantly increases the risk of developing other cardiovascular diseases, as well as diseases of the brain and kidneys.
The pharmacist will tell you about the drug Spironolactone: introduce you to its mechanism of action, indications for use, contraindications and side effects, and compare it with analogues.
Spironolactone: mechanism of action
Spironolactone belongs to the group of long-acting potassium-sparing diuretics. The international non-proprietary name of the medicinal product (INN) is Spironolactone, which is identical to the trade name. In addition, the substance is available as: Veroshpiron and Veroshpilakton.
The mechanism of action of Spironolactone is associated with the suppression of the effects of aldosterone, a hormone of the adrenal cortex responsible for the retention of sodium and water ions by the kidneys, as well as the excretion of potassium and magnesium. We can say that aldosterone is one of the main regulators of the balance of minerals and water in the human body. However, with stable high blood pressure, chronic heart failure, some kidney diseases and other conditions, the activity of the hormone increases many times over. This results in:
- Excessive accumulation of sodium and water, as a result of which the volume of circulating blood increases and the load on the heart increases;
- Excessive excretion of potassium, which disturbs the heart rhythm and increases blood pressure.
As an aldosterone antagonist, Spironolactone counteracts its pathological effects by increasing water and sodium excretion and conserving potassium.
Due to the prolonged action, the drug retains its effects for 24 hours.
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Spironolactone: from what tablets
A common request from patients for capsules and tablets Spironolactone: from what they are taken. The drug is prescribed in the complex therapy of cardiovascular diseases and other diseases, a symptom of which is fluid retention. The indications of Spironolactone include the treatment of adults and children from 3 years of age with:
- Arterial hypertension;
- Chronic heart failure;
- Cirrhosis of the liver, accompanied by edema or accumulation of fluid in the peritoneum;
- Nephrotic syndrome with edema;
- Elevated concentration of aldosterone in Conn’s syndrome;
- Reduced content of potassium in the body.
Spironolactone dosage
Spironolactone is available as 25 mg tablets and 25, 50 and 100 mg capsules.
The dosage of the drug is selected individually for each patient based on the indications, purpose of therapy and age. Doses are adjusted as treatment progresses. For example, for arterial hypertension, an average of 25 mg Spironolactone is prescribed, but if the target values are not reached within 2-4 weeks, the dose is increased. In some cases, an assessment of the level of potassium and creatinine in the blood serum is required.
Spironolactone: contraindications
- Hypersensitivity to drug components;
- Hereditary galactose intolerance, lactase deficiency and glucose-galactose malabsorption;
- Addison’s disease – decreased function of the adrenal cortex;
- High levels of potassium and sodium in the body;
- Renal insufficiency;
- Chronic heart failure with reduced glomerular filtration rates of the kidneys or increased creatinine;
- Co-administration with other potassium-sparing diuretics;
- Pregnancy and lactation;
- Children under 3 years of age.
Spironolactone side effects
- Increased potassium concentration;
- Cardiac arrhythmia;
- Erectile dysfunction and decreased libido;
- Nausea and vomiting;
- Increased fatigue;
- Confusion;
- Hypersensitivity reactions;
- Skin rash and urticaria;
- Decreased concentration of platelets and some other blood cells;
- Inflammation of the walls of blood vessels;
- Inflammation of the liver.
Spironolactone or Veroshpiron: which is better
We can say that Spironolactone and Veroshpiron are one and the same. Veroshpiron is a drug in the form of tablets and capsules based on Spironolactone. The difference lies in the manufacturing companies: in the case of Spironolactone, there are several of them, including domestic ones. Due to this, Spironolactone has a lower cost. Veroshpiron is produced by the Hungarian company Gedeon Richter.
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Spironolactone or Indapamide: which is better
Indapamide is a diuretic with a different mechanism of action. Similar to Spironolactone, the drug is used for cardiovascular diseases, but unlike the drug in question:
- Indapamide is indicated exclusively for hypertension to further reduce pressure and reduce edema;
- Indapamide reduces left ventricular hypertrophy of the heart caused by increased workload due to high blood pressure;
- Indapamide has other contraindications and side effects, including not used for the treatment of children under 18 years of age.
Spironolactone and Indapamide belong to the same group of drugs, but are used for different conditions. Spironolactone is prescribed for potassium deficiency, which increases the progression of heart disease, as well as for fluid accumulation. Indapamide, in turn, with arterial hypertension for an additional hypotensive effect and removal of edema.