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 call 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

Serious allergic reaction

It’s possible to have a serious allergic reaction (anaphylaxis) to spironolactone.

Immediate action required: Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• your throat feels tight or you’re struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who’s unwell may also have a rash that’s swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Other side effects

These are not all the side effects of spironolactone. 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

Side Effects, Dosage, Uses, and More

1. Spironolactone oral tablet is available as a brand-name drug and a generic drug. Brand name: Aldactone.
2. Spironolactone comes as an oral tablet and an oral suspension.
3. Spironolactone is used to reduce swelling from liver disease and nephrotic syndrome. It’s also used to treat high blood pressure, heart failure, and excessive aldosterone secretion.

• Potassium intake: This drug can cause hyperkalemia (high potassium levels). While taking this drug, you should watch your potassium intake. You should not take potassium supplements, eat a diet rich in potassium, or consume salt substitutes containing potassium. Having too much potassium in your body can lead to severe problems. This can even be fatal. Talk with your doctor or a nutritionist if you’re concerned about your potassium intake.
• Enlarged breasts: This drug may cause gynecomastia (increased breast size in males*†). If this happens, your doctor may stop your treatment with this drug. This symptom usually goes away once you stop taking this drug.
• Low blood pressure and worsening kidney function: This drug may result in low blood pressure and worsening kidney function. Your doctor will monitor your blood pressure and kidney function while you take this drug.

  * In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
  † This side effect could also affect someone who was assigned female at birth but has a certain level of testosterone in their body.

  Spironolactone is a prescription drug. It comes as an oral tablet and an oral suspension (a kind of liquid mixture).

  Spironolactone oral tablet is available as the brand-name drug Aldactone and as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

  This drug may be taken as part of a combination therapy with other medications.

  Why it’s used

  This drug is used to reduce swelling from liver disease and nephrotic syndrome (a kidney problem). It’s also used to treat high blood pressure, heart failure, and hyperaldosteronism (excessive secretion of the hormone aldosterone).

  How it works

  This drug belongs to a group of drugs called aldosterone antagonists (blockers), or potassium-sparing diuretics. These drugs are often used to treat similar conditions.

  Spironolactone works by blocking aldosterone activity. Aldosterone is a chemical made by the body that can cause water retention. This makes certain heart, kidney, and liver conditions worse. By blocking aldosterone, your body won’t retain fluid. This process also stops your body from ridding itself of potassium.

  This drug may lower your blood pressure by blocking aldosterone’s effect on your blood vessels.

  How long it lasts

  After you take a dose of spironolactone, it takes about 1.5 hours for half of the dose to leave your body. This is known as the drug’s half-life. The drug will have its greatest effect in your body during this time.

  How often you take spironolactone depends on the condition you’re taking the drug to treat. Studies have determined the dosages that help keep an effective level of the drug in the body for the different conditions spironolactone treats. Your doctor will recommend the right dosage of spironolactone for your condition.

  After you stop taking spironolactone, the drug should be removed from your body in about a day.

  If you have questions about how long spironolactone lasts in your body, ask your doctor or pharmacist.

  Spironolactone oral tablet may be used off-label for certain conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for. Examples of possible off-label uses of spironolactone are discussed below.

  For acne

  Spironolactone is often used off-label to treat acne. For this purpose, 2016 guidelines from the American Academy of Dermatology recommend the drug specifically for certain females.* The drug is not recommended for treating acne in males.*

  Research into the effectiveness of spironolactone for treating acne is ongoing.

  To find out more about taking spironolactone to treat acne, talk with your doctor or pharmacist.

  * In this article, we use the terms “male” and female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

  For hair loss

  Spironolactone may be used off-label to treat a certain kind of hair loss called female* pattern baldness. A small study suggests the drug may be effective for treating this condition, but more research is needed to confirm this.

  Spironolactone is usually not prescribed for male* pattern baldness. This is because it also has the potential to cause gynecomastia (increased breast size in males†). In certain situations, a doctor may consider using spironolactone off-label for male pattern baldness.

  To learn more about taking spironolactone to treat hair loss, talk with your doctor or pharmacist.

  * In this article, we use the terms “male” and female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
  † This side effect could also affect someone who was assigned female at birth but has a certain level of testosterone in their body.

  Spironolactone oral tablet may cause drowsiness. You should not drive, use machinery, or do similar tasks that require alertness until you know how this drug affects you.

  This drug can also cause other side effects.

  More common side effects

  The more common side effects that can occur with spironolactone include:

  • diarrhea and belly cramps
  • nausea and vomiting
  • hyperkalemia (high potassium level)
  • leg cramps
  • headache
  • dizziness
  • drowsiness
  • itching
  • irregular menstrual cycles or bleeding after menopause

  If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

  Serious side effects

  Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Allergic reaction. Symptoms can include:
    • skin rash
    • hives
    • fever
    • trouble breathing
    • swelling of your lips, mouth, tongue, or throat
  • Fluid and electrolyte problems. Symptoms can include:
    • mouth dryness
    • extreme thirst
    • extreme weakness and tiredness
    • fast heart rate and dizziness
    • not being able to urinate
  • Dangerously high potassium levels. Symptoms can include:
    • muscle weakness
    • not being able to move your legs and arms
    • extreme tiredness
    • tingling or numb feeling in your hands or feet
    • slow heart rate
  • Gynecomastia (increased breast size in males*†).
  • Severe skin reactions. Symptoms can include:
    • skin discoloration, blistering, peeling, or loosening of your skin, including inside of your mouth

  * In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
  † This side effect could also affect someone who was assigned female at birth but has a certain level of testosterone in their body.

  Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

  Spironolactone oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

  To help avoid interactions, be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. They’ll let you know if any interact with propranolol and adjust your treatment if needed. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

  Examples of drugs that can cause interactions with spironolactone are listed below.

  Drugs and supplements that increase potassium blood levels

  Taking certain medications with spironolactone can increase the amount of potassium in your body to unsafe levels. Examples of these drugs include:

  • angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril (Lotensin)
    • captopril
    • enalapril (Vasotec)
    • fosinopril
    • moexipril
    • perindopril
    • quinapril
    • ramipril (Altace)
    • trandolapril
  • angiotensin II receptor blockers (ARBs), such as:
    • irbesartan (Avapro)
    • losartan (Cozaar)
    • olmesartan (Benicar)
    • telmisartan (Micardis)
    • valsartan (Diovan)
  • direct renin inhibitors, such as:
    • aliskiren (Tekturna)
  • heparin and low molecular weight heparin (LMWH)
  • potassium supplements
  • potassium-sparing diuretics, such as:
    • triamterene (Dyrenium)
    • eplerenone (Inspra) (This drug should not be used with spironolactone. )

  Pain drugs

  Taking certain pain drugs with spironolactone can result in kidney damage and increased blood pressure. Examples of these pain drugs include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
    • diclofenac (Zipsor)
    • ibuprofen (Advil)
    • indomethacin (Indocin)
    • ketoprofen
    • ketorolac (Sprix)
    • meloxicam (Mobic)
    • nabumetone
    • naproxen (Aleve)
    • piroxicam (Feldene)

  Cholesterol drugs

  Taking certain cholesterol drugs with spironolactone can increase the amount of potassium and acid in your body to unsafe levels. Examples of these drugs include:

  • cholestyramine (Prevalite)

  Lithium

  Taking lithium (Lithobid) with spironolactone can increase the effects of lithium. Your doctor may lower your dosage of lithium if you take these drugs together.

  Digoxin

  Taking digoxin (Lanoxin) with spironolactone may increase the effects of digoxin. Your doctor may monitor you closely if you take these drugs together.

  Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

  This drug comes with several warnings.

  Allergy warning

  This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

  Call 911 or go to the nearest emergency room if you develop these symptoms.

  Do not take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

  Warnings for people with certain health conditions

  For people with liver disease: Taking this drug when you have liver disease may lead to a coma. Tell your doctor right away if you have the following symptoms, which may be signs of hepatic coma:

  • confusion
  • poor judgment
  • foggy memory
  • abnormal body movements and shaking
  • trouble concentrating

  For people with hyperkalemia: You should not take this drug if you have hyperkalemia (high potassium levels). It can worsen the condition.

  For people with kidney disease: You’re at increased risk of side effects from this drug. You’re also at increased risk of high potassium levels. If you take this drug, you should monitor your potassium levels closely. Your doctor can check your potassium levels using a blood test.

  For people with Addison’s disease: You should not take this drug if you have Addison’s disease. It can make your illness worse.

  For people with heart disease: Don’t take potassium supplements, eat a diet high in potassium, or take drugs that increase potassium levels if you have heart failure and you’re taking this drug. Dangerously high potassium levels are more likely if you have heart failure. This can be fatal.

  Warnings for other groups

  For pregnant people: There haven’t been enough studies done to be certain how the drug might affect a fetus.

  Despite this lack of research, this drug should be used during pregnancy only if the potential benefit justifies the potential risk. Tell your doctor if you’re pregnant or plan to become pregnant. If you become pregnant while taking this drug, contact your doctor right away.

  For people who are breastfeeding: A metabolite (substance that results from the breakdown of a drug) from spironolactone passes into breast milk. This may cause side effects in a child who is breastfed. Talk with your doctor if you breastfeed your child. They may recommend that you stop breastfeeding or suggest a different medication for your condition.

  For older adults: Older adults may process drugs more slowly. A usual adult dose may cause levels of spironolactone to be higher than usual. If you’re an older adult, you may need a lower dose or a different dosage schedule.

  For children: This medication should not be used in children younger than 18 years.

  When to call the doctor

  1. Call your doctor if you have trouble breathing or swelling in your legs. This means that your heart disease may be getting worse.

  Was this helpful?

  All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

  Drug forms and strengths

  Generic: Spironolactone

  • Form: oral tablet
  • Strengths: 25 milligrams (mg), 50 mg, 100 mg

  Brand: Aldactone

  • Form: oral tablet
  • Strengths: 25 mg, 50 mg, 100 mg

  Dosage for high blood pressure (hypertension)

  Adult dosage (ages 18 to 64 years)

  The typical starting dosage is 25 mg to 100 mg taken by mouth each day. It’s given as a single dose or split into two doses.

  Child dosage (ages 0 to 17 years)

  This medication isn’t approved for use in children younger than 18 years.

  Older adult dosage (ages 65 years and older)

  There are no specific recommendations for older adult dosing. Older adults may process drugs more slowly. A usual adult dose may cause levels of this drug to be higher than typical in your body. If you’re an older adult, you may need a lower dose or a different dosage schedule.

  Dosage for swelling (edema) from nephrotic syndrome and liver disease

  Adult dosage (ages 18 to 64 years)

  The typical starting dosage is 100 mg taken by mouth each day. It’s given as a single dose or split into two doses. Some people may take as little as 25 mg per day or as much as 200 mg per day.

  Child dosage (ages 0 to 17 years)

  This medication isn’t approved for use in children younger than 18 years.

  Older adult dosage (ages 65 years and older)

  There are no specific recommendations for older adult dosing. Older adults may process drugs more slowly. A usual adult dose may cause the level of this drug to be higher than typical in your body. If you’re an older adult, you may need a lower dose or a different dosage schedule.

  Dosage for heart failure

  Adult dosage (ages 18 to 64 years)

  The typical starting dosage is 25 mg taken by mouth once per day. Your doctor may increase or decrease your dosage based on how you respond to the drug. Some people may take 50 mg once per day, and others may take 25 mg once every other day.

  Child dosage (ages 0 to 17 years)

  This medication isn’t approved for use in children younger than 18 years.

  Older adult dosage (ages 65 years and older)

  There are no specific recommendations for older adult dosing. Older adults may process drugs more slowly. A usual adult dose may cause the level of this drug to be higher than typical in your body. If you’re an older adult, you may need a lower dose or a different dosage schedule.

  Dosage for excessive aldosterone secretion

  Adult dosage (ages 18 to 64 years)

  The typical dosage is 100 mg to 400 mg daily in preparation for surgery. If you cannot have surgery, your doctor may give you the lowest effective dose of this drug long term.

  Child dosage (ages 0 to 17 years)

  This medication isn’t approved for use in children younger than 18 years.

  Older adult dosage (ages 65 years and older)

  There are no specific recommendations for older adult dosing. Older adults may process drugs more slowly. A usual adult dose may cause the level of this drug to be higher than typical in your body. If you’re an older adult, you may need a lower dose or a different dosage schedule.

  Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

  Spironolactone is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

  If you do not take it at all: If you do not take this drug, your blood pressure will stay high. This can lead to a heart attack or stroke. Fluid may also build up in your body. This can cause serious worsening of kidney and liver disease.

  If you stop taking it suddenly: If you stop taking this drug, you may start retaining water. You may also have a sudden increase in your blood pressure. This can lead to a heart attack or stroke.

  If you do not take it on schedule: If you don’t take this drug on schedule, your blood pressure might not be managed. This can lead to a heart attack or stroke.

  What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours before the time for your next dose, then wait and only take one dose at that time. Never try to catch up by taking two doses at once. This could cause dangerous side effects.

  If you take too much: If you take too much of this drug, you may have the following symptoms:

  • drowsiness
  • confusion
  • skin rash
  • nausea
  • vomiting
  • dizziness
  • diarrhea
  • changes in your body’s electrolytes, which can cause irregular heart rate or muscle pain and cramping

  If you think you’ve taken too much of this drug, contact your doctor right away. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

  How to tell the drug is working: You may not be able to tell whether this drug is working or not. It’s important that you take your medication every day as directed by your doctor. Your doctor will monitor your condition and be able to tell if this drug is working. You may need to buy your own blood pressure monitor to check your blood pressure at home.

  Keep these considerations in mind if your doctor prescribes spironolactone for you.

  General

  • This drug can be taken with or without food.

  Storage

  • Store spironolactone at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t freeze this drug.
  • Keep it away from light.
  • Keep it away from high temperature.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

  Refills

  A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

  Travel

  When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

  Self-management

  You may need to check your blood pressure at home using a blood pressure monitor. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

  Clinical monitoring

  While you’re taking this drug, your doctor will check the following:

  • heart function
  • kidney function
  • liver function
  • electrolytes
  • blood pressure

  Hidden costs

  You may need to purchase a home blood pressure monitor to check your blood pressure at home. These are available for purchase at most pharmacies.

  Prior authorization

  Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

  Other drugs are available to treat your condition. Some may be better suited for you than others. Examples of alternatives for the conditions spironolactone treats are listed below. Not all of the alternatives available for treating the same conditions as spironolactone are included. Talk with your doctor about other options that may work for you.

  For high blood pressure

  Below are a couple of examples of alternatives to spironolactone that are used to treat high blood pressure:

  • hydrochlorothiazide
  • eplerenone (Inspra)

  For swelling from liver disease and nephrotic syndrome

  The following are some examples of medications other than spironolactone that may be used to treat swelling from liver disease and nephrotic syndrome (a kidney problem).

  • amiloride (Midamor)
  • eplerenone (Inspra)

  For heart failure

  Below are a couple of examples of alternatives to spironolactone that are used to treat heart failure:

  • torsemide (Soaanz)
  • bumetanide (Bumex)

  For excessive aldosterone secretion

  The following is an example of a medication other than spironolactone that may be used to treat hyperaldosteronism (excessive aldosterone secretion):

  • eplerenone (Inspra)

  Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

  From what tablets, mechanism, side effects, dosage

  Publication date: 03/14/2023

  THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS NECESSARY.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

  Article content

  • Spironolactone: mechanism of action
  • Spironolactone: what pills are for
  • Spironolactone: dosage
  • Spironolactone: contraindications
  • Spironolactone: side effects
  • Spironolactone or Veroshpiron: which is better
  • Spironolactone or Indapami e: which is better
  • Summary
  • Ask an expert on the topic of the article

  In 2021, the first comprehensive analysis of global trends in the prevalence of hypertension was carried out. The statistics turned out to be disappointing: over the past 30 years, the number of hypertensive patients among adults aged 30 to 79years 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 the excretion of water and sodium and conserving potassium. Due to the prolonged action, the drug retains its effects for 24 hours.

  All products Spironolactone

  20 reviews

  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;
  • Increased concentration of aldosterone in Conn’s syndrome;
  • Low potassium content 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 decreased glomerular filtration rate 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 arrhythmias;
  • Erectile dysfunction and decreased libido;
  • Nausea and vomiting;
  • Increased fatigue;
  • Confusion;
  • Hypersensitivity reactions;
  • Skin rash and urticaria;
  • Decreased concentration of platelets and certain other blood cells;
  • Inflammation of vessel walls;
  • 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.

  All products Veroshpiron

  20 reviews

  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 arterial hypertension to further reduce pressure and reduce edema;
  • Indapamide reduces left ventricular hypertrophy 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.

  All products Indapamide

  12 reviews

  Summary

  • Spironolactone is a long-acting potassium-sparing diuretic.
  • The drug is prescribed in the complex therapy of cardiovascular diseases, edema, pathological accumulations of fluid and reduced potassium content.
  • Spironolactone is available as 25 mg tablets and 25, 50 and 100 mg capsules.
  • Spironolactone has contraindications and side effects;
  • Veroshpiron is a drug in the form of tablets and capsules based on Spironolactone.
  • Spironolactone and Indapamide belong to the same group of drugs, but are used for different conditions.

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  Spironolactone-Darnitsa: instruction, price, analogues | tablets Darnitsa

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  • Pharmacological properties
  • Indications Spironolactone-Darnitsa
  • Application Spironolactone-Darnitsa
  • Contraindications
  • Side effects
  • Special instructions
  • Interactions
  • Overdose
  • Storage conditions
  • Diagnosis
  • Recommended alternatives
  • Trade names

  pharmacodynamics. The active substance of the drug is spironolactone, a competitive aldosterone antagonist that affects the distal tubules of the kidneys. Due to the blockade of aldosterone, it suppresses the retention of water and Na ⁺ ions and promotes the retention of K ⁺ ions, which not only increases the excretion of Na 9 ions0210 + and Cl ^– and reduces the excretion of K ⁺ ions in the urine, but also reduces the excretion of H ⁺ ions. As a result, the diuretic effect also has a hypotensive effect.

  Pharmacokinetics. After oral administration, the drug is rapidly and completely absorbed in the digestive tract. Bioavailability is 92-99% and increases when taken with food.

  C _max spironolactone in blood plasma is reached after 2.6 hours and is 80 ng / ml. Plasma protein binding is ≈90%. T _½ is 1.3 hours.

  Spironolactone is metabolized in the liver. Its active metabolites are 7α-thiomethylspironolactone and canrenone. The antialdosterone action is determined by canrenone, which makes up ≈50% of all metabolites of spironolactone. Indicators C _max in blood plasma and the time to achieve it: for 7α-thiomethylspironolactone – 391 ng / ml, 3.2 hours, for canrenone – 181 ng / ml, 4.3 hours. T _½ is 13.8 and 16.5 hours, respectively. Spironolactone and its metabolites pass into the placenta and into breast milk.

  Excreted from the body as metabolites mainly by renal excretion, a small part – with feces. Spironolactone has a cumulative effect.

  primary hyperaldosteronism.

  Congestive heart failure when other diuretics are ineffective or intolerant, or if their effectiveness needs to be increased.

  Essential hypertension, mainly in hypokalemia, usually in combination with other antihypertensive drugs.

  Cirrhosis of the liver with edema and/or ascites.

  Edema due to nephrotic syndrome.

  Hypokalemia – if other therapy is not possible.

  Prophylaxis of hypokalemia in patients taking cardiac glycosides when other therapies are considered inappropriate or inappropriate.

  the drug is to be taken by mouth for adults and children. In general, the daily dose of the drug is prescribed in 1 or 2 doses after meals. The daily dose for 1 dose or the first dose of the drug with double use is recommended in the morning.

  The duration of the course of treatment is individual, in some cases it can reach several years, while it is necessary to use the drug in the minimum effective dose, subject to constant monitoring of the electrolyte composition of the blood plasma and indicators of kidney function.

  Adults

  Primary hyperaldosteronism . In preparation for surgery, the drug is used at a dose of 100-400 mg / day.

  If surgical treatment is not possible, the drug can be used for a long time as maintenance therapy at the lowest effective dose, which is determined individually.

  In this case, every 14 days the initial dose may be reduced until the minimum effective dose is reached. With long-term treatment, it is recommended to use the drug in combination with other diuretics to reduce the severity of side effects.

  Congestive heart failure, edema due to nephrotic syndrome . The drug is used at an initial dose of 100 mg / day in 1 or 2 doses. The daily dose can also range from 25 to 200 mg.

  When prescribing the drug in higher doses, it can be used in combination with other diuretics acting in the proximal renal tubules. In this case, the dose of spironolactone should be adjusted.

  Essential AG . The drug is used at an initial dose of 50-100 mg / day in 1 or 2 doses in combination with other antihypertensive drugs. Treatment should be continued for at least 2 weeks, since by the end of this period the maximum antihypertensive effect is achieved. Further dose adjustment is individual, depending on the effect achieved.

  Cirrhosis of the liver with ascites and/or edema . If the ratio of Na ⁺ / K ⁺ in urine is >1, the drug is used at an initial dose of 100 mg / day. The maximum daily dose is 100 mg / day. If this ratio is <1, the drug is used at a dose of 200 mg / day, while the maximum daily dose is 400 mg / day.

  Hypokalemia . The drug is used at a dose of 25-100 mg / day in patients who do not have enough nutritional potassium supplements or other methods of potassium replacement therapy.

  Children . The drug is used at a dose of 1-3 mg / kg of body weight per day in 1 or 2 doses. With maintenance therapy in combination with other diuretics, the daily dose is 1-2 mg / kg of body weight.

  If it is necessary to use the drug in children under the age of 3 years, the tablet should be crushed, dissolved and given to the child to drink in the form of a suspension.

  Elderly patients . The drug is recommended to be used in lower doses, followed by a gradual increase until the maximum effect is achieved. It should be taken into account that in this category of patients there are hepatic and renal disorders that can affect the metabolism and excretion of the drug.

  hypersensitivity to the active substance or other components of the preparation.

  AKI, severe impairment of the nitrogen excretion function of the kidneys (glomerular filtration rate <10 ml/min), anuria.

  Hyperkalemia, hyponatremia.

  Addison’s disease.

  Simultaneous use with potassium-sparing diuretics and potassium preparations due to the possibility of hyperkalemia.

  from the side of the cardiovascular system: arterial hypotension, arrhythmia (in patients with renal insufficiency and those receiving potassium preparations), vasculitis.

  From the blood and lymphatic system: leukopenia (including agranulocytosis), thrombocytopenia, megaloblastic or aplastic anemia, eosinophilia.

  From the nervous system and psyche: headache, drowsiness, dizziness, ataxia, paralysis, paraplegia, lethargy, lethargy, confusion.

  From the side of the respiratory system, organs of the chest and mediastinum: change in the timbre of the voice.

  From the digestive tract: nausea, vomiting, loss of appetite, pain in the abdomen and stomach, diarrhea, constipation, intestinal colic, gastritis, gastric and duodenal ulcers, gastric bleeding.

  From the digestive system: hepatitis, impaired liver function.

  From the urinary system: acute renal failure.

  From the musculoskeletal system and connective tissue: osteomalacia, muscle spasm, muscle cramps of the lower extremities.

  From the side of metabolism and metabolism: hyperkalemia, hyponatremia, hypercreatininemia, increased plasma urea levels, hyperuricemia, porphyria, metabolic hyperchloremic acidosis or alkalosis, dehydration.

  From the endocrine system: hirsutism.

  On the part of the reproductive system and mammary glands: decreased libido, erectile dysfunction, gynecomastia, menstrual disorders, dysmenorrhea, amenorrhea, metrorrhagia during menopause, swelling and pain in the mammary glands in women, infertility (when used in high doses – 450 mg /day), a benign breast tumor.

  From the side of the immune system, skin and subcutaneous tissue: hypersensitivity reactions, including: rash, itching, urticaria, drug fever; hypertrichosis, alopecia, lupus-like syndrome, hyperemia, erythema annulare, eczema, Stevens-Johnson syndrome.

  General: asthenia, fatigue.

  the use of the drug, especially in patients with impaired renal function, can lead to a transient increase in plasma urea nitrogen and hyperkalemia, which can lead to the development of cardiac arrhythmias and reversible hyperchloremic metabolic acidosis. The drug is used with caution in patients with impaired renal function, liver and elderly patients. Plasma electrolytes and kidney function should be measured periodically. If hyperkalemia develops, treatment should be discontinued.

  The drug is used with caution in patients in whom existing diseases can cause the development of acidosis and / or hyperkalemia.

  The drug is used with caution in patients with diabetes mellitus, especially in the presence of diabetic nephropathy.

  Therapy with spironolactone may interfere with the determination of the concentration of cortisol, epinephrine and digoxin (by radioimmunoassay methods).

  Long-term unreasonable use of the drug should be avoided, since, according to the literature, long-term use of spironolactone in animals at maximum doses contributed to the development of carcinoma and myeloid leukemia.

  Do not drink alcohol while taking this medicine.

  The drug contains lactose, so patients with rare hereditary forms of galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome should not use the drug.

  Use during pregnancy and lactation. The drug is contraindicated during pregnancy and lactation.

  Children. The drug is used in pediatric practice as prescribed by a doctor.

  The ability to influence the reaction rate when driving vehicles or working with other mechanisms. During the initial period of treatment, the duration of which is individual, driving or operating other mechanisms is contraindicated.

  while using the drug with other drugs is possible:

  with antihypertensive agents (especially ganglion blockers, nicardipine, nimodipine) – excessive decrease in blood pressure; with simultaneous use, the dose of antihypertensive agents should be reduced, followed by its correction if necessary;

  with ammonium chloride, cholestyramine – increased risk of hyperkalemia and hyperchloremic metabolic acidosis;

  with potassium-sparing diuretics, potassium preparations, ACE inhibitors, angiotensin II receptor blockers, aldosterone receptor blockers, anticholinesterase agents, tacrolimus, cyclosporine – increased risk of developing hyperkalemia; simultaneous use with potassium-sparing diuretics and potassium preparations is contraindicated due to the possibility of developing hyperkalemia;

  with other diuretics – increased diuretic effect;

  with NSAIDs – increased risk of developing hyperkalemia and renal failure with a concomitant decrease in the diuretic, natriuretic and antihypertensive effect of spironolactone; when used simultaneously with acetylsalicylic acid, the synthesis of prostaglandins is also suppressed, with antipyrine, the metabolism of the drug in the liver is enhanced;

  with glucocorticoids, ACTH – increased diuretic, natriuretic action of spironolactone and a paradoxical increase in potassium excretion;

  with α- and β-agonists, carbenoxolone – weakening the action of spironolactone;

  with antipsychotics, tricyclic antidepressants – increased action of spironolactone;

  with barbiturates, narcotic drugs, ethanol – orthostatic hypotension;

  with terfenadine – increased risk of ventricular arrhythmia due to hypokalemia and imbalance of other electrolytes;

  with carbamazepine – increased risk of hyponatremia;

  with digoxin – increased risk of glycoside intoxication due to prolongation of its T _½ ;

  with lithium preparations – increased risk of developing intoxication due to a decrease in renal clearance of lithium; these drugs should not be used at the same time;

  with indirect anticoagulants (coumarin derivatives), mitotane, pressor amines (epinephrine), cardiac glycosides – weakening of the latter;

  with triptorelin, buserelin, gonadorelin – enhancing the action of the latter.