Spironolactone
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DRUG STATUS
Approvals
US(FDA), UK(BNF)
Essential Medicine
YES
Teratogenicity
Unlisted
Pharmaceutical Class
Aldosterone Antagonist
Spironolactone
Know More About This Medicine -
Click HereSummary
Spironolactone is used to ease fluid buildup in the body caused by conditions like heart failure, liver disease, or kidney problems. It also helps lower high blood pressure and is used for certain types of high blood pressure related to the adrenal glands.
Spironolactone works by blocking a hormone that makes your body hold onto salt and lose potassium. This action helps lower blood pressure and reduces swelling. It also helps your body keep potassium, an important mineral.
The dosage of Spironolactone varies depending on what it's treating. For heart problems and high blood pressure, the dose might start low and be adjusted based on your response. For swelling from liver disease, the dose starts higher and can be increased. It's usually taken orally.
Common side effects of Spironolactone include high potassium levels, low blood pressure, and kidney problems. It can also cause imbalances in other salts in your body and high blood sugar. In men, it might cause breast growth.
Spironolactone can raise your potassium levels, especially if you have kidney problems or take other medicines that also raise potassium. You shouldn't take it if you have high potassium, Addison's disease, or are taking a similar medicine called eplerenone. Pregnant women also shouldn't take it.
Indications and Purpose
What is Spironolactone used for?
Spironolactone is a medicine that helps with several health problems. It can ease fluid buildup (edema) in the body caused by things like heart failure, liver disease (cirrhosis), or kidney problems (nephrotic syndrome). It also helps lower blood pressure, often used in addition to other blood pressure medicines. For certain types of high blood pressure related to the adrenal glands (primary hyperaldosteronism), it's used before surgery and long-term to keep the condition under control. Essentially, it helps the body get rid of excess fluid and salt, improving symptoms.
How does Spironolactone work?
Spironolactone is a medicine that helps your body get rid of extra salt and water. It does this by blocking a hormone called aldosterone, which normally makes your kidneys hold onto salt and water. By blocking aldosterone, spironolactone makes you pee more, lowering your blood pressure and helping with swelling. Importantly, it also helps your body keep potassium, which is an important mineral.
Is Spironolactone effective?
A study showed that the medicine spironolactone helped people with a weak heart. It lowered the risk of death by 30%, and the chance of needing hospital treatment for heart problems by 30%. This was a significant improvement, and the results were very reliable (p less than 0.001). The study involved 1663 people with weakened hearts, and they took an average of 26 mg of spironolactone daily. The medicine seemed to work even better for people who didn't have much potassium in their blood to begin with.
How does one know if Spironolactone is working?
A study looked at how well spironolactone worked for lowering blood pressure. It helped more people who had low potassium levels in their blood to begin with, but it didn't help as much those with very weak hearts. The study also found that doses between 25 and 100 milligrams per day lowered blood pressure, but taking more didn't make it lower any further. It's important to note that these findings about specific groups of people need to be looked at carefully.
Directions for Use
What is the usual dose of Spironolactone?
Spironolactone is a medicine with different doses depending on what it's treating. For heart problems, it might start low and go up or down based on how you respond. For high blood pressure, the starting dose is more variable. For swelling from liver disease, it starts higher and can be increased. For a specific hormone problem (hyperaldosteronism), a much higher dose is used. It's not given to kids.
How do I take Spironolactone?
Spironolactone is a medicine you can take with or without food, but it's important to take it the same way every time. Don't take extra potassium, either in pills or from foods like bananas and potatoes, because it can be dangerous when combined with this drug. Also, avoid salt substitutes, as they often contain potassium.
For how long do I take Spironolactone?
Spironolactone's treatment time depends on why you're taking it. For a specific hormone problem (primary hyperaldosteronism), it might be a short time before surgery or longer if surgery isn't possible. For heart failure, your doctor carefully adjusts the dose based on your potassium levels and kidney function. If you have high blood pressure, your dose is increased slowly, every two weeks, but more than 100mg a day doesn't help more. For swelling (edema), you start on a low dose in the hospital and it's increased very gradually over at least five days.
How long does it take for Spironolactone to start working?
Spironolactone, a medicine, enters your bloodstream quickly, reaching its highest level in about half an hour to an hour and a half. A part of it changes into another active substance, canrenone, which takes a bit longer to reach its highest level, around 2.5 to 5 hours. But how well it works depends on many things, not just how much is in your blood.
How should I store Spironolactone?
Keep spironolactone pills and liquid in a cool, dry place, between 68° and 77°F (20° and 25°C). It's okay if the temperature goes slightly higher or lower, between 59° and 86°F (15° and 30°C). Keep the pills in a special container that blocks light and is safe for kids. If it's the liquid, shake it well before each use, and keep it in a closed container.
Warnings and Precautions
Who should avoid taking Spironolactone?
Spironolactone is a medicine that can cause some problems. It can raise your potassium levels (hyperkalemia), especially if you have kidney problems or take other medicines that also raise potassium. It can also lower your blood pressure (hypotension) and make your kidneys work worse, particularly if you're low on salt. Other possible side effects include imbalances in other salts in your body (sodium, magnesium, calcium, chloride) and high blood sugar. Men might also experience breast growth (gynecomastia). You shouldn't take it if you already have high potassium, Addison's disease, or are taking another similar medicine called eplerenone. And pregnant women shouldn't take it.
Can I take Spironolactone with other prescription drugs?
Spironolactone is a medicine that can interact badly with other medications. Taking it with potassium pills or medicines that raise potassium levels (like some blood pressure pills and pain relievers) can cause dangerously high potassium in your blood. It can also make lithium (a medicine for mental health) more toxic. Some pain relievers can lessen spironolactone's effect or make it less effective, and it shouldn't be taken with a specific prostate cancer medicine (abiraterone). It can also affect how your body handles digoxin (a heart medicine), so special blood tests are needed. Finally, a medicine used for high cholesterol (cholestyramine) can also cause serious problems when taken with spironolactone. It's very important to tell your doctor about all other medications you are taking before starting spironolactone.
Can I take Spironolactone with vitamins or supplements?
Spironolactone is a medicine that can raise your potassium levels. Taking potassium supplements or eating foods high in potassium while on this medicine can make your potassium levels dangerously high, which is very serious. That's why you should avoid extra potassium from supplements and foods like salt substitutes (which often contain potassium) while taking spironolactone.
Can Spironolactone be taken safely while pregnant?
Spironolactone is a medicine that shouldn't be taken during pregnancy, especially by women carrying boys. While it's not proven to cause major birth defects in humans, animal studies show it can affect the development of male babies' reproductive organs. There's a small chance of birth defects or miscarriage even without taking this medicine, but taking spironolactone adds an extra risk. Doctors will explain this risk to pregnant women.
Can Spironolactone be taken safely while breastfeeding?
Spironolactone is a medicine. A small amount of a broken-down part of it (called canrenone) might get into breast milk. Short-term studies show this doesn't seem to hurt babies, but we don't know about long-term effects. Mothers need to consider if the benefits of breastfeeding outweigh any possible, unknown risks to the baby. The mother's health condition should also be a part of this decision.
Is Spironolactone safe for the elderly?
Spironolactone is a medicine that's mostly removed from the body through the kidneys. Older people often have kidneys that don't work as well as younger people's kidneys. Because of this, doctors need to check how well their kidneys are working if they're taking spironolactone. If the kidneys aren't working properly, there's a bigger chance of side effects.
Is it safe to exercise while taking Spironolactone?
Yes, exercise is generally safe while taking Spironolactone. However, be mindful of potential side effects like dizziness or dehydration, especially if you're taking Spironolactone as a diuretic, as it could affect your fluid and electrolyte balance during intense physical activity.
Is it safe to drink alcohol while taking Spironolactone?
Drinking alcohol while taking Spironolactone is generally safe in moderation. However, alcohol can exacerbate certain side effects, such as dizziness or dehydration, and may affect your blood pressure.
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