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Spironolactone

Pronunciation

Generic Name: spironolactone (spir-ON-oh-LAK-tone)
Brand Name: Aldactone

Spironolactone has been shown to cause tumors in laboratory animals. Spironolactone should only be used for the conditions for which it is indicated. Avoid unnecessary use of spironolactone.


Spironolactone is used for:

Treating swelling and fluid retention in patients with congestive heart failure, liver cirrhosis, or a certain kidney problem (nephrotic syndrome). It is also used for treatment of high blood pressure, for increasing survival and reducing the need to go to the hospital for heart failure in certain patients, or for treating or preventing low blood potassium. It may also be used to treat excess secretion of the hormone aldosterone by the adrenal gland. It may also be used for other conditions as determined by your doctor.

Spironolactone is a potassium-sparing diuretic. It works by blocking the hormone aldosterone, causing the kidney to eliminate excess water, save potassium, and lower blood pressure.

Do NOT use spironolactone if:

  • you are allergic to any ingredient in spironolactone
  • you are unable to urinate, have severe kidney problems, have high blood potassium levels, or Addison disease
  • you are taking another potassium-sparing diuretic (eg, amiloride, triamterene), another aldosterone-blocker (eg, eplerenone), or tacrolimus

Contact your doctor or health care provider right away if any of these apply to you.

Before using spironolactone:

Some medical conditions may interact with spironolactone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have high acidity in your body fluids, dehydration, electrolyte problems (eg, low blood sodium or magnesium levels), kidney or liver problems, heart problems (eg, heart failure), or diabetes
  • if you have menstrual disease
  • if you have a history of high blood potassium levels, or if your diet has a lot of potassium in it

Some MEDICINES MAY INTERACT with spironolactone. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Adrenocorticotropic hormone (corticotropin) (ACTH) or corticosteroids (eg, prednisone) because low blood electrolyte levels may occur
  • Cholestyramine because a severe side effect called metabolic acidosis may occur
  • Barbiturates (eg, phenobarbital) or narcotics (eg, morphine) because the risk of dizziness upon standing may be increased
  • Aliskiren, angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), angiotensin II receptor antagonists (eg, valsartan), canagliflozin, heparin or related products (eg, dalteparin, enoxaparin), other aldosterone-blockers (eg, eplerenone), other potassium-sparing diuretics (eg, amiloride, triamterene), potassium supplements, or tacrolimus because the risk of high blood potassium levels may be increased
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, indomethacin) because they may decrease spironolactone's effectiveness and increase the risk of kidney problems and high blood potassium
  • Digoxin or lithium because the risk of their side effects and toxicity may be increased by spironolactone

This may not be a complete list of all interactions that may occur. Ask your health care provider if spironolactone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use spironolactone:

Use spironolactone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take spironolactone by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Spironolactone may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.
  • If you miss a dose of spironolactone, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use spironolactone.

Important safety information:

  • Spironolactone may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use spironolactone with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Check with your doctor before you drink alcohol while you are using spironolactone.
  • Spironolactone can raise your blood potassium level. The risk may be increased in people with kidney or liver problems, or in the elderly. High blood potassium levels may lead to serious and possibly fatal irregular heartbeat. Discuss any questions or concerns with your doctor.
  • Spironolactone may cause enlarged breasts in some men who take it. This effect is normally reversible after spironolactone is stopped, but may rarely persist after stopping it. Contact your doctor if you experience enlarged breasts.
  • Check with your doctor before you use a salt substitute or a product that has potassium in it.
  • Tell your doctor or dentist that you take spironolactone before you receive any medical or dental care, emergency care, or surgery.
  • Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
  • Spironolactone may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking spironolactone.
  • Lab tests, including kidney function, blood pressure, and blood electrolyte levels (eg, potassium), may be performed while you use spironolactone. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use spironolactone with caution in the ELDERLY; they may be more sensitive to its effects, especially high blood potassium levels.
  • Spironolactone should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using spironolactone while you are pregnant. Spironolactone is found in breast milk. Do not breast-feed while taking spironolactone.

Possible side effects of spironolactone:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; drowsiness; headache; nausea; stomach cramping; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry, or bloody stools; breast pain; change in the amount of urine produced; confusion; dark urine; decreased coordination; decreased sexual ability; fever, chills, or persistent sore throat; irregular or missed menstrual periods; leg cramps; pale stools; red, swollen, blistered, or peeling skin; severe or persistent stomach pain; symptoms of abnormal fluid or electrolyte levels (eg, burning, numbness, or tingling; fainting; fast, slow, or irregular heartbeat; increased thirst; muscle pain, weakness, or cramping; restlessness; severe or persistent dry mouth, nausea, or vomiting; severe or persistent dizziness or drowsiness; unusual fatigue or sluggishness); unusual bruising or bleeding; vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; diarrhea; dizziness; drowsiness; irregular heartbeat; nausea; vomiting.

Proper storage of spironolactone:

Store spironolactone at room temperature, below 77 degrees F (25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep spironolactone out of the reach of children and away from pets.

General information:

  • If you have any questions about spironolactone, please talk with your doctor, pharmacist, or other health care provider.
  • Spironolactone is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take spironolactone or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about spironolactone. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to spironolactone. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using spironolactone.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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