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Aldactone

Generic Name: spironolactone (spir ON oh LAK tone)
Brand Names: Aldactone, CaroSpir

Medically reviewed on February 6, 2018.

What is Aldactone?

Aldactone (spironolactone) is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

Aldactone is used to treat heart failure, high blood pressure (hypertension), or hypokalemia (low potassium levels in the blood).

Aldactone also treats fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome.

Aldactone is also used to diagnose or treat a condition in which you have too much aldosterone in your body. Aldosterone is a hormone produced by your adrenal glands to help regulate the salt and water balance in your body.

Important Information

You should not use Aldactone if you have kidney problems, high levels of potassium in your blood, Addison's disease, if you are unable to urinate, or if you are also taking eplerenone.

Aldactone has caused tumors in animals but it is not known whether this could occur in people. Do not use this medicine for any condition that has not been checked by your doctor.

Before taking this medicine

You should not use Aldactone if you are allergic to spironolactone, or if you have:

  • Addison's disease (an adrenal gland disorder);

  • high levels of potassium in your blood (hyperkalemia);

  • if you are unable to urinate; or

  • if you are also taking eplerenone.

To make sure Aldactone is safe for you, tell your doctor if you have ever had:

  • an electrolyte imbalance (such as low levels of magnesium in your blood);

  • kidney disease;

  • liver disease; or

  • heart disease.

In animal studies, Aldactone caused certain types of tumors. It is not known whether tumors could occur in people using this medicine. Ask your doctor about your risk.

It is not known whether Aldactone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Spironolactone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take Aldactone?

Take Aldactone exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not share this medicine with another person, even if they have the same symptoms you have.

You may take Aldactone with or without food, but take it the same way each time.

While using Aldactone, you may need frequent blood tests.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Aldactone.

If you need surgery, tell the surgeon ahead of time that you are using Aldactone. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from heat, light, and moisture.

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Aldactone?

Drinking alcohol can increase certain side effects of spironolactone.

See also: Aldactone and alcohol (in more detail)

Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking Aldactone.

Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.

Spironolactone may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Aldactone side effects

Get emergency medical help if you have signs of an allergic reaction to Aldactone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Aldactone and call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • little or no urination;

  • signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • low potassium - uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling; or

  • signs of other electrolyte imbalances - vomiting, muscle spasms or contractions, numbness or tingly feeling, slow heart rate, weak pulse, headache, confusion, slurred speech, severe weakness, loss of coordination, feeling unsteady.

Common Aldactone side effects may include:

  • mild nausea or vomiting, diarrhea;

  • breast swelling or tenderness;

  • dizziness, headache, mild drowsiness;

  • leg cramps; or

  • impotence, difficulty having an erection.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Aldactone dosing information

Usual Adult Dose for Edema:

25 to 200 mg orally per day in single or divided doses

Duration of therapy: When given as the sole diuretic, continue the initial dose for at least 5 days, after which the initial dose may be adjusted to an optimal maintenance dose.

Comments:
-A second diuretic that acts more proximally at the renal tubule may be added if adequate diuresis has not been achieved after 5 days. The dose of this drug should remain unchanged if a second diuretic is added.

Uses:
-Treatment of edematous conditions in patients with congestive heart failure who are only partially responsive to or intolerant of other therapeutic measures or who are taking digitalis when other therapies are considered inappropriate.
-Treatment of edematous conditions in patients with liver cirrhosis accompanied by edema and/or ascites.
-Treatment of edematous conditions in patients with nephrotic syndrome when treatment of the underlying disease, restriction of fluid and sodium intake, and the use of other diuretics do not provide an adequate response.

Usual Adult Dose for Hypertension:

Initial dose: 50 to 100 mg orally per day in single or divided doses

Duration of therapy: Treatment should be continued for at least 2 weeks to achieve a maximum response. Subsequently, the dose may be adjusted according to patient response.

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 25 mg orally once a day assuming serum potassium is less than or equal to 5 mEq/L and serum creatinine is less than or equal to 2.5 mg/dL

Maintenance dose:
-Patients tolerant of initial dose: May increase to 50 mg orally once a day as clinically indicated
-Patients intolerant of initial dose: May decrease to 25 mg orally every other day

Use: To increase survival and reduce the need for hospitalization of severe heart failure patients (New York Heart Association [NYHA] class III to IV) when used in addition to standard therapy.

Usual Adult Dose for Primary Hyperaldosteronism:

Diagnostic dose:
-Long test: 400 mg orally per day for 3 to 4 weeks
-Short test: 400 mg orally per day for 4 days

Maintenance dose: 100 to 400 mg orally per day until surgery; may be used long-term at the lowest effective dose in patients deemed unsuitable for surgery.

Comments:
-For the long test, correction of hypokalemia and hypertension provides presumptive evidence of primary hyperaldosteronism.
-For the short test, increased serum potassium with this drug and a decrease upon discontinuation provide presumptive evidence of primary hyperaldosteronism.

Uses:
-Initial diagnostic measure to provide presumptive evidence of primary hyperaldosteronism while patients are on normal diets.
-Short-term preoperative treatment of patients with primary hyperaldosteronism.
-Long-term maintenance therapy for patients deemed unsuitable for surgery or those with idiopathic hyperaldosteronism.

Usual Adult Dose for Hypokalemia:

25 to 100 mg orally per day

Uses:
-Treatment of patients with hypokalemia when other measures are considered inappropriate or inadequate.
-Prophylaxis of hypokalemia in patients taking digitalis when other measures are considered inadequate or inappropriate.

What other drugs will affect Aldactone?

Taking this medicine with other drugs that make you dizzy or lower your blood pressure can worsen these effects. Ask your doctor before taking a sleeping pill, opioid pain medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all your current medicines and any you start or stop using, especially:

This list is not complete. Other drugs may interact with spironolactone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Aldactone only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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