Spironolactone Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 11, 2024.

Applies to spironolactone: oral suspension, oral tablet.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Do not take this medicine together with eplerenone (Inspra®). Using these medicines together may cause serious unwanted effects.

Do not take other medicines unless they have been discussed with your doctor. This especially includes potassium supplements or salt substitutes containing potassium, certain diuretics (eg, amiloride, triamterene (Dyazide®, Dyrenium®, Maxzide®, Midamor®, Moduretic®), or other products containing spironolactone (Aldactazide®).

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have the following symptoms: stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, or weakness or heaviness of the legs. Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.

Spironolactone may worsen kidney function in patients with low to no salt in their body or in those who take other blood pressure medicines (eg, ARB, ACE inhibitor). Talk to your doctor if you have concerns about this.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up suddenly from a lying or sitting position. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

This medicine may also cause electrolyte imbalances (including low sodium, magnesium, and calcium in the blood, hypochloremic alkalosis) and an increase in your uric acid and blood sugar levels. Talk to your doctor if you have concerns.

Check with your doctor right away if you become sick while taking this medicine, especially if you have severe or continuing nausea, vomiting, or diarrhea that does not stop. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

This medicine may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.

Make sure any doctor or dentist who treats you knows that you are using this medicine.

Serious side effects of spironolactone

Along with its needed effects, spironolactone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking spironolactone:

Get emergency help immediately if any of the following symptoms of overdose occur while taking spironolactone:

Symptoms of overdose

• irregular heartbeat
• nervousness
• numbness or tingling in the hands, feet, or lips
• rash with flat lesions or small raised lesions on the skin
• reddened skin
• weakness or heaviness of the legs

Other side effects of spironolactone

Some side effects of spironolactone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to spironolactone: compounding powder, oral suspension, oral tablet.

General adverse events

The most common adverse effect was gynecomastia.^[Ref]

Endocrine

• Very common (10% or more): Gynecomastia (13%)
• Frequency not reported: Breast disorders in women, slight androgenic effects, breast tenderness in women, voice deepening in women, breast pain^[Ref]

Metabolic

• Common (1% to 10%): Hyperkalemia, hyponatremia
• Uncommon (0.1% to 1%): Acidosis in patients with liver problems
• Rare (less than 0.1%): Dehydration, porphyria, hyperuricemia
• Frequency not reported: Reversible hyperchloremic metabolic acidosis in patients with decompensated hepatic cirrhosis, electrolyte disturbances^[Ref]

Genitourinary

• Common (1% to 10%): Changes in vaginal secretions, amenorrhea, postmenopausal bleeding
• Frequency not reported: Reproductive system disorders, erectile dysfunction, impotence, menstrual disorders^[Ref]

Nervous system

• Common (1% to 10%): Lethargy in patients with cirrhosis, paresthesia
• Rare (less than 0.1%): Paralysis, paraplegia of the limbs due to hyperkalemia
• Frequency not reported: Headache, drowsiness, dizziness, ataxia^[Ref]

Gastrointestinal

• Common (1% to 10%): Nausea, vomiting
• Very rare (less than 0.01%): Gastric inflammation, gastric ulcers, intestinal hemorrhage, cramps
• Frequency not reported: Digestive system disorders, diarrhea, indigestion, gastric bleeding^[Ref]

Psychiatric

• Common (1% to 10%): Libido reduced in women
• Uncommon (0.1% to 1%): Confusion
• Frequency not reported: Libido reduced in men^[Ref]

Oncologic

• Common (1% to 10%): Malaise
• Very rare (less than 0.01%): Breast cancer^[Ref]

Other

• Common (1% to 10%): Weakness
• Frequency not reported: Fatigue, fever^[Ref]

Dermatologic

• Uncommon (0.1% to 1%): Rash, urticaria, erythema, chloasma, pruritus, exanthema
• Rare (less than 0.1%): Eczema
• Very rare (less than 0.01%): Alopecia, erythema annulare centrifugum, hypertrichosis
• Frequency not reported: Hirsutism, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS), maculopapular or erythematous cutaneous eruptions^[Ref]

Musculoskeletal

• Uncommon (0.1% to 1%): Muscle spasms, leg cramps
• Very rare (less than 0.01%): Systemic lupus erythematosus, osteomalacia^[Ref]

Renal

• Uncommon (0.1% to 1%): Serum creatinine elevated
• Rare (less than 0.1%): BUN increased
• Very rare (less than 0.01%): Acute renal failure
• Frequency not reported: Renal dysfunction^[Ref]

Hematologic

• Rare (less than 0.1%): Thrombocytopenia, eosinophilia, leukopenia
• Frequency not reported: Agranulocytosis^[Ref]

Immunologic

• Rare (less than 0.1%): Hypersensitivity
• Frequency not reported: Anaphylactic reactions^[Ref]

Cardiovascular

• Very rare (less than 0.01%): Vasculitis
• Frequency not reported: Mild hypotension^[Ref]

Hepatic

• Very rare (less than 0.01%): Hepatitis
• Frequency not reported: Mixed cholestatic/hepatocellular toxicity^[Ref]

See also:

Frequently asked questions

• Winlevi vs Spironolactone: How do they compare?
• What is the strength of CaroSpir (spironolactone) oral suspension?

Further information

Spironolactone side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer