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Spironolactone
Spironolactone is a type of medication known as a diuretic or water pill. It is primarily used to treat fluid buildup due to heart failure, liver scarring, or kidney disease. It can also be used to treat high blood pressure and conditions where your body is making too much aldosterone, a natural substance that regulates salt and water balance in your body. The common side effects include nausea, diarrhea, and breast tenderness or enlargement.
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Frequently Asked Questions
Can I drink alcohol while taking spironolactone?
It's advisable to limit your alcohol intake while taking spironolactone, as it can increase the risk of side effects such as dizziness and fainting.
Can I take spironolactone if I have kidney disease?
Spironolactone is not usually recommended for those with significant kidney impairment or high potassium levels. It can lead to worsening kidney function.
Can spironolactone cause breast enlargement and tenderness?
Yes, one potential side effect of spironolactone is gynecomastia or enlarged breast tissue. It can also cause breast tenderness.
Does spironolactone make you lose weight?
Spironolactone can cause weight loss due to increased urination. However, rapid and excessive weight loss can be a sign of fluid loss rather than fat loss.
I missed a dose of spironolactone, what should I do?
If it's close to your next scheduled dose, then skip the missed dose. Otherwise, take it as soon as you remember, unless it's almost time for your next dose.
Comprehensive Drug Guide
How Does Spironolactone Work?
Spironolactone is an aldosterone antagonist that increases sodium excretion while retaining potassium. It works as a diuretic by blocking the effects of aldosterone in the renal tubules, thereby increasing the excretion of water and sodium while reducing the excretion of potassium.
What is Spironolactone Used For?
FDA indications: Spironolactone is used to treat conditions such as heart failure, high blood pressure, hyperaldosteronism, and in some cases, edema (swelling) from other causes.
Offlabel uses: It's often prescribed offlabel to treat acne, and polycystic ovary syndrome (PCOS), and to promote diuresis in people with liver cirrhosis.
Common Dosages
Tablets: 25mg, 50mg, 100mg
Oral suspension: 25mg/5mL
Typical Dosing
FDA Approved Indications
- For FDAapproved indications:
- Heart failure: 12.5 to 50mg per day.
- Hypertension: 50 to 100mg per day.
- Hyperaldosteronism: Dosage ranges widely, from 100400mg per day.
- Edema: 25 to 200mg per day.
Off-Label Uses
- For offlabel uses:
- Acne: 50 to 100mg per day.
- PCOS: 50 to 200mg per day.
- Liver cirrhosis: 100 to 400mg per day.
Who Shouldn't Take Spironolactone?
- Those with kidney disease or uncontrolled kidney dysfunction.
- Those with hyperkalemia (high potassium levels).
- Those diagnosed with Addison's disease.
- Women who are pregnant, planning to become pregnant, or are breastfeeding.
- Individuals are allergic to spironolactone
Advice From The Pharmacist
- It's best to take this medication in the morning to avoid having to urinate during the night.
- Because this is a diuretic, it's crucial to stay properly hydrated.
- This medication can cause changes in your potassium levels, so avoid potassium supplements and potassiumrich foods unless your doctor tells you otherwise.
- Report any signs of high potassium to your healthcare provider this includes muscle weakness, slow heart rate, and a weak pulse.
- Keep all followup appointments so that your doctor can monitor your progress and adjust your medication as needed.
Side Effects of Spironolactone
Common Side Effects
- Common side effects: Nausea, vomiting, stomach pain, or diarrhea.
Uncommon/Severe Side Effects
- Rare side effects: Tingling in the hands or feet.
- Severe side effects: Slow or irregular heartbeat, muscle weakness or limp feeling, severe dizziness, and a feeling like you might pass out.
Risks and Warnings of Spironolactone
- Spironolactone should be used cautiously in patients with impaired renal function or preexisting elevated blood potassium levels.
- It can lead to severe hyperkalemia (high blood potassium) which can be lifethreatening; regular monitoring is necessary.
Interactions with Spironolactone
Common Drug Interactions
- Lithium
- ACE inhibitors (like lisinopril)
- Angiotensin II receptor antagonists (like losartan)
- Digoxin
- Nonsteroidal antiinflammatory drugs (like ibuprofen)
Alternatives to Spironolactone
- Chlorthalidone
- Hydrochlorothiazide (HCTZ)
- Furosemide
- Bumetanide
- Torsemide
- Indapamide