Spironolactone is used to treat high blood pressure. It is also used to reduce fluid accumulation in the body caused by conditions such as heart failure, cirrhosis of the liver, kidney disease, and the long-term use of some drugs.
Spironolactone reduces fluid accumulation by increasing the elimination of salt and water through the kidneys. It may be used in combination with other diuretics to prevent potassium loss. Since spironolactone blocks the effects of a chemical (aldosterone) released from the adrenal gland, it can also be used to diagnose and treat an overactive adrenal gland.
Spironolactone Facts
Brand names (manufacturers): Aldactone (Searle); spironolactone (various manufacturers)
Type of drug: Diuretic and antihypertensive
Ingredient: Spironolactone
Dosage form: Tablets (25 mg, 50 mg, and 100 mg)
Storage: Store at room temperature in a tightly closed, light-resistant container.
To learn more about the various types of blood pressure medications, visit our main Blood Pressure Medications page.
Treatment
To decrease stomach irritation from spironolactone, you can take spironolactone with a glass of milk or with a meal (unless your doctor directs you to do otherwise). Try to take it at the same time every day. Avoid taking a dose after 6:00 in the evening; otherwise, you may have to get up during the night to urinate.
Spironolactone does not cure high blood pressure, but it will help to control the condition as long as you continue to take it.
If you miss a dose of spironolactone, take the missed dose as soon as possible. However, if it is almost time for the next dose, do not take the missed dose at all; just wait until the next scheduled dose. Do not double the next dose.
Side Effects
Minor: Cramping, diarrhea, dizziness, drowsiness, dry mouth, headache, increased urination, nausea, rash, restlessness, vomiting, or weakness. As your body adjusts to spironolactone, these side effects should disappear.
Dry mouth can be relieved by chewing sugarless gum or sucking on hard candy.
If spironolactone makes you feel dizzy or light-headed, sit or lie down for a while, get up slowly from a sitting or reclining position, and be careful on stairs.
To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion.
Major: Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about anxiety; clumsiness; confusion; deepening of the voice (in women); enlarged breasts (in both sexes); fever; impotence; increased hair growth; menstrual disturbances; muscle cramps; numbness or tingling in the hands, feet, or lips; palpitations; postmenopausal bleeding; rapid weight gain (three to five pounds within a week); stomach cramps; uncoordinated movements; or unusual tiredness or weakness.
Interactions
Spironolactone may interact with several other medications as well as with certain food products:
* Concurrent use of spironolactone with amiloride, antihypertensive agents (such as benazepril, captopril, enalapril, fosinopril, lisinopril, quinapril, and ramipril) triamterene, potassium salts, low-salt milk, salt substitutes, or laxatives can cause serious side effects such as hyperkalemia (high blood levels of potassium).
* Spironolactone may increase the side effects of lithium, digoxin, digitoxin, and ammonium chloride.
* The effectiveness of oral anticoagulants (blood thinners) may be decreased by spironolactone.
* Concurrent use of aspirin may decrease the diuretic effects of spironolactone.
* Extreme drowsiness can occur when spironolactone is taken with other central nervous system depressants, such as alcohol, antihistamines, antidepressants, barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, pain medications, and sleeping medications.
Before starting to take spironolactone, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above.
Warnings
* Tell your doctor about unusual or allergic reactions you have had to any medications, especially to spironolactone or to any other diuretic.
* Tell your doctor if you have ever had kidney or urination problems, heart disease, hyperkalemia (high blood levels of potassium), liver disease, menstrual abnormalities, breast enlargement, or diabetes mellitus.
* Spironolactone can cause hyperkalemia. Signs of hyperkalemia include palpitations; confusion; numbness or tingling in the hands, feet, or lips; anxiety; or unusual tiredness or weakness. However, do not alter your diet in an effort to avoid this problem unless your doctor tells you to do so. Elderly patients may be more susceptible to hyperkalemia.
* There are several generic brands of this drug. Consult your pharmacist about these items; some of them are not equivalent to the brand-name medications.
* Limit your intake of alcoholic beverages to prevent dizziness and light-headedness while taking spironolactone.
* Do not take any over-the-counter (nonprescription) medications for weight control or for allergy problems, asthma, cough, cold, or sinus problems unless you first get your doctor's approval.
* Spironolactone may cause extreme fatigue and dizziness. Your ability to perform tasks that require alertness, such as driving a car or operating potentially dangerous machinery, may be decreased. Take appropriate caution.
* To prevent severe water loss (dehydration) while taking spironolactone, check with your doctor if you have or develop any illness that causes severe or continuous nausea, vomiting, or diarrhea.
* Be sure to tell your doctor if you are pregnant. Spironolactone crosses the placenta, and its safety in human pregnancy has not been established. Adverse effects have been observed in the fetuses of animals that were given large doses of this drug during pregnancy. Also tell your doctor if you are breast-feeding an infant.