Spironolactone Uses, Side Effects & Interactions

Spironolactone is used in part to manage your potassium or sodium levels in the body. Changes in diet or physical activity may be necessary to increase the body's reaction to spironolactone.

Spironolactone is used to treat hyperaldosteronism, a condition which is caused when the body produces an excessive amount of the drug aldosterone. This can disrupt natural sodium or potassium levels in the body which can lead to more severe conditions. Spironolactone can help keep these conditions under control but does not have the ability to cure any conditions in the body. It can take up to two weeks for the full effects of spironolactone to come into effect, so do not stop taking your medication early because it appears as though it is not working. Your doctor will monitor your condition to help ensure that all is working as it should be.

Indications and Usage

Spironolactone is usually sold under the brand name Aldactone. It is used to help manage the body's natural production of aldosterone which can cause low potassium levels, edema, heart liver or kidney disease. This may also be used alongside with other medications to treat high blood pressure or to eliminate unneeded water or sodium from the body. In less common cases this mediation may be used to treat precocious puberty.

Spironolactone is given as a tablet which is to be taken orally once or twice a day depending on your prescription. You should try to take this medication around the same time every day to keep a constant dose in your system. If you forget to take your medication, do not double up doses to make up for it. Instead take your dose as soon as you remember, or skip your dose if it is too close to the next period where you will be taking your medication.

You will need to inform your doctors and dentist that you are using spironolactone as it can alter the results of your medical examinations. You should also inform your gynecologist about your use of spironolactone because it can cause tenderness, swelling or lumps in the breasts which can be mistaken for a serious condition including cancer. Have these conditions checked to eliminate the risk that you might be having a more serious reaction that requires medical attention.

Spironolactone Dosage

In most cases, the patient is started on low doses of spironolactone which will be increased gradually to combat the individual's reaction to the medication.

  • At first adults may be given 100 mg for edema, 25 mg for heart failure and 50-100 for high blood pressure. Those using spironolactone for excessive amounts of aldosterone in the body can take 400 mg for up to 4 weeks, which will then be reduced between 100-400 mg per day to monitor the condition. Doses should not exceed this level for any condition.
  • Childrenwill often receive doses based on their body weight and development. In some cases, a full adult dose may be given.

Who Should Not Take

  • If you already suffer from liver or kidney disease your doctor may tell you not to take spironolactone because it can make your condition worse. Discuss these risks as well as any precautions you may need to take before using spironolactone.
  • Pregnant women or those who are breastfeeding should not take spironolactone. It is not usually safe to drastically alter your hormones during this time due to the hormone changes that are naturally occurring. You may also transfer this drug to your child while pregnant or breastfeeding which could impact their growth or development negatively.
  • In laboratory studies, this medication has been shown to produce tumors in the body. If you notice lumps anywhere on your body or you have any symptoms that are similar to cancer, then you need to contact your doctor for an examination immediately. If you are already at risk for cancer or you are undergoing treatment for this disease you may not be able to take spironolactone. Talk with your doctor about this risk before continuing with your prescription.

Spironolactone Side Effects

Side effects of spironolactone are not necessarily common, but can be serious and require medical attention when they occur. Contact your doctor regarding any reactions you have to spironolactone to help determine if you need medical attention or a change in your dosing size. These side effects include blood in the stool, chills, cloudy or dark urine, difficulty urinating, changes in urine output, diarrhea, difficulty swallowing, dizziness, dimpling of the skin, heartburn, headaches, fatigue, fast heartbeat, loss of appetite, lumps in the breasts or arms, nausea, puffiness in the face, rash, sore breasts, ulcers in the mouth, swollen lymph nodes, unusual bleeding, vomiting up blood, weight gain, wheezing, yellowing of the eyes or skin, shakiness, or tightness in the chest.

If you begin to experience convulsions, difficulty breathing, irregular heartbeat, coma, confusion, drowsiness, muscle cramps, nervousness, rash, reddened skin, numbing of the hands, feet or lips, swelling of the ankles or hands or weakness in the legs you may be suffering from an overdose of spironolactone. Contact emergency medical assistance as soon as possible. If you can, have information regarding your prescription size and how much you have taken ready to give the doctor some indications of what might be in your system.

Interactions

Drugs known to interact with spironolactone include lithium, digoxin, steroid based medications, ACE inhibitors, or NSAIDs such as ibuprofen and meloxicam. Inform your doctor about any medications you might be taking before you start using spironolactone so they can inform you if you will need to alter your doses in any way to avoid a negative reaction to the medication.

You should not drink alcohol while on spironolactone as this increases bloating and water retention in the body which could impair your treatment. You will also need to take precautions in hot weather to avoid becoming dehydrated for similar reasons. Talk with your doctor about how much liquid you should take as consuming too little or too much during this time could be dangerous.

Patients may be told that they need to reduce their salt intake or take on a daily exercise program while on spironolactone. You may also need to avoid sodium or potassium based supplements while you are on your medication. This includes avoiding potassium rich foods such as prunes, banana or orange juice. Do not make any radical changes to your diet or level of physical activity without consulting with your doctor first.

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