Spironolactone is a drug used to lower blood pressure in hypertension. This drug can also be used in the treatment of heart failure, hypokalemia, cirrhosis, edema, or conditions when the body produces too much of the hormone aldosterone (hyperaldosteronism).
Spironolactone belongs to a type of potassium-sparing diuretic drug. This drug works by inhibiting the absorption of excess salt (sodium) into the body and keeping potassium levels in the blood from getting too low, so blood pressure can be lowered.
Spironolactone trademark: Aldactone, Carpiaton, Letonal, Spirola, Spironolactone
What is Spironolactone
| group | Prescription drugs |
| Category | Potassium sparing diuretic |
| Benefit | Treating hypertension, heart failure, hypokalemia, cirrhosis, edema, or hyperaldosteronism |
| Consumed by | Adults and children |
| Spironolactone for pregnant and lactating women | Category C: Animal studies have shown adverse effects on the fetus, but there are no controlled studies in pregnant women. The drug should only be used if the expected benefit outweighs the risk to the fetus. Spironolactone can be absorbed into breast milk. Therefore, breastfeeding mothers are advised to consult a doctor before taking this drug, so that the doctor can weigh the benefits and risks. |
| Drug form | Tablet |
Warning Before Taking Spironolactone
Follow the doctor's recommendations and advice when undergoing treatment with spironolactone. Before taking this drug, you need to pay attention to the following:
- Do not take spironolactone if you are allergic to this drug.
- Tell your doctor about your medical history, especially if you have Addison's disease, liver disease, kidney disease, or hyperkalemia (high levels of potassium in the blood).
- Tell your doctor if you are taking certain medications, herbal products, or supplements, especially those containing potassium.
- Tell your doctor that you are taking spironolactone if you are having surgery, including dental surgery.
- Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy.
- Do not drive a vehicle or operate equipment that requires alertness while you are taking spironolactone, as this medicine may cause dizziness and drowsiness.
- See your doctor right away if you have an allergic reaction or overdose after taking spironolactone.
Dosage and Instructions for Use of Spironolactone
The dose of spironolactone that your doctor prescribes can be different for each patient. The following is a spironolactone dosage based on the goals and age of the patient:
Purpose: Treating hypertension (high blood pressure)
- Mature: 50–100 mg per day, the dose can be divided into 1-2 times a day. The dose can be adjusted after 2 weeks.
Purpose: Treating edema
- Mature: 100 mg per day. Furthermore, the dose can be increased up to 400 mg per day.
Purpose: Treating cirrhosis with edema and ascites
- Mature: 100–400 mg per day, depending on the sodium and potassium levels in the urine.
- seniors: Starting with the lowest dose, then can be increased if needed.
- Children: 3 mg/kgBB per day, which can be divided into several consumption schedules. The dose will be adjusted according to the patient's body response.
Purpose: Treating primary hyperaldosteronism
- Mature: 400 mg per day, for 3-4 weeks.
- seniors: Starting with the lowest dose, then can be increased if needed.
- Children: 3 mg/kgBB per day, which can be divided into several consumption schedules. The dose will be adjusted according to the patient's body response.
Purpose: Preoperative care in patients with hyperaldosteronism
- Mature: 100–400 mg per day. Long-term treatment without surgery applies the lowest effective dose.
- seniors: Start with the lowest dose, then the dose can be increased if needed.
- Children: 3 mg/kgBB per day, which can be divided into several consumption schedules. The dose will be adjusted according to the patient's response.
Purpose: Treating heart failure
- Mature: Initial dose of 25 mg, once daily, with a maximum dose of 50 mg per day.
- seniors: Start with the lowest dose, then the dose can be increased if needed.
- Children: 3 mg/kgBB per day, which can be divided into several consumption schedules. The dose will be adjusted according to the patient's response.
Purpose: Treat hypokalemia due to diuretics
- Adults: 25–100 mg per day.
How to Take Spironolactone Correctly
Be sure to read the instructions on the drug packaging label and always follow the doctor's advice in taking spironolactone. Do not increase or decrease the dose consult a doctor.
Spironolactone can be taken with food or after a meal. This medication is usually taken once a day, and the best time to take it is before noon.
After taking this medicine, you will urinate more frequently. Spironolactone is not recommended to be taken at night because it can interfere with your sleep. If given twice a day, the last dose should be taken before 18.00.
If you forget to take spironolactone, take it as soon as you remember if your next consumption schedule is not too close. If it is near, ignore it and do not double the missed dose.
Store spironolactone in a dry place away from direct sunlight. Keep out of reach of children.
Spironolactone Interactions with Other Drugs
Spironolactone can cause drug interactions if used concurrently with other medicines. The following are some of the effects of drug interactions that may occur:
- Increases risk of hyperkalemia if taken with ACE inhibitors. angiotensin II receptor antagonist, heparin, potassium supplements, trilostane, or other potassium-sparing diuretics, such as eplerenone
- Increases risk of impaired renal function if taken with ciclosporin or NSAIDs
- Increase the toxic effect of lithium drug
- Increases risk of metabolic acidosis and hyperkalemia if taken with cholestyramine
- Increases risk of orthostatic hypotension if taken with phenobarbital
- Increase digoxin levels in the blood
Spironolactone Side Effects and Dangers
Some of the side effects that may arise after taking spironolactone are:
- Dizzy
- Headache
- Nauseous
- Throw up
- Diarrhea
- Erectile dysfunction
- Swelling in the breast
Consult a doctor if the above side effects do not subside immediately or get worse. You need to see a doctor immediately if you experience an allergic drug reaction or more serious side effects, such as:
- Dizzy and feel like passing out
- Decreased amount of urine and frequency of urination
- Muscle cramp
- Heart rhythm disturbances
- Vomiting blood
- Defecation with blood
- Easy bruising
- A yellowish discoloration of the skin and eyes (jaundice)