Know the basics
What is spironolactone used for?
Spironolactone is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat swelling (edema) caused by certain conditions (e.g., congestive heart failure) by removing excess fluid and improving symptoms such as breathing problems.
This medication is also used to treat low potassium levels and conditions in which the body is making too much of a natural chemical (aldosterone).
Spironolactone is known as a “water pill” (potassium-sparing diuretic).
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication has also been used to treat excessive hair growth (hirsutism) in women with polycystic ovary disease.
How should I take spironolactone?
Take this medication by mouth, as directed by your doctor. If stomach upset occurs, take it with food or milk. It is best to take your dose early in the day (before 6 p.m.) to prevent having to get up during the night to urinate. Consult your doctor or pharmacist if you have any questions.
Dosage is based on your medical condition and response to therapy. In children, the dosage is also based on body weight.
Take this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day as directed. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.
Take this medication exactly as prescribed. Do not increase your dose, take it more often than prescribed, or stop using this medicine without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped.
Inform your doctor if your condition worsens (e.g., if you notice an increase in your routine blood pressure readings).
How do I store spironolactone?
Spironolactone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store spironolactone in the bathroom or the freezer. There may be different brands of spironolactone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush spironolactone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Know the precautions & warnings
What should I know before using spironolactone?
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of spironolactone in the pediatric population. Safety and efficacy have not been established.
No information is available on the relationship of age to the effects of spironolactone in geriatric patients.
Is it safe to take spironolactone during pregnancy or breast-feeding?
There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.
Know the side effects
What are the side effects of spironolactone?
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using spironolactone and call your doctor at once if you have a serious side effect such as:
- numbness or tingly feeling;
- muscle pain or weakness;
- slow, fast, or uneven heart rate;
- feeling drowsy, restless, or light-headed;
- urinating less than usual or not at all;
- shallow breathing;
- tremors, confusion;
- nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
- severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious side effects may include:
- mild nausea or vomiting;
- dizziness, headache;
- gas, stomach pain; or
- skin rash
Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.
Know the interactions
What drugs may interact with spironolactone?
Spironolactone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Arsenic Trioxide
- Enalapril Maleate
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amtolmetin Guacil
- Choline Salicylate
- Flufenamic Acid
- Ibuprofen Lysine
- Mefenamic Acid
- Niflumic Acid
- Salicylic Acid
- Sodium Salicylate
- Tiaprofenic Acid
- Tolfenamic Acid
Does food or alcohol interact with spironolactone?
Spironolactone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.
What health conditions may interact with spironolactone?
Spironolactone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:
- Addison’s disease (adrenal problem) or
- Anuria (not able to pass urine) or
- Hyperkalemia (high potassium in the blood) or
- Kidney disease, severe—Should not be used in patients with these conditions.
- Electrolyte imbalance (eg, low chloride, magnesium, or sodium in the body) or
- Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or
- Liver disease, severe (eg, cirrhosis)—Use with caution. May make these conditions worse.
Understand the dosage
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.
What is the dose of spironolactone for an adult?
Usual Adult Dose for Edema:
25 to 200 mg/day orally in 1 or 2 divided doses.
Usual Adult Dose for Hypertension:
25 to 200 mg/day orally in 1 or 2 divided doses.
Usual Adult Dose for Hypokalemia:
25 to 200 mg/day orally in 1 or 2 divided doses.
Usual Adult Dose for Primary Hyperaldosteronism Diagnosis:
100 to 400 mg/day orally in 1 or 2 divided doses.
Usual Adult Dose for Hirsutism:
50 to 200 mg/day orally in 1 or 2 divided doses.
Usual Adult Dose for Congestive Heart Failure:
25 mg/day orally. Increase or decrease based on response and evidence of hyperkalemia.
Usual Adult Dose for Primary Hyperaldosteronism:
Initial dose: 100 mg orally once a day. This dosage may be divided into two daily doses, and increased as tolerated every two to three days to a maximum recommended total daily dose of 400 mg. It is recommended that the dosage be titrated to decrease sodium retention, hypertension, weakness, hypokalemia, and any other signs or symptoms of primary hyperaldosteronism in this patient.
If this patient has an adrenal adenoma or carcinoma, the lowest possible spironolactone dosage should be given while waiting for surgery. Adrenal hyperplasia, however, usually does not respond to surgery, and chronic spironolactone therapy is recommended.
Patients with adrenal hyperplasia often require other antihypertensive therapy to control their associated hypertension.
What is the dose of spironolactone for a child?
Usual Pediatric Dose for Hypertension:
Neonates: 1 to 3 mg/kg/day orally every 12 to 24 hours.
Children: 1.5 to 3.3 mg/kg/day or 60 mg/m2/day orally in divided doses every 6 to 12 hours not to exceed 100 mg/day.
Usual Pediatric Dose for Primary Hyperaldosteronism Diagnosis:
Children: 100 to 400 mg/m2/day orally in 1 to 2 divided doses.
How is spironolactone available?
Spironolactone is available in the following dosage forms and strengths:
Tablet 25 mg; 50 mg; 100 mg
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.
Symptoms of overdose may include:
- tingling in arms and legs
- loss of muscle tone
- weakness or heaviness in legs
- irregular or slow heartbeat
What should I do if I miss a dose?
If you miss a dose of spironolactone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: May 30, 2016 | Last Modified: January 4, 2017
Spironolactone. https://www.drugs.com/spironolactone.html. Accessed July 15, 2016.
Spironolactone. http://www.webmd.com/drugs/2/drug-6288/spironolactone-oral/details. Accessed July 15, 2016.
Spironolactone. http://patient.info/medicine/spironolactone-aldactone. Accessed July 15, 2016.