Aldactone (spironolactone) is a prescription drug used to treat high blood pressure, heart failure, and certain other conditions. The drug comes as an oral tablet. Your dosage depends on the condition Aldactone is being used to treat.

Aldactone is used in adults to treat:

The active ingredient in Aldactone is spironolactone. Aldactone belongs to a group of drugs called potassium-sparing diuretics or aldosterone antagonists (blockers).

This article describes the dosages of Aldactone, as well as its strengths and how to take it. To learn more about Aldactone, see this in-depth article.

This section describes the usual dosages of Aldactone. Keep reading to learn more.

What is Aldactone’s form?

Aldactone is available as an oral tablet.

What strengths does Aldactone come in?

Aldactone comes in three strengths:

  • 25 milligrams (mg)
  • 50 mg
  • 100 mg

What are the usual dosages of Aldactone?

Your dosage of Aldactone depends on the condition the drug is being used to treat and other factors. Your doctor will likely start you on a low dosage of Aldactone and adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The maximum dosage of Aldactone you’ll be prescribed depends on certain factors, such as:

  • how severe your condition is
  • how your condition responds to Aldactone
  • other conditions you may have (such as liver or kidney problems)
  • other medications you may be taking

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs. In some cases, doctors may adjust your dosage from those shown below.

Dosage for high blood pressure

The typical Aldactone dosage for adults with high blood pressure is 25 to 100 mg per day when starting treatment. Depending on your dosage, your doctor may prescribe the medication to be taken once per day or taken in multiple doses throughout the day.

Your doctor will typically start you on a lower dosage and adjust it over time. They may review and adjust your dosage every 2 weeks based on how you respond to the medication.

The maximum Aldactone dosage that’s recommended for high blood pressure is 100 mg per day.

Talk with your doctor if you have questions about your dosage of Aldactone for high blood pressure.

Dosage for heart failure

The typical Aldactone (spironolactone) dosage for adults with heart failure depends on certain factors. Your dosage is based on your blood potassium levels and how much blood your heart pumps. Your doctor will monitor your blood potassium levels regularly to determine the best dosage for you.

Your starting dosage for Aldactone will likely be 25 mg of Aldactone taken once per day. Your doctor may adjust your dosage gradually up to 50 mg per day if needed to manage your condition.

However, if you have high potassium levels, they may lower your dosage to 25 mg taken once every other day.

Talk with your doctor if you have questions about your dosage of Aldactone for heart failure.

Dosage for edema in people with certain liver or kidney problems

The typical starting dosage of Aldactone for edema (fluid retention) in adults with cirrhosis or nephrotic syndrome is 100 mg taken daily. However, your dosage depends on the severity of your condition, how your body responds to treatment, and whether you are taking other medications for edema in addition to Aldactone.

The typical dosage range of Aldactone for edema is 25 to 200 mg per day. Your doctor may prescribe Aldactone to be taken once per day or divided into multiple doses per day.

To treat edema from cirrhosis (liver disease), your doctor will likely have you start taking Aldactone while in the hospital. They’ll typically prescribe a low dose to start and adjust it slowly as needed.

If you’re taking Aldactone alone to treat fluid retention, you’ll likely take the dosage you’ve been prescribed for at least 5 days before your doctor adjusts your dose. This is to see how you respond to the medication.

If you have questions about your dosage of Aldactone, talk with your doctor or pharmacist to learn more.

Dosage for primary hyperaldosteronism

The typical Aldactone dosage for adults with primary hyperaldosteronism is 100 to 400 mg taken daily in preparation for surgery. Your doctor will discuss your dosage with you and tell you how long you’ll take the medication before you have surgery.

In cases where you can’t have surgery for hyperaldosteronism, your doctor will prescribe a maintenance dosage that you’ll take long term. They’ll prescribe the lowest effective dosage based on your condition.

Talk with your doctor if you have questions about your dosage of Aldactone for primary hyperaldosteronism.

How to take Aldactone

Aldactone comes as an oral tablet. Your dosage and how often you take Aldactone depends on the condition the drug is being used to treat. Try to take it around the same time every day. This helps keep consistent levels of the drug in your body so it can work effectively.

You can take Aldactone with or without food, but you should take it the same way every time. So if you plan to take it with food, take all your doses with food. This will help ensure you have consistent levels of Aldactone in your body.

You can cut or crush Aldactone tablets if you have trouble swallowing them. You can also see this article for tips on swallowing pills.

You should not suddenly stop taking Aldactone. This can increase your risk of side effects or sudden worsening of your condition. If you have concerns about your dosage, talk with your doctor. They can discuss your options with you.

You should not take potassium supplements or foods that have a high potassium content while you’re taking Aldactone. This can increase your risk of serious side effects with Aldactone.

If you have questions about how to take Aldactone, talk with your doctor or pharmacist to learn more.

Is Aldactone used long term?

Yes, for most uses, Aldactone is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.

For primary hyperaldosteronism, Aldactone is typically used short-term before surgery. However, it may be used long-term if you’re not a candidate for surgery. In this case, your doctor will prescribe the lowest effective dose to manage your condition.

If you have questions about how long you’re likely to take Aldactone, talk with your doctor to learn more.

Do not take more Aldactone than your doctor prescribes, as this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you take too much Aldactone

Call your doctor right away if you think you’ve taken too much Aldactone. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Below are answers to some commonly asked questions about Aldactone’s dosage.

What is the Aldactone dosage for acne?

Aldactone is not approved by the Food and Drug Administration (FDA) to treat acne. However, your doctor may prescribe Aldactone off-label to treat acne. This is when a drug is used for a purpose other than its approved uses.

According to the American Academy of Dermatology’s 2024 guidelines, the drug is recommended for use in certain females. However, it is not recommended for treating acne in males. (Note: In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.)

Because Aldactone is not approved to treat acne, there is no recommended Aldactone dosage for acne.

If you’re interested in learning about taking Aldactone for acne, talk with your doctor or pharmacist.

How long does Aldactone take to start working?

Aldactone starts to work soon after you take your first dose. Aldactone works by blocking the effects of aldosterone (a hormone made by the body that can cause fluid buildup). Your doctor will monitor you carefully during treatment. They’ll adjust your dosage of Aldactone slowly based on how your body responds to treatment.

If you have other questions about what to expect from Aldactone treatment, talk with your doctor.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.