Advertisement

Spironolactone, Oral Tablet

Highlights for spironolactone

  1. Spironolactone oral tablet is available as a brand-name drug and a generic drug. Brand name: Aldactone.
  2. Spironolactone comes as an oral tablet and an oral suspension.
  3. Spironolactone is used to reduce swelling from congestive heart failure, liver disease, nephrotic syndrome, ascites, and pulmonary edema. It’s also used to treat high blood pressure, heart failure, low potassium levels caused by other blood pressure medications, and excessive aldosterone secretion.
Advertisement
Advertisement

Important warnings

Important warnings

FDA warning: Proper usage warning
  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
  • This drug has been shown to cause tumors in rats during long-term exposure. It’s important to only take this medication if your doctor prescribes it to you.

Other warnings

  • Potassium intake: While taking this drug, you should watch your potassium intake. You shouldn’t take potassium supplements, eat a diet rich in potassium, or consume salt substitutes containing potassium. Having too much potassium in your body can lead to severe problems. This can even be fatal. Talk to your doctor or a nutritionist if you are concerned about your potassium intake.
  • Gallbladder and liver: In rare cases, this drug can be dangerous to your gallbladder and liver. Go to the emergency room right away if you have these symptoms:
    • extreme tiredness
    • loss of appetite
    • nausea
    • yellowing of your skin or the whites of eyes
    • itching
  • Enlarged breasts: This drug may cause you to have enlarged breasts (gynecomastia). This can happen in both men and women. If this happens, your doctor may you’re your treatment with this drug. This symptom usually goes away once you stop taking this drug.

About

What is spironolactone?

Spironolactone is a prescription drug. It comes as an oral tablet and an oral suspension.

Spironolactone oral tablet is available as the brand-name drug Aldactone and as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

This drug may be taken as part of a combination therapy with other water pills that work on a different part of the kidney.

Why it's used

This drug is used to reduce swelling from congestive heart failure, liver disease, nephrotic syndrome (kidney problem), ascites, and pulmonary edema. It’s also used to treat high blood pressure, heart failure, low potassium levels caused by other blood pressure medications, and excessive aldosterone secretion.

How it works

This drug belongs to a class of drugs called aldosterone antagonists (blockers), or potassium-sparing diuretics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug works by blocking aldosterone activity. Aldosterone is a chemical made by the body that can cause water retention. This makes certain heart, kidney, and liver conditions worse. By blocking aldosterone, your body won’t retain fluid. This process also stops potassium from being excreted by your body.

This drug may lower your blood pressure by blocking aldosterone’s effect on your blood vessels.

Advertisement
Advertisement
Advertisement

Side effects

Spironolactone side effects

Spironolactone oral tablet may cause drowsiness. You shouldn’t drive, use machinery, or do similar tasks that require alertness until you know how this drug affects you.

This drug can also cause other side effects.

More common side effects

The more common side effects that can occur with spironolactone include:

  • diarrhea and abdominal cramping
  • nausea and vomiting
  • high potassium levels
  • leg cramps
  • headache
  • dizziness
  • drowsiness
  • itching
  • irregular menstrual cycles or bleeding after menopause

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Allergic reactions. Symptoms can include:
    • skin rash
    • hives
    • fever
    • trouble breathing
    • swelling of your lips, mouth, tongue, or throat
  • Electrolyte and/or fluid problems. Symptoms can include:
    • mouth dryness
    • extreme thirst
    • extreme weakness and tiredness
    • fast heart rate and dizziness
    • not being able to urinate
  • Dangerously high potassium levels. Symptoms can include:
    • muscle weakness
    • not being able to move your legs and arms
    • extreme tiredness
    • tingling or numb feeling in your hands or feet
    • slow heart rate
  • Breast enlargement (gynecomastia). Symptoms can include:
    • growth of breast tissue in males and females
  • Severe skin reactions. Symptoms can include:
    • redness, blistering, peeling or loosening of your skin, including inside of your mouth

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Interactions

Spironolactone may interact with other medications

Spironolactone oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with spironolactone are listed below.

Blood pressure drugs

Taking blood pressure drugs with spironolactone can increase the amount of potassium in your body to unsafe levels. Examples of these drugs include:

  • angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril
    • captopril
    • enalapril
    • enalaprilat
    • fosinopril
    • imidapril
    • moexipril
    • perindopril
    • quinapril
    • ramipril
    • trandolapril
  • angiotensin II receptor blockers (ARBs), such as:
    • irbesartan
    • losartan
    • olmesartan
    • telmisartan
    • valsartan
  • direct renin inhibitors, such as:
    • aliskiren
  • potassium-sparing diuretics, such as:
    • eplerenone
    • triamterene
  • heparin and low molecular weight heparin (LMWH)
  • potassium supplements

Pain drugs

Taking certain pain drugs with spironolactone can increase the amount of potassium in your body to unsafe levels. Taking these drugs together may also lower your blood pressure too much. Examples of these pain drugs include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
    • diclofenac
    • ibuprofen
    • indomethacin
    • ketoprofen
    • ketorolac
    • meloxicam
    • nabumetone
    • naproxen
    • piroxicam
  • narcotics, such as:
    • codeine
    • dihydrocodeine
    • fentanyl
    • hydrocodone
    • hydromorphone
    • levorphanol
    • meperidine
    • methadone
    • morphine
    • opium
    • oxycodone
    • oxymorphone
    • tramadol

Cholesterol drugs

Taking certain cholesterol drugs with spironolactone can increase the amount of potassium in your body to unsafe levels. Examples of these drugs include:

  • cholestyramine

Barbiturates

Taking barbiturates with spironolactone can lower your blood pressure too much. Examples of these drugs include:

  • amobarbital
  • butabarbital
  • butalbital
  • methohexital
  • pentobarbital
  • phenobarbital
  • secobarbital
  • thiopental

Corticosteroids and adrenocorticotropic hormone (ACTH)

Taking these drugs with spironolactone can decrease the amount of potassium in your body to unsafe levels. Examples of these drugs include:

  • dexamethasone
  • methylprednisolone
  • prednisolone
  • prednisone
  • ACTH

Lithium

Taking lithium with spironolactone can increase the effects of lithium. Your doctor may lower your dosage of lithium if you take these drugs together.

Heart drugs

Taking certain heart drugs with spironolactone can increase the effect of the heart drugs. Your doctor may need to adjust your dosage of your heart drug if you take it with spironolactone. Examples of these heart drugs include:

  • digoxin

Anesthesia drugs

Spironolactone can decrease the effects of some anesthesia drugs. Examples of these drugs include:

  • norepinephrine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Advertisement
Advertisement

Other warnings

Spironolactone warnings

This drug comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Call 911 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

The use of drinks that contain alcohol can increase your risk of a sedative effect. You may have slowed reflexes, poor judgment, and sleepiness. This can be dangerous. If you drink alcohol, talk to your doctor.

Warnings for people with certain health conditions

For people who don’t make urine (anuria): You shouldn’t take this drug if you have anuria or don’t produce urine.

For people with liver disease: Taking this drug when you have liver disease may lead to a coma. Tell your doctor right away if you have the following symptoms, which may be signs of hepatic coma:

  • confusion
  • poor judgment
  • foggy memory
  • abnormal body movements and shaking
  • trouble concentrating

For people with kidney disease: You should not take this drug if you have kidney disease or kidney damage. This drug can increase your risk for electrolyte changes, such as too much nitrogen in your bloodstream.

For people with Addison’s disease: You shouldn’t take this drug if you have Addison’s disease. It can make your illnesses worse.

For people with heart disease: Don’t take potassium supplements, eat a diet high in potassium, or take drugs that increase potassium levels if you have heart failure and you’re taking this drug. Dangerously high potassium levels are more likely if you have heart failure. This can be fatal.

Warnings for other groups

For pregnant women: This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Taking spironolactone while pregnant may harm your pregnancy. Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to your pregnancy.

For women who are breastfeeding: This drug passes into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

When to call the doctor
Call your doctor if you have trouble breathing or swelling in your legs. This means that your heart disease is getting worse.

For seniors: Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal. If you’re a senior, you may need a lower dose or a different schedule.

For children: This medication shouldn’t be used in children younger than 18 years.

Advertisement

Dosage

How to take spironolactone

All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Drug forms and strengths

Generic: Spironolactone

  • Form: oral tablet
  • Strengths: 25 mg, 50 mg, 100 mg

Brand: Aldactone

  • Form: oral tablet
  • Strengths: 25 mg, 50 mg, 100 mg

Dosage for high blood pressure (hypertension)

Adult dosage (ages 18–64 years)

The typical starting dosage is 50–100 mg taken by mouth each day. It’s given as a single dose or split into two doses.

Child dosage (ages 0–17 years)

This medication isn’t approved for use in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different dosage schedule.

Dosage for low potassium levels (hypokalemia) from other blood pressure medications

Adult dosage (ages 18–64 years)

Typical dosage ranges from 25–100 mg per day.

Child dosage (ages 0–17 years)

This medication isn’t approved for use in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Dosage for swelling (edema) from congestive heart failure, nephrotic syndrome, liver disease, or ascites

Adult dosage (ages 18–64 years)

The typical starting dosage is 100 mg taken by mouth each day. It’s given as a single dose or split into two doses. Some people may start as low as 25 mg per day or as high as 200 mg per day.

Child dosage (ages 0–17 years)

This medication isn’t approved for use in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different dosage schedule.

Dosage for heart failure

Adult dosage (ages 18–64 years)

The typical starting dosage is 12.5–25 mg taken by mouth once per day. Your doctor may increase or decrease your dosage based on how you respond to the drug. Some people may take 50 mg once per day, and others may take 25 mg once every other day.

Child dosage (ages 0–17 years)

This medication isn’t approved for use in children younger than 18 years.

Senior dosage (ages 65 years and older)

Typical dosage for seniors is 12.5–25 mg once per day. Maximum dosage is 25 mg per day.

Dosage for excessive aldosterone secretion

Adult dosage (ages 18–64 years)

  • For the long test for excessive aldosterone diagnosis: 400 mg taken once per day for 3–4 weeks.
  • For the short test for excessive aldosterone diagnosis: 400 mg taken once per day for 4 days.
  • People waiting for surgical correction of excessive aldosterone secretion: 100–400 mg taken per day until the day of your surgery.

Child dosage (ages 0–17 years)

This medication isn’t approved for use in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different dosage schedule.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Advertisement
Advertisement

Take as directed

Take as directed

Spironolactone is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don't take it at all: If you do not take this drug, your blood pressure will stay high. This can lead to a heart attack or stroke. Your body may also become overloaded with fluid. This can cause serious worsening of kidney and liver disease.

If you stop taking it suddenly: If you stop taking this drug, you may start retaining water. You may also have a sudden increase in your blood pressure. This can lead to a heart attack or stroke.

If you don't take it on schedule: If you don’t take this drug on schedule, your blood pressure might not be controlled. This can lead to a heart attack or stroke.

What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours before the time for your next dose, then wait and only take one dose at that time. Never try to catch up by taking two doses at once. This could cause dangerous side effects.

If you take too much: If you take too much of this drug, you may have the following symptoms:

  • drowsiness
  • confusion
  • skin rash
  • nausea
  • vomiting
  • dizziness
  • diarrhea
  • changes in your body’s electrolytes, which can cause irregular heart rate or muscle pain and cramping

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

How to tell the drug is working: You may not be able to tell whether this drug is working or not. It’s important that you take your medication every day as directed by your doctor. Your doctor will monitor your condition and be able to tell if this drug is working. You may need to buy your own blood pressure monitor to check your blood pressure at home.

Important considerations

Important considerations for taking spironolactone

Keep these considerations in mind if your doctor prescribes spironolactone for you.

General

  • This drug can be taken with or without food.

Storage

  • Store spironolactone at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t freeze this drug.
  • Keep it away from light.
  • Keep it away from high temperature.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You may need to check your blood pressure at home using a blood pressure monitor. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

Clinical monitoring

While you’re taking this drug, your doctor will check the following:

  • heart function
  • kidney function
  • liver function
  • electrolytes
  • blood pressure

Hidden costs

You may need to purchase a home blood pressure monitor to check your blood pressure at home. These are available for purchase at most pharmacies.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Advertisement
Advertisement
Advertisement

Alternatives

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.

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 other healthcare professional before taking any medication. The drug information contained here in 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.

Article resources
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement