Spironolactone
Diuretic · Aldosterone antagonist
Indications
Hypertension, congestive cardiac failure, hepatic cirrhosis, malignant ascites, nephrotic syndrome, primary aldosteronism.
Dosage
Adults: Oedema: 25-200 mg/day in 1-2 divided doses. Hypokalaemia: 25-100 mg daily. Hypertension: 25-50 mg in 1-2 divided doses. Diagnosis of primary aldosteronism: Long test, 400 mg daily for 3-4 wk; short test 400 mg daily for 4 days; maintenance until surgical correction 100-400 mg/day in 1-2 divided doses. Ascites in cirrhosis of the liver: 100-400 mg daily, altered acc to response. Malignant ascites: Initially 100-200 mg daily, then increased if required to 400 mg daily, maintenance dose altered acc to response. Nephrotic syndrome: 100-200 mg daily. Heart failure: 12.5-25 mg/day, max 50 mg/day. If 25 mg once daily not tolerated, reduce dose every other day to the lowest maintenance dose. Elderly: Based on indication. Initially 12.5-50 mg/day in 2-3 divided doses, increasing by 25-50 mg every 5 days as required. Children: Oedema in heart failure and in ascites, nephrotic syndrome,…
Adverse Effects
Gynaecomastia, Gl upset, rash, drowsiness, headache, confusion, malaise, benign breast neoplasm, blood dyscrasias, hepatic impairment, electrolyte disturbances, leg cramps, ataxia, dizziness, changes in libido, confusion, menstrual disorders, breast pain, skin reaction, acute renal failure, alterations in voice pitch.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Anuria, severe or progressive renal failure. Hyperkalaemia; Addison's disease, diabetes, diabetic nephropathy. Moderate to severe renal impairment in children. Precautions: Renal or hepatic impairment. Long term use in young patients. Hyponatraemia, porphyria. Predisposition to acidosis. Monitor fluid, electrolytes and BUN.
Interactions
K+ supplements, K+ sparing diuretics, carbenoxolone, antihypertensives, ACE inhibitors, digoxin, angiotensin II inhibitors, NSAIDs, cyclosporin, fludrocortisone, lithium, anticoagulants, tacrolimus, noradrenaline, co-trimoxazole.
Advice to Patient
Take with meals. Contact prescriber if there is mental confusion; chest pain; rapid heartbeat; palpitations; clumsiness; constant fatigue; chills; numbness or muscle weakness in hands, feet or face; acute persistent diarrhoea; breast tenderness or increased body hair in females; breast enlargement or inability to achieve erection in males; excessive thirst or difficulty in respiration. Avoid natural licorice. Weigh yourself at the same time each day wearing the same amount of clothing and notify prescriber if weight gain is more than 2 lb (0.9 kg) per day or 5 lb (2.3 kg) per week. Do not take diets rich in potassium. Check blood pressure and report prescriber if pressure is greater than 140 mm Hg systolic or 90 mm Hg diastolic.
Pharmacokinetics
Duration: Tab: 2-3 days. Bioavailability: High-fat/-calorie meal increased the bioavailability of spironolactone approx. 90%. Metabolism: Rapid and extensive; hepatic. Half-life elimination: Tab: Approx. 1-4 hrs. Susp: 1-2 hrs. Time to peak, serum: Tab: 2.6-4.3 hrs. Susp: 0.5-1.5 hrs. Excretion: Urine and bile.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.