Aldactone (Spironolactone)

Description

Aldactone (Spironolactone) is a potassium-sparing diuretic. It helps the body expel water and sodium while retaining potassium. Spironolactone belongs to a drug class called aldosterone receptor antagonists; it prevents aldosterone, a hormone, from binding to its receptor, which can help reduce blood volume and lower blood pressure. Doctors typically prescribe it to treat conditions like heart failure, high blood pressure, and conditions characterized by low potassium levels. Moreover, it's also used to manage hyperaldosteronism, a condition in which the body produces too much aldosterone.

Directions

The starting Aldactone dosage often varies based on the condition being treated, with changes made according to the response to therapy. For heart failure, Aldactone is typically started at 25 mg once daily. However, for conditions like primary hyperaldosteronism, the dosage starts much higher at 100 to 400 mg. It's important to follow your doctor's instructions, which may include whether to take the medicine with food or not.

Ingredients

The active ingredient in Aldactone is Spironolactone.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Hyperkalemia, or elevated levels of potassium in the blood
• Addison's disease, a disorder of the adrenal glands causing insufficient hormone production
• Combined use with eplerenone due to an increased risk of severe side effects

Cautions

• Before starting treatment with Aldactone, be sure to tell your healthcare provider if you have:
• Any existing health conditions
• Any allergies
• A list of all medications you are currently taking
• Whether you are pregnant or breastfeeding

• Aldactone can increase potassium levels in your blood, which may become dangerous. This risk is higher if you have kidney problems or use potassium supplements, salt substitutes containing potassium, or certain medications like ACE inhibitors or ARBs. Your doctor will monitor your potassium levels within the first week of starting or adjusting Aldactone and regularly after that. If your potassium levels become too high, your dose may be reduced, or the medication may be stopped.
• Aldactone can cause dehydration and low blood pressure if it removes too much fluid from the body. This is more likely if you are also taking medications like ACE inhibitors or ARBs. It may also worsen kidney function, especially if used with drugs that can harm the kidneys (e.g., NSAIDs or certain antibiotics). Your doctor will check your fluid levels and kidney health regularly.
• Aldactone can cause imbalances in the body’s salts, including low sodium, magnesium, calcium, or chloride levels. It can also raise blood sugar and uric acid levels, which may trigger gout in rare cases. Regular blood tests will help monitor these levels and ensure they stay within a healthy range.
• Aldactone may cause the development of breast tissue in men (gynecomastia). This side effect is dose-dependent and can appear within a few months or take over a year to develop. In most cases, it goes away after stopping the medication.

Side Effects

The most common side effects of Aldactone include gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Some people may experience dizziness, drowsiness, or headache. Hormonal changes like gynecomastia in men and menstrual irregularities in women have also been observed. These effects are generally mild but should be discussed with a healthcare provider if they’re bothersome.

Serious reactions include hyperkalemia (high potassium levels), which can cause weakness, confusion, or heart rhythm changes. Rare hypersensitivity reactions, such as Stevens-Johnson syndrome, anaphylaxis, or drug rash with eosinophilia and systemic symptoms (DRESS), have been reported. In some cases, liver toxicity or renal dysfunction may occur. Notify a healthcare provider immediately if you experience severe skin reactions, signs of liver problems, or worsening kidney function.

References

1. Aldactone (Spironolactone) Product Monograph. New York, NY: Pfizer Labs; 2022.
2. Aldactone (Spironolactone) Drug Label Information. New York, NY: Pfizer Labs; 2024.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....