Spironolactone: Uses, Dosage, Side Effects & Brands | MedexInfo

Spironolactone

Rx

Generic NameSpironolactone

Therapeutic ClassPotassium-sparing diuretic, Aldosterone antagonist

Common Strength25 mg, 50 mg, 100 mg tablets

PregnancyUse only if clearly needed

Indications ▼

Edema: Management of edema associated with congestive heart failure, liver cirrhosis, and nephrotic syndrome.

Hypertension: Adjunct therapy for high blood pressure, particularly in resistant cases.

Primary Hyperaldosteronism: Diagnostic and therapeutic use in Conn's syndrome to reduce aldosterone effects.

Hypokalemia Prevention: Prevents potassium loss in patients taking loop or thiazide diuretics.

Off-label (Dermatology): Treatment of hirsutism, acne, and androgen-related skin disorders in females.

Mechanism & Pharmacokinetics ▼

Mechanism: Spironolactone is an aldosterone receptor antagonist in the distal renal tubules, reducing sodium and water reabsorption while conserving potassium. Also has anti-androgen effects which help in hirsutism and acne.

Pharmacokinetics: Well absorbed orally; peak plasma levels in 2–3 hours. Extensively metabolized in the liver to active metabolites including canrenone. Half-life ~1.5 hours (spironolactone) and 16–18 hours (canrenone). Excreted via urine and feces.

Dosage & Administration ▼

Indication	Dose	Frequency / Notes
Edema (Adults)	25–100 mg	Once or twice daily; titrate based on response
Hypertension	50–100 mg	Once daily; may be combined with other antihypertensives
Primary Hyperaldosteronism	100–400 mg	Once or twice daily
Hypokalemia Prevention	25–50 mg	Once daily
Hirsutism / Acne (Females, Off-label)	50–100 mg	Once daily; duration depends on clinical response

Note: Adjust dose in renal or hepatic impairment. Monitor potassium and renal function.

Side Effects ▼

Hyperkalemia, especially in renal impairment

Gynecomastia, breast tenderness, menstrual irregularities

Dizziness, hypotension

Gastrointestinal upset: nausea, vomiting, diarrhea

Rash, headache

Contraindications ▼

Hyperkalemia or severe renal insufficiency

Hypersensitivity to spironolactone or its excipients

Acute renal failure

Pregnancy (first trimester use only if clearly needed)

Drug Interaction ▼

ACE inhibitors, ARBs, potassium supplements: increased risk of hyperkalemia

Diuretics (loop/thiazide): may potentiate hypotension or dehydration

NSAIDs: may reduce diuretic and antihypertensive effect

Other anti-androgens: additive hormonal effects

Pregnancy & Lactation ▼

Use only if clearly needed; avoid in first trimester if possible

Excreted in breast milk in small amounts; caution advised

Clinical / Research Summary ▼

Clinical Role: Potassium-sparing diuretic used in edema, hypertension, hyperaldosteronism, and hormonal disorders.

Advantage: Reduces potassium loss compared to loop or thiazide diuretics; anti-androgen effects useful in females.

Limitation: Risk of hyperkalemia and hormonal side effects; requires monitoring.

Monitoring: Serum potassium, renal function, blood pressure, hormonal side effects.

Patient Counseling Points ▼

Take with or after meals to improve absorption

Do not skip doses; take exactly as prescribed

Report signs of hyperkalemia: muscle weakness, palpitations

Regular monitoring of potassium, renal function, and blood pressure

Women: report menstrual changes or breast tenderness

Storage & Handling ▼

Store below 30°C

Protect from moisture and light

Keep out of reach of children

Brand Names (Bangladesh & Global) ▼

Bangladesh:

Inospiron Tablet Spiretic Tablet Spirocard Tablet Verospiron Tablet Aldactone Tablet

Global:

Aldactone® Spiroton®

Medical Disclaimer: For educational purposes only. Not a substitute for professional medical advice.

Reference Hubs:

• Drug Class: Potassium-sparing Diuretics • Condition: Edema • Condition: Hypertension • Condition: Hirsutism / Acne