Last Updated on May 31, 2022 by Dr.Derek Fhisher
Most popular brand: Aldactone
Active ingredient: Spironolactone
Available dosage forms: 25, 100 mg
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Spironolactone: how it works, dosage, side effects & more
What is spironolactone?
Spironolactone, also known as spirolactone, is used in the treatment of severe acne that is not responding to other medicines. Spironolactone is a steroid that belongs to a class of drugs called aldosterone receptor blockers. Spironolactone works by blocking the action of aldosterone. Aldosterone is a hormone that acts on the kidneys to help regulate sodium and water levels in the body. Spironolactone can be used to treat: The use of spironolactone in the treatment of acne has not been studied.
Spironolactone is a man-made drug that causes potassium to be excreted by the kidneys. It’s used to treat both adrenal and potassium levels in the body. It’s also used to treat a condition called primary aldosteronism. Spironolactone is also used to treat certain types of kidney disease, high blood pressure and severe heart failure.
Aldosterone is a hormone that controls blood pressure. A lower blood pressure means a lower risk of heart attack, heart failure and stroke. Aldosterone also makes the body retain salt (electrolytes) and water. The result of these actions is that your blood pressure can drop too low. When this happens, your heart works harder to pump blood around the body and your kidneys need to work harder to remove the salt and water from your body and control blood pressure.
Because aldosterone is produced by the adrenal glands (a collection of small glands behind the kidneys) taking spironolactone can reduce the amount of aldosterone your body produces, and therefore help to lower your blood pressure.
Taking spironolactone can also decrease fluid retention in the body, which can make it easier for you to take in enough salt (electrolytes) and water for the body.
Spironolactone is sometimes prescribed to increase breast feeding in women.
How does spironolactone work?
Spironolactone is an antiandrogen, which means that it is a hormone that blocks androgens (testosterone, its male form, and related substances) from attaching to their receptors. This is what allows the growth of the prostate and production of the fluid that contributes to the signs of BPH. Spironolactone does not interfere with estrogen. This means that it won’t be effective for men who have a condition that causes a buildup of estrogen.
Spironolactone works by preventing aldosterone from binding to your cells. The higher your levels of aldosterone, the higher your potassium levels. Therefore, if you take this medication, the aldosterone will be prevented from binding with your cells and then your body can absorb and excrete potassium more efficiently.
How should I use spironolactone?
Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. If you are taking an extended-release tablet, you may take your doses once daily with meals or as directed by your doctor. Swallow the tablet with a full glass of water. Do not lie down for at least 30 minutes after taking the tablet. Take this medication with a full glass of water. Do not lie down for at least 30 minutes after taking this medicine. Store this medication in the refrigerator, do not freeze.
What happens if I miss a dose?
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include headache, dizziness, rapid or irregular heartbeat, hallucinations, and severe weakness.
What should I avoid while using spironolactone?
Avoid drinking alcohol while taking spironolactone because it may increase the risk of side effects.
What are the possible side effects of spironolactone?
Get emergency medical help if you have signs of an allergic reaction to spironolactone: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects: fever, sore throat, painful or burning urination, painful or difficult urination; new or increased back or side pain; blurred vision; rapid weight gain; feeling like passing out; loss of appetite; swelling, weight gain, or fluid retention. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
What other drugs will affect spironolactone?
Other drugs may interact with spironolactone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Where can I get more information? Your pharmacist can provide more information about spironolactone. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Just like many powerful prescription medications, spironolactone has some side effects you need to know about before taking it. At present, spironolactone is just available by prescription from your physician. An individual taking hydrochlorothiazide might feel dizzy within the initial days of remedy. To begin with, this drug should always be used under medical supervision.
If you’re pregnant or desire to develop into pregnant during the treatment, it is recommended to talk with your doctor. Before you intake the medicine it’s always wise to seek advice from your doctor. As soon as you start to select the medicine, don’t miss it. Pregnancy during spironolactone therapy needs to be avoided.
Those people about to undergo a surgery, even if it’s a dental surgery, they need to inform the physician if they’re using spironolactone. The rest of the kinds of tumors that secrete hCG can likewise increase estrogen also. Testosterone is basically a male hormone, but it really is also present in women in little amounts. I saw results just also as Propecia, except without needing to manage some of the negative facets of the drug.
Older patients are somewhat more possible to suffer from the side results and could require close observation. Aspirin could also decrease the results of spironolactone. It is likewise utilized to treat or avoid hypokalemia (low potassium levels within the blood). Drink a lot of water while on the medication, as additionally, it functions as a diuretic.
If you’re over 17 years old, then you don’t even require a prescription to purchase morning after pill. The morning after pill will not affect your luck of getting pregnant later on. Additionally, due to the higher urination, the ideal time to select the drug is really in the morning so you don’t wind up waking right up in the middle of the night to really go pee.
Spironolactone or flutamide used in the treatment of acne issue. That drop will raise the effect of androgens on your own entire body and cause oilier skin. Aloe vera can assist with baldness.
As the kidney accounts for throwing away the extra water away from the body, any issue with the kidney can lead to water retention to occur. They also eliminate hair after various illness, after suffering a superior fever, and after shedding weight rapidly. The source of this ailment are certainly unclear and there’s no very clear cause. You must speak with your physician to specify the specific causes of your own symptoms, and talk about the treatment possibilities that are available to you.
It shouldn’t be used if you’re suffering with kidney difficulties, breast cancer, ovarian cancer or uterine cancer. Additionally It is possible that increased estrogen levels can happen in certain testicular tumors in addition to in hyperthyroidism. Flutamide can also be used to take care of excess androgen levels in women, which is here the drug has also been utilized to treat female baldness. It is stated the drug can be helpful for female baldness treatment too, but there aren’t any substantial results.
When water gets accumulated within the body, the individual has a tendency to put on a tiny weight, which could be very frustrating. It doesn’t target the source of hair loss and cannot work for everybody. The common way is to eliminate unwanted hair.
Spironolactone is used for healing hormonal acne breakout also. The reason is the fact that while spironolactone for acne is common, it’s likewise utilized as a significant blood pressure treatment. As a result of its antiandrogen effects, the usage of spironolactone is frequently recommended for treating acne or hirsutism. Here’s a big advantage and it’s also related to spironolactone acne treatments.
Doctors generally don’t recommend it for treating hair fall in men. If treatment isn’t started once possible after the very first hints of hair loss appear, there’s a chance that extended androgenic alopecia will destroy a whole lot of hair follicles. Spironolactone acne treatment is only going to help women with this specific particular hormonal acne. Still, They will help lessen the male hormone levels and decrease acne.
If you come from a family with a very long field of hair loss complications, you might want to learn how to embrace the fact your hair will gradually fall out and it’ll never grow back again. Currently, hair loss is quite a standard problem and both women and men are suffering from it. Mostly, women suffer with acne issue. Now, women can bid farewell to acne issue.
Spironolactone medical info
Spironolactone is a mild potassium-saving diuretic, a competitive aldosterone antagonist. It is used for hypertension, hypokalemia, edema syndrome, congestive heart failure, nephrotic syndrome, adrenal adenoma, hyperaldosteronism.
Spironolactone is a potassium-saving diuretic, a competitive antagonist of aldosterone, a mineral – corticosteroid hormone of the adrenal cortex.
Accumulative potassium diuretics have a relatively weak diuretic effect, so spironolactone can be called a mild diuretic.
Aldosterone regulates endogenous water balance: the higher the aldosterone level, the more water accumulates in the body. Aldosterone speeds up the excretion of potassium from the body and prevents strong sodium and water excretion (facilitates Na+ reabsorption in the renal tubules).
As an aldosterone antagonist, spironolactone competitively binds to aldosterone receptors in the distal renal tubules.
The use of spironolactone reduces the aldosterone level in the body and thus increases the excretion of sodium, chloride and water from the body, which simultaneously leads to the accumulation of potassium and magnesium (unlike furosemide and thiazide a).
Diuretic effect occurs on the 2nd to 5th day of treatment and lasts for 2 to 3 days after discontinuation of spironolactone.
Spironolactone reduces titratable acidity of urine. Increased diuresis causes a hypotensive effect that is not permanent.
Spironolactone has anti-androgenic properties, so it slightly reduces the level of androgens in the blood. This property is used to minimize the phenomenon of masculinization during the steroid course, as well as after it to return to femininity.
When taken orally, it is quickly absorbed from the gastrointestinal tract. Bioavailability is 90 – 100%. Food intake increases absorption and bioavailability of spironolactone.
Cmax when taking 100 mg daily for 15 days is 80 ng/ml, TCmax after morning administration is. 2,6 ч.
It is rapidly metabolized in the liver. Reversible “first pass” effect. The main metabolites of spironolactone are canrenone (canrenate) and 7 – alpha – (thiomethyl) – spironolactone. T1 / 2 – 13 – 24 hours.
Binding to plasma proteins -. 98% (canrenone – 90%).
Spironolactone and its metabolites penetrate the placenta, excreted in breast milk.
It is excreted in the urine (50% – as metabolites, 10% – unchanged), partly in the bile and feces. Excretion of canrenone (mainly by kidneys) is biphasic, T1/2 in the first phase is 3 – 2 hours, in the second phase – 12 – 96 hours.
In liver cirrhosis and heart failure T1/2 is increased without signs of accumulation (possibility of its. increase against the background of chronic renal failure and hyperkalemia).
- hypertension (as part of combination therapy);
- hypokalemia, prevention of hypokalemia in the treatment saluretikami, digitalis preparations;
- edema syndrome in patients with chronic heart failure, nephrotic syndrome, nephropathy pregnant women, newborns;
- cirrhosis, accompanied by ascites and / or swelling;
- primary hyperaldosteronism – Conn’s syndrome (for further diagnosis and in preparation for surgery);
- adrenal adenoma producing aldosterone (long-term maintenance therapy with contraindications to surgery or in case of refusal from it);
- idiopathic aldosteronism;
- myasthenia gravis (aid);
- hirsutism, polycystic ovary syndrome, premenstrual syndrome (aid);
- asthma complicated by right heart failure (adjuvant).
Dosage and administration:
Orally, with food or milk in a single dose at breakfast. The dose is determined individually, depending on the severity of disorders of water-electrolyte metabolism and hormonal status.
In case of edema syndrome development in patients with chronic heart failure, liver cirrhosis, nephrotic syndrome, spironolactone is prescribed in initial daily dose 100 mg (once or in 2 – 4 doses). Thereafter (usually after 5 days), depending on clinical effect, the daily dose of spironolactone may be reduced to 25 mg or gradually increased to 200 mg (in hydropic syndrome in cirrhosis, depending on the ratio of potassium to sodium – Na+/K+ ratio, at least one daily dose is 100 mg, if the ratio is greater than 1 – 200 – 400 mg/day). If the expected diuretic effect does not develop, another diuretic acting on the proximal renal tubules (in combination with a loop or thiazide diuretic) is prescribed; the dose of spironolactone should not be changed. The maintenance dose is determined individually.
In essential hypertension, the initial daily dose of spironolactone is 50 to 100 mg (in one or 2 to 4 doses), usually in combination with antihypertensive agents. If necessary, the daily dose is gradually increased over 2 weeks to 200 mg. The duration of treatment should be at least 2 weeks.
To prevent hypokalemia caused by taking saluretics, spironolactone is used in a daily dose of 25 to 100 mg once or in divided doses (maximum daily dose is 400 mg).
Spironolactone can be used for primary diagnosis as an indirect indicator of primary aldosteronism in patients who are on a normal diet. For this purpose, perform appropriate tests.
Long-term test: spironolactone is administered at a daily dose of 400 mg for 3 to 4 weeks in adults. Elimination of hypokalemia and hypertension is indirectly indicative of primary hyperaldosteronism.
Short test: spironolactone is administered in a daily dose of 400 mg for four days. If serum potassium concentrations increase while taking the drug and decrease when spironolactone is withdrawn, the result may indirectly indicate primary hyperaldosteronism.
Once hyperaldosteronism is diagnosed with a more informative diagnostic test, spironolactone may be administered in preparation for surgery at a dose of 100 to 400 mg/day in 2 to 4 divided doses.
For patients not undergoing surgery, spironolactone may be used as long-term maintenance therapy at minimal effective doses that are set on an individual basis.
Idiopathic hyperaldosteronism – 100 mg/day. the regimen is adjusted based on plasma K+ concentration values. In severe hyperaldosteronism and reduced plasma K+ content, spironolactone is prescribed in a daily dose of 300 mg in 2 to 3 doses (up to 400 mg/day), with improvement of condition, the dose is gradually reduced to 25 mg/day.
In polycystic ovaries and hirsutism, 100 mg twice daily. Children
as a diuretic and antihypertensive agent, spironolactone is indicated at a daily dose of 1 to 3.3 mg/kg, or 30 to 90 mg per square meter of body surface. The frequency of administration is 1 to 4 times per day. After 5 days, the dose is increased and adjusted if necessary.
Symptoms: nausea, vomiting, dizziness, drowsiness, confusion, rash and diarrhea. Possible disorders of water-electrolyte balance and dehydration: severe hyperkalemia (paresthesia, muscle weakness, arrhythmia), hyponatremia (dry mouth, thirst, drowsiness, etc.), hypercalcemia, increased blood urea levels.
Treatment: stop taking the drug, induce vomiting and gastric lavage. There is no specific antidote. Symptomatic treatment of dehydration, disorders of water – electrolyte balance, arterial hypotension is necessary. Elimination of hyperkalemia is achieved by rapid administration of glucose (10 – 20% solution) and insulin at the rate of 0.25 – 0.5 units per 1 g of glucose. Potassium-exchanging diuretics and ion-exchange resins are used. Hemodialysis is possible.