SPIRONOLACTONE

Brand & Generic Names

Aldactone
Novospiroton
Sincomen

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antihypertensive, diuretic

Uses

• Reduces high blood pressure.
• Prevents fluid retention.
• Treats hyperaldosteronism, hypokalemia, polycystic ovary syndrome, female hirsutism.

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid or food to lessen stomach irritation. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
1 dose a day--Take after breakfast.
More than 1 dose a day--Take last dose no later than 6 p.m.

If you forget a dose:
1 dose a day--Take as soon as you remember up to 12 hours late. If more than 12 hours, wait for next scheduled dose (don't double this dose).
More than 1 dose a day--Take as soon as you remember. Wait 6 hours for next dose.

What drug does:
Increases sodium and water excretion through increased urine production, decreasing body fluid and blood pressure.
Retains potassium.

Time lapse before drug works:
3 to 5 days.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Thirst, drowsiness, confusion, fatigue, weakness, nausea, vomiting, irregular heartbeat, excessive blood pressure drop.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Drowsiness or headache, thirst, nausea, vomiting, diarrhea, abdominal cramping, muscle cramps.

Infrequent:

• Confusion, irregular heartbeat, shortness of breath, constipation, breast tenderness, unusual sweating.
• Numbness, tingling in hands or feet; menstrual irregularities; change in sex drive; dizziness; energy loss.

Rare:

• Rash or itchy skin, fever.
• Deep voice in women, excess hair growth, voice change, enlarged clitoris in women.

Warnings & Precautions

Don't take if:

• You are allergic to spironolactone.
• You have impaired kidney function.
• Your serum potassium level is high.

Before you start, consult your doctor:

• If you have had kidney or liver disease.
• If you have diabetes.
• If you have menstrual abnormalities or breast enlargement.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:

• Limit use to 2 to 3 weeks if possible.
• Adverse reactions and side effects may be more frequent and severe than in younger persons.
• Heat or fever can reduce blood pressure. May require dose adjustment.
• Overdose and extended use may cause blood clots.

Pregnancy:
No proven harm to unborn child. Avoid if possible. Consult doctor.

Breast-feeding:
No proven problems. Consult doctor.

Infants & children:
Use only under medical supervision.

Prolonged use:

• Potassium retention with irregular heartbeat, unusual weakness and confusion.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure, kidney function, ECG* and serum electrolytes.

Skin & sunlight:
Increased sensitivity to sunlight.

Driving, piloting or hazardous work:
Avoid if you feel drowsy. Otherwise, no problems expected.

Discontinuing:
Consult doctor about adjusting doses of other drugs.

Others:
No problems expected.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
ACE inhibitors*:	Possible excessive
captopril, enalapril,	potassium in blood.
Amiloride	Dangerous potassium retention.
Anticoagulants*,	Possible decreased
oral	anticoagulant effect.
Antihypertensives*,	Increased antihypertensive
other	effect.
Aspirin	Decreased spironolactone effect.
Carteolol	Increased antihypertensive effect.
Cyclosporine	Possible excessive potassium in
	blood.
Digitalis	Decreased digitalis
preparations*	effect.
Diuretics*, other	Increased effect of both drugs.
	Beneficial if needed and dose is
	correct.
Laxatives*	Reduced potassium levels.
Lithium	Likely lithium toxicity.
Nicardipine	Blood pressure drop. Dosages may
	require adjustment.
Nimodipine	Dangerous blood pressure drop.
Nitrates*	Excessive blood pressure drop.
Potassium iodide	May raise potassium level in blood
	to toxic levels.
Potassium	Dangerous potassium retention,
supplements*	causing possible heartbeat
	irregularity.
Salicylates*	May decrease spironolactone effect.
Sodium bicarbonate	Reduced high potassium levels.
Sotalol	Increased antihypertensive effect.
Terazosin	Decreases effectiveness of
	terazosin.
Triamterene	Dangerous potassium retention.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Low-salt milk.	Possible potassium toxicity.
Cocaine:	Increased risk of heart block and
	high blood pressure.
Salt.	Don't restrict unless directed by
	doctor.
Salt substitutes.	Possible potassium toxicity.
Marijuana:	Increased thirst, fainting.
Tobacco:	None expected.