by Dr. Manura Nanayakkara

Created on: July 08, 2010   Last Updated: July 10, 2010

Spironolactone is a prescription only diuretic in the Aldosterone receptor blocker family. Its commonest brand name is Aldactone®. This drug acts on distal renal tubules in human nephrons and excretes excess water and salt. This medication is prescribed to remove edema fluid in cirrhosis, nephritic syndrome and in heart failure. This medicationi is also co- prescribed with other diuretics like Lasix ® to enhance diuretic effect and to prevent losing potassium. Main side effects are gastro intestinal disturbances and dry mouth.

Human Aldosterone hormone removes potassium, retains sodium and water. Spironolactone inhibits Aldosterone action and retains potassium and excretes sodium and water. So it is a potassium sparing diuretic and has some antihypertensive effects as well.

 Before prescribing Spironolactone the doctor should know a patient’s complete medical history including over the counter medication he/she is currently on. If the patient has kidney disease, liver disease, Addison’s disease or acute porphyria then he/she should discuss it with the doctor before taking Spironolactone. The doctor may not prescribe Spironolactone, if the patient is pregnant . This medicationi is found to be toxic to the fetus, in animal studies. Even though, amount found in breast milk are too small, manufacturer advices to avoid in breast feeding.

Spironolactone is available as tablets. Tablets should be taken as a whole with a full glass of water to minimize side effects. This medication can be taken without regard to the meals.

Main side effects

Most common side effects are gastro intestinal disturbances like nausea/vomiting. Serious electrolyte imbalance with reduced sodium, increased potassium and increased magnesium can occur with this medication. Some patients can get impotence. Abnormally increased breast size is another side effect. Menstrual irregularities are reported with some women. Headache is another side effect that can be controlled by pain killers. Certain patients can get confused with this medication, especially elderly patients. Some patients have reported rashes.

Liver damage is another side effect. If patient gets severe nausea and vomiting, with appetite loss then he/she should seek medical help.

Allergic reactions like hives, rashes and anaphylaxis can occur. If a patient develops wide spread hives, faintishness, skin peeling off from the body, then medical help should be sought right away.

Inflammation and destruction of the pancrease is sometimes reported with certain patients, severe abdominal pain is the usual presenting feature.

Sometimes reduced white blood cell counts can occur with Spironolactone. This can be due to bone marrow suppression. The Patient can have anemia, increased bleeding tendency and infections as a result of this.

 Sources

British National Formulary

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