Spironolactone

Spironolactone

Spironolactone is indicated for the treatment of 

  • Congestive heart failure
  • Liver cirrhosis 
  • Conn’s syndrome 

This may also be used as an add-on therapy for the treatment of hypertension. Lowering high blood pressure may reduce the risk of fatal and non-fatal cardiovascular events, myocardial infarctions, and primarily strokes. 

The Food and Drug Administration (FDA) has already approved this medication. Spironolactone comes as a tablet for oral use. Each tablet is available in the dosage strengths of 25 mg, 50 mg, and 100 mg. 

Congestive heart failure

This is a chronic progressive condition that affects the pumping power of your heart muscles. Congestive heart failure specifically refers to the stage in which fluid builds up around the heart and causes it to pump efficiently. This condition develops when your ventricles can’t pump enough blood volume to the body. Eventually, blood and other fluids can back up inside of your:

  • Abdomen
  • Lungs
  • Lower body
  • Liver 

Liver cirrhosis

This is caused by many forms of liver disease and conditions. Each time your liver is injured, whether by disease or excessive alcohol consumption, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms which make it difficult for the liver to function. Some signs and symptoms of the condition may include:

  • Loss of appetite
  • Fatigue
  • Nausea
  • Weight loss
  • Itchy skin
  • Easily bleeding or bruising 

Conn’s syndrome 

This is a rare health problem that happens when the adrenal glands make too much aldosterone. Aldosterone is a hormone that controls salt and potassium levels in the blood. Too much of aldosterone may lead to high blood pressure. Signs and symptoms of Conn’s syndrome may include:

  • Frequent voiding
  • Lack of muscle strength
  • Headache
  • Nighttime voiding 
  • Increased thirst
  • Eyesight problems 
  • Muscle twitching and cramps
  • Paralysis that comes and goes 

How does Spironolactone work?

Spironolactone blocks the actions of a hormone in the body called aldosterone. This hormone is produced by glands found above the kidneys called the adrenal glands. Aldosterone acts in the kidneys where it is involved in controlling the balance of salt and water in the body. Blocking the action of aldosterone causes the kidneys to increase the number of salts such as sodium. It is those they filter out of the blood and into the urine. When these salts are filtered out of the blood by the kidneys, water is also drawn alongside. Spironolactone, therefore, increases the amount of water that is drawn out of the blood and into the urine. This helps excess fluid to be removed from the body.

Many conditions can lead to an accumulation of fluid in the body. These include heart failure where the fluid may build up in the lungs, causing breathlessness, or the ankles, causing swollen ankles. It may also be liver cirrhosis where fluid may build up in the abdominal cavity, causing a swollen abdomen. Spironolactone is used to remove excess fluid associated with these conditions and thus relieve the related symptoms.

How to use Spironolactone?

The recommended dosage will depend on your medical condition, age, and response to the treatment. You must take this medication exactly as it is prescribed. You should not take more or less or more often than it is given by your doctor. For the best benefit from this product, take it regularly. Do not stop taking this medication without the consent of your doctor. It may cause another complication or may worsen your current condition. 

Spironolactone is to be taken by mouth. It is to be taken exactly as directed by your doctor. You may take each dose with or without a meal. Swallow the drug as a whole with a full glass of water. Do not crush, break, or chew the tablets. Remember to take it at the same time and in the same way each day. If you missed a dose, take it as soon as you remember it. If it is almost time for your next dose, skip the missed dose and follow your regular schedule. Inform your doctor if your condition gets worse or does not improve. Let your doctor know if your condition does not improve. 

What are the side-effects of Spironolactone?

Common side effects:

  • Feeling confused
  • Stomach cramps
  • Dizziness or like you might pass out
  • Chills or fever
  • Sore throat
  • Headache
  • Diarrhea 
  • Any unexplained bruising or bleeding
  • Black or bloody stools
  • Menstrual or period changes
  • Breast pain
  • Enlarged breasts for males

Stop using this medication and call your doctor right away if you have these side effects:

  • Little or no urination
  • A light-headed feeling like you might pass out 
  • Low potassium (extreme thirst, leg discomfort, muscle weakness, or limp feeling)
  • Signs of stomach bleeding (coughing up blood, bloody or tarry stools, and vomit looks like coffee grounds)
  • Signs of other electrolyte imbalances (muscle spasms, vomiting, weak pulse, severe weakness, and loss of coordination)

Warnings and Precautions 

  • This medication is not recommended for use in people with high levels of potassium in their blood, severe kidney failure, or those with Addison’s disease.
  • Some people including the elderly may need a lower dose of this medication or extra monitoring. As well as people with decreased kidney or liver function and the hereditary blood disorder called porphyrias, this drug should be used carefully. 
  • Spironolactone should be used with caution during pregnancy and only if the expected benefit to the mother is greater than any possible risk to the baby. 
  • Spironolactone passes into breast milk in small amounts. Mothers who need treatment with this medicine should not breastfeed and bottle-feed their infants instead. Seek further medical advice from your doctor.
  • While you are taking Spironolactone, you should always check with your doctor before taking other medicine or on the patient information leaflet provided with your medication. 
  • Spironolactone may enhance the blood pressure-lowering effect of medicines used to treat high blood pressure. If you are taking medicines for high blood pressure in combination with Spironolactone and you frequently feel dizzy, you should let your doctor know as your medicine doses may need adjusting.