Spironolactone(speer on oh lak’ tone)
Aldactone, Novo-Spiroton (CAN)
PREGNANCY CATEGORY C
PREGNANCY CATEGORY D (GESTATIONAL HYPERTENSION)
Drug Classes
Aldosterone antagonist
Potassium-sparing diuretic
Therapeutic Actions
Competitively blocks the effects of aldosterone in the renal tubule, causing loss of sodium and water and retention of potassium.
Indications
Diagnosis and maintenance of primary hyperaldosteronism
Adjunctive therapy in edema associated with HF, nephrotic syndrome, hepatic cirrhosis when other therapies are inadequate or inappropriate
Treatment of hypokalemia or prevention of hypokalemia in patients who would be at high risk if hypokalemia occurred (eg, patients receiving cardiac glycosides), patients with cardiac arrhythmias
Essential hypertension, usually in combination with other drugs
Adjunctive therapy for treatment of severe heart failure (NYHA class III to IV) to increase survival and decrease need for hospitalization
Unlabeled uses: Treatment of hirsutism because of its antiandrogenic properties, palliation of symptoms of PMS, treatment of familial male precocious puberty, short-term treatment of acne vulgaris, pediatric hypertension
Contraindications and Cautions
Contraindicated with allergy to spironolactone, hyperkalemia, renal disease, anuria, amiloride or triamterene use.
Use cautiously with pregnancy, lactation.
Available Forms
Tablets—25, 50, 100 mg
Dosages
Adults
Edema: Initially, 100 mg/day PO (range, 25–200 mg/day). When given as the sole agent, continue at least 5 days; then adjust dosage or add another diuretic or both.
Diagnosis of hyperaldosteronism: 400 mg/day PO for 3–4 wk (long test). Correction of hypokalemia and hypertension are presumptive evidence of primary hyperaldosteronism. 400 mg/day PO for 4 days (short test). If serum potassium increases but decreases when drug is stopped, presumptive diagnosis can be made.
Maintenance therapy for hyperaldosteronism: 100–400 mg/day PO in preparation for surgery.
Essential hypertension: 50–100 mg/day PO. Continue treatment for at least 2 wk before reevaluating. May be combined with other diuretics.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
