Spironolactone – Aldosterone antagonist for heart failure and hormonal conditions.
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What is Spironolactone?
Spironolactone is a unique medication that provides life-saving benefits for heart failure patients while also offering effective treatment for hormonal conditions in women. Its dual mechanism as both a cardiovascular medication and anti-androgen makes it valuable across multiple specialties.
Book an online consultation if you have heart failure, resistant high blood pressure, persistent hormonal acne, or excessive hair growth that may be hormone-related. Our GPs can assess your cardiovascular health or hormonal symptoms and determine if Spironolactone is appropriate for your specific condition.
What is Spironolactone used for?
- Heart failure with reduced ejection fraction
- Resistant hypertension
- Primary hyperaldosteronism
- Fluid retention (ascites, oedema)
- Hormonal acne in women
- Hirsutism (excessive hair growth) in women
- Post-myocardial infarction with heart failure
How does Spironolactone work?
A potassium-sparing diuretic that blocks aldosterone receptors, preventing sodium retention and potassium loss. This reduces fluid overload, lowers blood pressure, and provides cardioprotective benefits while maintaining potassium levels.
Dosage and Administration
Adults
Heart failure: 25mg once daily initially, increasing to 50mg daily. Hypertension: 25-100mg daily. Acne (women): 50-100mg daily. Adjust based on kidney function and potassium levels.
Children
Specialist supervision required—dosing based on weight and specific condition.
Important Notes
- Take with food to reduce stomach upset.
- Start with low dose and increase gradually.
- Regular monitoring of kidney function and potassium levels essential.
- For hormonal conditions, effects may take 3-6 months to see.
Side Effects
Common Side Effects
- Hyperkalemia (high potassium)
- Breast tenderness and enlargement
- Menstrual irregularities
- Fatigue and weakness
- Headache
- Nausea and stomach upset
- Dizziness
Serious Side Effects
Seek immediate medical attention if you experience:
- Dangerous hyperkalemia (life-threatening)
- Severe kidney problems
- Severe electrolyte imbalances
- Severe allergic reactions
- Liver problems
- Blood disorders
Important Warnings
- Regular blood tests essential to monitor potassium and kidney function.
- Tell your GP immediately if you develop muscle weakness, irregular heartbeat, or tingling.
- Avoid potassium supplements and salt substitutes unless specifically advised.
- Not suitable for patients with severe kidney disease or high potassium levels.
- Can cause breast enlargement in men and menstrual changes in women.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- ACE inhibitors and ARBs—increased risk of dangerous potassium levels.
- Potassium supplements—risk of life-threatening hyperkalemia.
- NSAIDs—may worsen kidney function and increase potassium.
- Lithium—may increase lithium levels.
- Digoxin—effects may be altered by potassium changes.
Frequently Asked Questions
How does Spironolactone help with heart failure?
It blocks aldosterone, reducing fluid retention and remodeling of the heart muscle. Studies show it significantly reduces hospitalization and death in heart failure patients.
Can Spironolactone help with hormonal acne?
Yes, in women it can reduce androgen effects on the skin, helping with hormonal acne and excessive hair growth. Effects typically take 3-6 months to see.
Why do I need regular blood tests with Spironolactone?
To monitor potassium levels, which can become dangerously high, and kidney function, which can be affected by the medication.
Can men take Spironolactone long-term?
Yes, but it can cause breast enlargement and tenderness in men due to anti-androgen effects. The benefits for heart conditions usually outweigh this side effect.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14