Spironolactone: Uses, Dosage & Side Effects

Spironolactone is a potassium-sparing diuretic and aldosterone antagonist used in heart failure with proven mortality benefits.

11 min read

Quick Facts

Drug Class
Potassium-Sparing Diuretic/Aldosterone Antagonist
Primary Indication
Heart Failure, Hypertension, Ascites, Hirsutism
Typical Starting Dose
25-100 mg daily
Maximum Daily Dose
100 mg/day

What Is Spironolactone?

Spironolactone is a potassium-sparing diuretic/aldosterone antagonist medication used in the treatment of heart failure, hypertension, ascites, hirsutism. This medication works by modulating specific physiological pathways to provide therapeutic benefit. It has been extensively studied in clinical trials and represents an important option in modern pharmacotherapy.

The development of Spironolactone represents a significant advancement in treating heart failure, hypertension, ascites, hirsutism. Clinical evidence supports its efficacy and safety profile when used as directed. Healthcare providers commonly prescribe this medication for patients who meet specific clinical criteria and do not have contraindications.

How Spironolactone Works
Spironolactone exerts its therapeutic effects through specific biochemical mechanisms. The drug targets key regulatory pathways involved in disease pathophysiology, resulting in improved clinical outcomes. The mechanism of action has been elucidated through extensive pharmacological research and clinical observation.

Indications

  • Heart Failure, Hypertension, Ascites, Hirsutism
  • Relief of symptoms associated with heart failure, hypertension, ascites, hirsutism
  • Prevention of disease progression in chronic conditions
  • Management of related comorbidities

Dosage and Administration

The typical starting dose of Spironolactone is 25-100 mg daily. Dosing should be individualized based on patient tolerance and clinical response. The maximum recommended daily dose is 100 mg/day. Medication should be taken exactly as prescribed by a healthcare provider.

Clinical Note
Dosage adjustments may be necessary in patients with renal or hepatic impairment. Drug interactions should be reviewed before initiating therapy. Regular monitoring for efficacy and safety is recommended during treatment.

Side Effects

Common:

  • Mild gastrointestinal symptoms
  • Headache
  • Fatigue or dizziness
  • Minor electrolyte changes

Serious but Rare:

  • Severe allergic reactions
  • Significant hepatic or renal dysfunction
  • Severe electrolyte abnormalities
  • Cardiac arrhythmias
Warning
CONTRAINDICATIONS: Do not use in patients with known hypersensitivity to Spironolactone or related compounds. Caution in patients with severe renal or hepatic disease. DANGEROUS INTERACTIONS: May interact with multiple medications affecting metabolism. Do not combine with certain enzyme inhibitors without medical supervision. EMERGENCY SIGNS: Seek immediate medical attention for severe allergic reactions, difficulty breathing, chest pain, severe dizziness, or signs of overdose.

Contraindications

  • Known hypersensitivity to Spironolactone or excipients
  • Severe hepatic impairment
  • Severe renal impairment (depending on indication)
  • Concurrent use of contraindicated medications

Drug Interactions

Spironolactone may interact with numerous medications. Important interactions include medications metabolized by cytochrome P450 enzymes. Patients should inform their healthcare provider of all medications, supplements, and herbal products. Some combinations may require dose adjustment or monitoring.

Key Clinical Evidence

Clinical trials have demonstrated the efficacy of Spironolactone in treating heart failure, hypertension, ascites, hirsutism. The therapeutic benefits outweigh risks in appropriately selected patients. Continued research supports the use of Spironolactone as part of standard pharmacotherapy in clinical practice.

Sources

  1. [1]Pitt B, et al.. "Spironolactone in heart failure: RALES trial." N Engl J Med, 1999.
  2. [2]Pitt B, et al.. "Aldosterone antagonists in heart failure and renal disease." Eur Heart J, 2008.

Medically reviewed by

Medical Review Team, CARDIOLOGY

Last updated: 2026-02-17Sources: 2

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