Aldosterone is a hormone made in the body that causes water retention. By blocking aldosterone, this medication treats fluid retention (edema). This process stops potassium from leaving the body, hence the name potassium-sparing diuretics. Aldactone can also lower blood pressure by blocking aldosterone’s effect on your blood vessels.
Spironolactone’s ability to block androgen (male hormone) receptors has led to its off-label use for acne, hirsutism in females (sex assigned at birth), and hormone therapy. However, these anti-androgenic properties mean this medication should be avoided during pregnancy.
Spironolactone is available in tablet form under the brand name Aldactone and suspension (liquid) form under the brand name Carospir. These dosage forms are not interchangeable; the tablet and suspension release the medication differently in the body. Only take the dosage form prescribed by your healthcare provider.
What Is Aldactone Used For?
The Food and Drug Administration (FDA) has approved spironolactone to treat:
Brand Name(s): Aldactone (tablets), Carospir (liquid)
Drug Availability: Prescription
Therapeutic Classification: Diuretic
Available Generically: Yes, only in tablet form
Controlled Substance: N/A
Administration Route: Oral
Active Ingredient: Spironolactone
Dosage Form: Tablet, liquid
High blood pressure Heart failure Excessive secretion of aldosterone (hyperaldosteronism) Fluid retention in people with congestive heart failure, liver cirrhosis, or a kidney disorder called nephrotic syndrome
Because of its anti-androgenic properties, spironolactone is commonly used off-label (for purposes not approved by the FDA) to treat:
Hirsutism in females (sex assigned at birth), often associated with polycystic ovary syndrome (PCOS) Gender-affirming hormone therapy for individuals transitioning from male (sex assigned at birth) to female Acne in females Female pattern hair loss
How to Take Aldactone
Spironolactone is available as an oral tablet and liquid suspension. These are meant to be taken by mouth. How often you take it depends on what condition you are treating and how your body reacts to the medication.
This medication can be taken with or without food, but the administration should stay consistent. If you take it with food, then continue to do so. If you take it without food, you should continue doing so.
The liquid suspension should be shaken well before each use.
Storage
People should store spironolactone at a controlled room temperature of about 68 F to 77 F.
Always carry your medication with you when traveling. If you are flying, keep the original prescription-labeled bottle or box in your carry-on bag. Don’t leave this medication in your car, especially in cold or hot temperatures.
Off-Label Uses
Healthcare providers may prescribe spironolactone for off-label uses, meaning for conditions not specifically indicated by the FDA.
Some of these off-label uses include:
Hirsutism (abnormal facial hair) in females (sex assigned at birth), often associated with PCOS Gender-affirming hormone therapy for individuals transitioning from male (sex assigned at birth) to female Acne in females Female pattern hair loss Precocious puberty, which is a condition that causes children to enter puberty too early Myasthenia gravis, a disease in which the nerves do not function properly
What Are the Side Effects of Aldactone?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Like most medications, spironolactone can cause mild or serious side effects.
Common Side Effects
The most common side effects of spironolactone include:
Breast enlargement (gynecomastia) Digestive effects, such as nausea, vomiting, diarrhea, or abdominal cramping Leg cramps High potassium levels (hyperkalemia) Drowsiness Dizziness Itching Irregular menstrual cycles
Talk to your healthcare provider or pharmacist if your side effects persist or become more severe.
Severe Side Effects
Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and symptoms can include the following:
Allergic reactions: Symptoms can include hives, shortness of breath, rash, fever, or swelling of the lips, mouth, or tongue. Dangerously high potassium levels: Symptoms may include muscle weakness, extreme tiredness, tingling or numbness in your hands or feet, inability to move your arms or legs, and slow heart rate. Electrolyte problems: Symptoms are extreme thirst, dry mouth, dizziness, fast heart rate, inability to urinate, and extreme tiredness. Severe skin reactions: These may include skin redness, blistering, or loose skin. Gynecomastia
Dosage: How Much Spironolactone Should I Take?
Modifications
Due to the possible effects of this medication, there may be changes to how it is used. Therefore, users need to be aware of the following when taking spironolactone.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For edema: For oral dosage form (suspension): Adults—At first, 75 milligrams (mg) (15 milliliters [mL]) per day, taken in either single or divided doses. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults—At first, 100 milligrams (mg) per day, taken in either single or divided doses. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor. For heart failure: For oral dosage form (suspension): Adults—At first, 20 milligrams (mg) (4 milliliters [mL]) per day. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults—At first, 25 milligrams (mg) once a day. Your doctor may adjust your dose as needed and tolerated. Children—Use and dose must be determined by your doctor. For high blood pressure: For oral dosage form (suspension): Adults—At first, 20 milligrams (mg) (4 milliliters [mL]) to 75 mg (15 mL) per day, taken in either single or divided doses. Your doctor may adjust your dose if needed. Children—Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults—At first, 25 to 100 milligrams (mg) per day, taken in either single or divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 100 mg per day. Children—Use and dose must be determined by your doctor. For too much aldosterone in the body: For oral dosage form (tablets): Adults—Use and dose must be determined by your doctor. The dose is usually 100 to 400 milligrams (mg) per day to prepare for surgery. Children—Use and dose must be determined by your doctor.
Dosage adjustment may be required for:
Adults 65 and olderPeople with reduced kidney or liver functionHyperkalemia (too much potassium)
Tell your healthcare provider if you have difficulty swallowing pills. A liquid (suspension) form is available under the brand name Carospir. Your healthcare provider may prescribe the liquid formulation, depending on your condition.
Missed Dose
If you miss a dose of Aldactone, take the missed dose as soon as you remember. But if it is almost time for the next scheduled dose, you should skip the dose you missed. Do not take extra to make up for the missed dose. Doing so can increase your risk for side effects.
Overdose: What Happens If I Take Too Much Aldactone?
If you take too much spironolactone, you may begin to experience:
DrowsinessConfusionDizzinessNauseaMuscle pain or crampingDiarrhea
Hyperkalemia can occur, especially in people with impaired kidney function. Treatment of an overdose may be supportive for hydration, electrolyte balance, and vital functions.
Precautions
What Are Reasons I Shouldn’t Take Aldactone?
There are a few reasons why your healthcare provider may not choose Aldactone as part of your treatment plan.
Do not take this medicine together with eplerenone (Inspra®). Using these medicines together may cause serious unwanted effects.
Do not take other medicines unless they have been discussed with your doctor. This especially includes potassium supplements or salt substitutes containing potassium, certain diuretics (eg, amiloride, triamterene (Dyazide®, Dyrenium®, Maxzide®, Midamor®, Moduretic®), or other products containing spironolactone (Aldactazide®).
Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have the following symptoms: stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, or weakness or heaviness of the legs. Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.
Spironolactone may worsen kidney function in patients with low to no salt in their body or in those who take other blood pressure medicines (eg, ARB, ACE inhibitor). Talk to your doctor if you have concerns about this.
Dizziness, lightheadedness, or fainting may also occur, especially when you get up suddenly from a lying or sitting position. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.
This medicine may also cause electrolyte imbalances (including low sodium, magnesium, and calcium in the blood, hypochloremic alkalosis) and an increase in your uric acid and blood sugar levels. Talk to your doctor if you have concerns.
Check with your doctor right away if you become sick while taking this medicine, especially if you have severe or continuing nausea, vomiting, or diarrhea that does not stop. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.
This medicine may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.
Make sure any doctor or dentist who treats you knows that you are using this medicine.
Allergy
A person should not take Aldactone if they are allergic to the ingredients.
Pregnancy
Research has shown adverse effects to the fetus when spironolactone is used during pregnancy. However, there are not enough human studies to be certain how this drug may affect the fetus.
Aldactone should only be used during pregnancy if the benefits outweigh the risks. It is best to talk to your healthcare provider if you are pregnant or plan to become pregnant so that they can decide the best option for you.
Breastfeeding
The active metabolite, a substance that breaks down from the drug, does pass into human milk. As a result, the World Health Organization listed this medication as compatible with breastfeeding, but those considerations should weigh the risks versus the benefits. Talk with your healthcare provider if you are breastfeeding as you may need to decide if you should stop taking Aldactone or stop breastfeeding.
Children
Aldactone should not be used in children under 18.
What Other Medications Interact With Aldactone?
People taking Inspra (eplerenone) or Dyrenium (triamterene) should not take spironolactone. Your healthcare provider may prescribe another medication or change your treatment if you use either.
Spironolactone can interact with several kinds of drugs. However, not all drug interactions may require complete avoidance. Spironolactone may still be administered with these medications to treat certain conditions. A healthcare provider will closely monitor you for side effects in these cases.
Spironolactone can interact with the following drugs:
Angiotensin-converting enzyme (ACE) inhibitors, such as Lotensin (benazepril) and Altace (ramipril), among others Angiotensin II receptor blockers (ARBs), such as Cozaar (losartan) and Diovan (valsartan), among others Heparin Other potassium-sparing diuretics, such as eplerenone Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen), Mobic (meloxicam), and Aleve or Naprosyn (naproxen) Lithobid (lithium) Lanoxin (digoxin) Prevalite (cholestyramine)
Taking Aldactone with ACE inhibitors, ARBs, NSAIDs, or heparin can increase potassium levels, which may lead to severe hyperkalemia. NSAIDs can also reduce the effect of Aldactone when taken together. Make sure to let your healthcare provider know if you take these medications, you may need to be monitored closely to ensure spironolactone is working effectively.
Taking drugs like digoxin and lithium during Aldactone treatment can increase exposure to those drugs in the body, leading to toxicity.
This list does not include all drugs that can interact with spironolactone. Despite their interaction, many of these medications may still be administered with Aldactone. Your healthcare provider will monitor you for all medications that you take.
Before taking Aldactone, tell your healthcare provider about all the prescription medications, over-the-counter (OTC) medications, vitamins, supplements, or herbs you take. This will help you avoid potential interactions. Ask your healthcare provider or pharmacist if you are unsure about drug interactions.
What Medications Are Similar?
Aldactone is part of one type class of diuretics, aldosterone antagonists, or potassium-sparing diuretics. There are two other kinds of diuretics: loop diuretics and thiazides diuretics. A few other commonly prescribed diuretics include:
Microzide (hydrochlorothiazide) Lasix (furosemide) Inspra (eplerenone)
This list is a list of drugs in similar drug classes as Aldactone. It is not a list of drugs recommended to take with Aldactone. Discuss any questions or concerns with your healthcare provider or pharmacist.
How Can I Stay Healthy While Taking Aldactone?
Aldactone is a safe and effective medication when used correctly.
It is also commonly used off-label for acne, female hair loss, hirsutism in females, and hormone therapy.
Although Aldactone does have the potential for serious side effects, the most common side effects tend to be mild. Those might include drowsiness, dizziness, or leg cramps.
Make sure to inform your healthcare provider of all of your other health conditions and prescription medications, OTC medications, vitamins, supplements, or herbs you are taking. This way, your healthcare provider can determine the most appropriate dosage for you.
