Aldactone: Effective Potassium-Sparing Diuretic Therapy
| Product dosage: 100mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 60 | $1.10 | $66.15 (0%) | 🛒 Add to cart |
| 90 | $1.04 | $99.22 $93.21 (6%) | 🛒 Add to cart |
| 120 | $1.01 | $132.30 $121.27 (8%) | 🛒 Add to cart |
| 180 | $0.99 | $198.44 $177.40 (11%) | 🛒 Add to cart |
| 270 | $0.96 | $297.67 $259.58 (13%) | 🛒 Add to cart |
| 360 | $0.96
Best per pill | $396.89 $345.77 (13%) | 🛒 Add to cart |
Aldactone (spironolactone) is a prescription medication belonging to the class of potassium-sparing diuretics. It functions as a competitive antagonist of aldosterone, primarily acting on the distal renal tubules to promote sodium and water excretion while conserving potassium. This mechanism makes it uniquely valuable in managing conditions characterized by fluid overload and hormonal imbalances, particularly where potassium preservation is clinically advantageous. Its therapeutic applications extend beyond diuresis to include antiandrogenic effects in certain endocrine disorders.
Features
- Active ingredient: Spironolactone
- Drug class: Potassium-sparing diuretic and aldosterone antagonist
- Available formulations: 25mg, 50mg, and 100mg oral tablets
- Bioavailability: Approximately 90% following oral administration
- Protein binding: More than 90% to plasma proteins
- Metabolism: Hepatic, via CYP3A4 to active metabolites (including canrenone)
- Elimination half-life: 1.3-2 hours for spironolactone; 16-23 hours for active metabolites
- Excretion: Primarily renal (40-57%) and biliary (35-40%)
Benefits
- Effectively reduces edema and fluid retention in congestive heart failure, cirrhosis, and nephrotic syndrome
- Preserves potassium levels while promoting sodium excretion, reducing the need for potassium supplementation
- Demonstrates proven mortality benefit in patients with severe heart failure when used alongside standard therapy
- Provides targeted antiandrogenic effects for management of hirsutism in polycystic ovary syndrome
- Offers long-term cardiovascular and renal protection in resistant hypertension
- Reduces hospitalizations for heart failure exacerbations through sustained volume management
Common use
Aldactone is primarily indicated for the treatment of edema in congestive heart failure, cirrhosis of the liver accompanied by edema and/or ascites, and nephrotic syndrome. It is also approved for essential hypertension, particularly in cases where other antihypertensive agents have proven insufficient. Additionally, it is utilized in the diagnosis and treatment of primary hyperaldosteronism. Off-label applications include management of hirsutism, acne vulgaris in women, and potassium supplementation in hypokalemic states. The medication has established utility in heart failure with reduced ejection fraction as part of guideline-directed medical therapy.
Dosage and direction
Dosage must be individualized based on the condition being treated and patient response. For edema in adults: initial dose is typically 100mg daily in single or divided doses, ranging from 25mg to 200mg daily. For hypertension: initial dose is 50-100mg daily in single or divided doses. For hypokalemia: 25-100mg daily. For primary hyperaldosteronism: 100-400mg daily in preparation for surgery. Tablets should be taken with meals to enhance absorption and minimize gastrointestinal discomfort. Dosage adjustments are necessary in renal impairment, and periodic monitoring of electrolytes is essential during therapy.
Precautions
Patients should be monitored regularly for electrolyte imbalances, particularly hyperkalemia, which can be life-threatening. Renal function should be assessed before initiation and periodically during treatment. Use with caution in patients with renal impairment, hepatic dysfunction, or metabolic acidosis. Avoid potassium supplements and potassium-rich diets unless hypokalemia develops and dietary supplementation is inadequate. Elderly patients may be more susceptible to hyperkalemia and renal impairment. Caution is advised when operating machinery or driving until the patient’s response to therapy is established.
Contraindications
Aldactone is contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal function, or hyperkalemia. Additional contraindications include Addison’s disease and concomitant use with other potassium-sparing diuretics or potassium supplements. Hypersensitivity to spironolactone or any component of the formulation prohibits use. The medication is contraindicated in patients with demonstrated hypersensitivity to other sulfonamide-derived drugs, though cross-reactivity between drug classes is variable.
Possible side effect
Common adverse reactions include hyperkalemia (particularly in patients with renal impairment or excessive potassium intake), gynecomastia (dose-related and often reversible upon discontinuation), gastrointestinal disturbances (nausea, vomiting, diarrhea, cramping), drowsiness, lethargy, headache, and maculopapular eruptions. Less frequently reported effects include menstrual irregularities, impotence, hirsutism, deepening of the voice, and Stevens-Johnson syndrome. Drug rash with eosinophilia and systemic symptoms (DRESS) has been reported rarely. Electrolyte imbalances including hyponatremia and hypomagnesemia may occur.
Drug interaction
Significant interactions occur with ACE inhibitors, angiotensin II receptor blockers, NSAIDs, and other potassium-sparing agents, increasing hyperkalemia risk. Concurrent use with digoxin may alter digoxin clearance. Spironolactone may potentiate the effects of other antihypertensive medications. CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) may increase spironolactone concentrations. Inducers of CYP3A4 (rifampin, carbamazepine, phenytoin) may decrease efficacy. Lithium toxicity may be enhanced due to reduced renal clearance. Additive effects occur with other diuretics.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed administration. Consistent daily administration is important for maintaining therapeutic effect, particularly for hypertension management. Healthcare providers should be consulted if multiple doses are missed or if uncertainty exists about proper dosing.
Overdose
Symptoms of overdose primarily manifest as electrolyte disturbances, particularly hyperkalemia (muscle weakness, paralysis, arrhythmias) and hyponatremia (confusion, lethargy, seizures). Dehydration may occur due to excessive diuresis. Gastric lavage may be beneficial if performed soon after ingestion. Treatment is supportive and symptomatic, with particular attention to correcting electrolyte imbalances. Hyperkalemia may require calcium gluconate IV, glucose with insulin, sodium bicarbonate, or kayexalate. Hemodialysis may be effective in removing active metabolites, particularly in patients with renal impairment.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in a tight, light-resistant container. Keep away from moisture and heat. Do not store in bathroom cabinets where humidity levels fluctuate. Keep out of reach of children and pets. Properly discard any medication that is outdated or no longer needed through medication take-back programs or according to FDA guidelines. Do not flush medications down the toilet or pour into drains unless specifically instructed to do so.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Individual patient responses to Aldactone may vary. Healthcare professionals should consult full prescribing information before initiating therapy. Patients must not alter their dosage or discontinue medication without consulting their physician. This summary does not include all possible uses, directions, precautions, or interactions. Proper medical supervision is essential throughout treatment.
Reviews
Clinical studies demonstrate Aldactone’s efficacy in reducing mortality by 30% in severe heart failure when added to standard therapy (RALES trial). Meta-analyses confirm its beneficial effects in resistant hypertension with an average additional blood pressure reduction of 20-25/7-10 mmHg. Dermatological studies show significant improvement in hirsutism scores in 70-80% of patients with polycystic ovary syndrome after 6 months of therapy. Gastroenterological research indicates effective ascites control in 70% of cirrhotic patients. The medication maintains a favorable risk-benefit profile when appropriately monitored, though hyperkalemia remains a significant concern requiring vigilant management.