From the Guidelines
Aldactone (Spironolactone) is a potassium-sparing diuretic that acts as an aldosterone antagonist, used to treat conditions such as heart failure and resistant hypertension.
Key Characteristics
- It works by blocking the effects of aldosterone, a hormone that promotes water retention and increases blood pressure 1
- The typical dose of spironolactone is 12.5 to 25 mg daily, or occasionally on alternate days, with a maximum dose of 50 mg daily 1
- Common side effects include hyperkalemia, renal dysfunction, and gynecomastia, which can be mitigated with careful monitoring and dose adjustment 1
Clinical Use
- Spironolactone has been shown to reduce mortality and hospitalization rates in patients with severe heart failure, with a relative risk reduction of 30% and an absolute risk reduction of 11.4% 1
- It is also used to treat resistant hypertension, with studies suggesting that it can provide additional blood pressure lowering when added to other treatments 1
Important Considerations
- Patients with renal dysfunction or hyperkalemia should be monitored closely, as spironolactone can exacerbate these conditions 1
- The use of spironolactone in combination with other medications, such as ACE inhibitors and ARBs, requires careful consideration and monitoring to minimize the risk of hyperkalemia and renal dysfunction 1
From the FDA Drug Label
Spironolactone tablets, USP contain 25 mg, 50 mg, or 100 mg of the aldosterone antagonist spironolactone, 17-hydroxy-7α-mercapto-3-oxo-17α-pregn-4-ene-21-carboxylic acid γ-lactone acetate Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule.
Aldactone (Spironolactone) is an aldosterone antagonist that acts as a diuretic and antihypertensive drug by competing with aldosterone for receptor sites, causing increased amounts of sodium and water to be excreted, while potassium is retained 2.
From the Research
What is Aldactone (Spironolactone)?
Aldactone, also known as Spironolactone, is a synthetic 17-lactone steroid that primarily acts as an aldosterone antagonist 3. It has been used for over 50 years in the treatment of various conditions, including hypertension, heart failure, and dermatological conditions such as acne, hirsutism, and female pattern hair loss.
Mechanism of Action
Spironolactone's antiandrogenic effects are exerted by reducing testosterone production and inhibiting its action on target tissues 3. It also has a role as a potassium-sparing diuretic, which makes it useful in the treatment of conditions such as liver cirrhosis, idiopathic edema, and nephrosis 4.
Uses in Dermatology
Spironolactone is used in the treatment of various dermatological conditions, including:
Other Uses
Spironolactone is also used in the treatment of:
- Resistant hypertension 7
- Primary hyperaldosteronism 4, 7
- Heart failure with reduced ejection fraction 7
- Polycystic ovary syndrome 4
Important Considerations
Spironolactone should not be used in pregnancy due to its teratogenic effects and is not used in men due to the risk of feminization 3. It is also important to note that spironolactone has a long-term safety profile, but continuous treatment is required to sustain its effects 3.