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SpironolactoneAka: Aldactone

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  1. Definition
    1. Potassium-Sparing Diuretic via aldosterone blockade
  2. Indications
    1. Left-sided Congestive Heart Failure
      1. First line agent in conjunction with ACE Inhibitor
      2. Monitor for Hyperkalemia (esp. with ACE Inhibitor)
    2. Edematous states
      1. Cirrhosis
      2. Primary Hyperaldosteronism
      3. Nephrotic Syndrome
    3. Hyperandrogenism in women
      1. Hirsutism
      2. Polycystic Ovary Disease
    4. Refractory Hypertension
      1. See Hypertension Combination Therapy
  3. Contraindications
    1. Anuria
    2. Renal insufficiency with Serum Creatinine over 2.4
    3. Hyperkalemia
  4. Drug Interactions
    1. Increased Serum Potassium (Hyperkalemia risk)
      1. Potassium Supplementation
      2. NSAIDs
      3. ACE Inhibitor
    2. Increases Digoxin half-life
    3. Salicylates decreases spironolactone effect
  5. Dosing
    1. Congestive Heart Failure: 25 to 50 mg PO qd
    2. Diuretic: 50-100 mg PO per day divided qd to bid
    3. Hyperandrogenism: 50 mg PO bid
    4. Hypertension: 12.5 to 50 mg PO qd
  6. Monitoring
    1. Serum Potassium
    2. Renal Function (Serum Creatinine)
  7. Pharmacokinetics
    1. Primarily renal excretion
    2. Half-life: 14 to 16 hours
  8. Mechanism
    1. General
      1. Spironolactone is a aldosterone competitive inhibitor
      2. Acts at distal convoluted renal tubule
    2. Congestive Heart Failure
      1. Works synergistically with ACE Inhibitors in CHF
      2. ACE Inhibitors block Angiotensin II production
        1. Renal response is to increase Aldosterone
        2. Spironolactone blocks aldosterone escape
  9. References
    1. Margo (2001) Am Fam Physician 64(8):1393
    2. Pitt (1999) N Engl J Med 341:709

Spironolactone (C0037982)

Definition (MSH)A potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827)
Definition (CSP)potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules; used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis; its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects.
Definition (PDQ)A synthetic 17-spironolactone corticosteroid with potassium-sparing diuretic, antihypertensive, and antiandrogen activities. Spironolactone competitively inhibits adrenocortical hormone aldosterone activity in the distal renal tubules, myocardium, and vasculature. This agent may inhibit the pathophysiologic effects of aldosterone produced in excess by various types of malignant and benign tumors. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39444&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39444&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C840" NCI Thesaurus)
Definition (NCI)A synthetic 17-spironolactone corticosteroid with potassium-sparing diuretic, antihypertensive, and antiandrogen activities. Spironolactone competitively inhibits adrenocortical hormone aldosterone activity in the distal renal tubules, myocardium, and vasculature. This agent may inhibit the pathophysiologic effects of aldosterone produced in excess by various types of malignant and benign tumors. (NCI04)
ConceptsSteroid (T110) , Pharmacologic Substance (T121)
EnglishSpirolactone, Spironolactone, SPIRONOLACTONE PREPARATION, SPL, Veroshpiron, Verospirone
Spanishespironolactona
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Aldactone (C0591054)

ConceptsSteroid (T110) , Pharmacologic Substance (T121)
EnglishAldactone, Pharmacia Brand of Spironolactone, Pharmacia Spain Brand of Spironolactone, Roche Brand of Spironolactone, Searle Brand of Spironolactone
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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