Aldactone is a brand-name prescription medication. It’s FDA-approved to treat certain forms of the following in adults:*

* Aldactone is approved to treat these conditions in certain situations. For details, see the “Aldactone uses” section below.

Drug details

Aldactone contains the active drug ingredient spironolactone and is classified as a diuretic drug. Specifically, it belongs to a class of medications called aldosterone antagonists, or potassium-sparing diuretics. (A medication class is a group of medications that work together in a similar way.)

Aldactone comes as a tablet that you swallow. It’s available in three strengths: 25 milligrams (mg), 50 mg, and 100 mg. How often you take Aldactone depends on which condition it’s treating. (To learn more, see the “Aldactone dosage” section below.)

Effectiveness

For information on the effectiveness of Aldactone, see the “Aldactone uses” section below.

Aldactone is a brand-name drug that contains the active drug spironolactone. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.

The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

If you’re interested in using the generic form of Aldactone, talk with your doctor. They can tell you if it comes in forms and strengths that can be used for your condition.

Aldactone can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Aldactone. These lists don’t include all possible side effects.

For more information on the possible side effects of Aldactone, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Aldactone, you can do so through MedWatch.

Mild side effects

Mild side effects of Aldactone can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Aldactone. To learn about other mild side effects, talk with your doctor or pharmacist, or see Aldactone’s prescribing information.
† For information on these side effects, see the “Side effect details” section below.

Serious side effects

Serious side effects from Aldactone aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms, which are explained below in “Side effect details,” can include:

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Aldactone. It isn’t known how often this side effect may have occurred in clinical trials.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth, swelling, or redness in your skin)
  • fever

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Aldactone. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Electrolyte imbalance

Aldactone can cause problems with the levels of electrolytes, including potassium and sodium. (Electrolytes are minerals that are electrically charged.) It’s not known how often this side effect may have occurred in clinical trials of Aldactone.

High level of potassium

Aldactone is a type of drug called a diuretic (water pill). Aldactone causes your body to get rid of sodium and water, but it helps your body retain potassium. As a result, Aldactone may cause the level of potassium in your blood to become too high. This is known as hyperkalemia.

Hyperkalemia may not cause symptoms. But in some cases, it may cause symptoms such as:

Low level of sodium

Aldactone also affects how much sodium your body gets rid of, so the drug can cause a low level of sodium in your blood. This is called hyponatremia.

Symptoms of hyponatremia can include:

  • confusion
  • headache
  • feeling irritable
  • fatigue (lack of energy)
  • weakness

Changes in other levels

In addition to changing the levels of potassium and sodium, Aldactone can cause changes in the levels of other electrolytes. These include low levels of magnesium, calcium, and chloride. Also, Aldactone can cause a high level of uric acid and a high level of blood sugar.

While you’re taking Aldactone, your doctor may regularly monitor your electrolyte levels, including potassium and sodium. If you have questions about how Aldactone may affect your electrolytes, talk with your doctor.

Breast swelling in men

One of the more common side effects of Aldactone is breast swelling in men. This is known as gynecomastia.

One clinical study looked at people taking Aldactone for heart failure.* About 9% of men who took Aldactone developed gynecomastia. It isn’t known how often this side effect may have occurred in men who took a placebo (treatment with no active drug).

Gynecomastia may occur any time from 1 month to more than a year after you start treatment with Aldactone. It’s been noted that this side effect usually goes away once you stop taking the drug.

If you’re a man taking Aldactone and notice breast swelling, talk with your doctor. They’ll likely have you stop taking the medication and help find the best treatment for your condition.

* The heart failure was classified as New York Heart Association Class III or IV heart failure.

Confusion

It’s possible that confusion can occur with Aldactone use. This side effect was reported by people who took the drug in clinical trials, but it’s not known exactly how many people may have developed confusion.

A 1973 review looked at 788 people who took spironolactone, the active drug in Aldactone, while they were in the hospital. Most people took the medication for heart failure or edema (swelling and fluid retention) due to a liver problem called cirrhosis.

Researchers found that about 2% of these people reported neurological (nervous system) problems that included confusion. This review looked only at people who took spironolactone. As a result, spironolactone wasn’t compared with a different drug or a placebo.

If you experience confusion while taking Aldactone, be sure to tell your doctor. They’ll help determine if it’s a side effect of the drug and work with you to find the best treatment for your condition.

Sexual dysfunction and reproductive problems

Sexual and reproductive dysfunction was a reported side effect of Aldactone in clinical trials. But it’s not known how often this may have occurred in people who took the drug.

Examples of sexual and reproductive dysfunctions reported by people taking Aldactone include:

If you experience changes in your sexual or reproductive functioning while taking Aldactone, talk with your doctor. They’ll help determine the best treatment for your condition.

Skin conditions

It’s possible to have mild, moderate, and even serious skin conditions as a side effect of Aldactone use. However, it’s important to note that most people don’t have this side effect, and serious skin conditions are very rare with the drug.

A 1973 review looked at 788 people who took spironolactone, the active drug in Aldactone, while they were in the hospital. Most people took the medication for heart failure or edema (swelling and fluid retention) due to a liver problem called cirrhosis.

Researchers found that about 0.5% of these people reported having a skin rash. This review looked only at people who took spironolactone. As a result, spironolactone wasn’t compared with a different drug or a placebo.

If you develop a rash while using Aldactone that’s bothersome to you, talk with your doctor. They may be able to recommend a treatment to help ease your discomfort.

Severe skin reaction

Although unlikely, you may experience a severe skin reaction while taking Aldactone. These reactions include Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The reactions were reported in clinical trials and since the drug was released onto the market. Most people took the medication for heart failure or edema due to cirrhosis.

Symptoms of SJS and TEN can include:

  • skin blisters
  • skin rash
  • hives (itchy welts on your skin)
  • sores in your mouth

If you’re using Aldactone and have any symptoms of SJS or TEN, call your doctor right away. In some cases, these conditions can be life threatening.

The Food and Drug Administration (FDA) hasn’t approved Aldactone to treat acne, but the drug is commonly used off-label to treat this condition. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

According to guidelines from the American Academy of Dermatology, spironolactone (the active drug in Aldactone) can be effective in treating acne in certain women.

However, the guidelines don’t recommend that men use Aldactone to treat acne. This is because the side effects seem to be worse than any benefit men get from taking the drug.

If you have acne and are interested in using Aldactone or finding a different treatment, talk with your doctor.

The Food and Drug Administration (FDA) approves prescription drugs such as Aldactone to treat certain conditions. Aldactone may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Aldactone for heart failure

Aldactone is FDA-approved to treat heart failure classified as New York Heart Association (NYHA) Class III or IV heart failure.* For this purpose, Aldactone is approved for use in adults with heart failure with reduced ejection fraction.

There are three goals of this Aldactone treatment. One is to help manage edema (swelling and fluid retention). The second is to lower the risk of a hospital stay due to heart failure. The third is to help you live longer.

* According to the NYHA scale, Class I heart failure is the least severe, and Class IV is the most severe. Your doctor will typically classify your heart failure based on how severe your symptoms are.

Heart failure

Here’s some information on heart failure and ejection fraction.

Heart failure explained

Heart failure occurs when your heart can no longer pump enough blood to supply your body.

For some people, this is because the heart struggles to pump enough blood to support other organs. Other people may have heart muscles that have become stiff or hard. This can reduce or even block blood flow to the heart.

Symptoms of heart failure can include:

  • loss of appetite
  • long-lasting cough
  • fatigue (lack of energy)
  • shortness of breath
  • sudden weight gain
  • swelling in your ankles, belly, or legs

Ejection fraction explained

“Ejection fraction” is a measure of how much blood the heart pumps out when it contracts. Ejection fraction is recorded as a percentage. A normal ejection fraction is between 50% and 70%, according to the American Heart Association. But it’s still possible to have heart failure when your ejection fraction is normal.

A low ejection fraction is defined as 40% or lower. (Ejection fractions between 40% and 50% are considered “on the border.”)

People with a low ejection fraction may have symptoms such as fatigue (lack of energy), shortness of breath, and swelling in their feet or lower legs. A low ejection fraction is usually a sign of heart disease, including heart failure.

When you have heart failure with reduced ejection fraction, it means that the left side of the heart pumps out less blood than usual.

Effectiveness for heart failure

Aldactone has been shown to be effective for treating heart failure in a clinical study.

Researchers looked at people with NYHA Class III or IV heart failure to see if Aldactone worked better than a placebo (treatment with no active drug). Specifically, they wanted to see if Aldactone helped people avoid a hospital stay and reduce their risk of dying.

People in the study were randomly chosen to take either Aldactone or a placebo once a day. They kept taking their other heart failure medications during the study.

At the end of the study, the researchers found that people who took Aldactone:

  • had a 30% lower risk of death than people who took a placebo
  • had a 30% lower risk of a hospital stay due to heart problems than people who took a placebo

Aldactone for high blood pressure

Aldactone is FDA-approved to treat hypertension (high blood pressure) in adults. For this purpose, Aldactone should be used with other blood pressure drugs.

A decrease in blood pressure can help lower the risk of cardiovascular (heart and blood vessel) problems, such as heart attack and stroke. In some cases, these problems can be fatal.

High blood pressure explained

As blood flows through arteries, it exerts a force on the artery walls. This is called blood pressure. When the force is higher than usual, it’s considered high blood pressure.

Many people with high blood pressure don’t have any symptoms of the condition. In fact, it’s possible for you to have high blood pressure for many years before you notice any symptoms, if you ever have symptoms at all.

Symptoms of high blood pressure can include:

If high blood pressure isn’t treated, it can lead to serious complications, including damage to your arteries and heart. In rare cases, these complications can be fatal. High blood pressure can also lead to decreased blood supply to your brain, which could result in brain damage.

Effectiveness for high blood pressure

According to clinical guidelines from the American College of Cardiology and American Heart Association, spironolactone may be used with other medications to help lower blood pressure.

A review of studies looked at spironolactone (the active drug in Aldactone) in people with high blood pressure. The people had tried other blood pressure drugs, but they weren’t effective enough. The results showed that adding spironolactone to their other treatments was effective in treating high blood pressure.

Researchers looked at a total of 869 people across four different studies who took spironolactone to treat their high blood pressure. The results showed that the drug was more effective than a placebo.

Aldactone for edema in people with certain liver or kidney problems

Aldactone is FDA-approved to treat edema (swelling and fluid retention) caused by:

  • A liver condition called cirrhosis. For this purpose, Aldactone should be used only if a diet low in salt and fluids doesn’t successfully treat the edema.
  • A kidney condition known as nephrotic syndrome. For this purpose, Aldactone should be used only if the following weren’t able to successfully treat the edema:
    • a diet low in salt and fluids
    • treating nephrotic syndrome itself

With cirrhosis, you have poor liver function with severe scarring. Edema appears as swelling in in the legs. People with cirrhosis may develop edema because blood can’t flow as quickly through the damaged liver. This causes an increase in blood pressure in the veins that supply the liver. Also, cirrhosis prevents your body from properly getting rid of fluid. This may contribute to fluid retention and swelling.

With nephrotic syndrome, proteins leak out of your urine due to kidney damage. These proteins help absorb fluid in the body, in addition to other functions. Edema occurs in nephrotic syndrome because your body isn’t able to properly balance its fluid levels. Edema appears as swelling in and around the eyes, and in the feet and ankles.

Effectiveness for edema in people with certain liver or kidney problems

Aldactone has been shown to be effective for treating edema in people with certain liver or kidney problems.

A 2003 study looked at people with edema due to cirrhosis. Every day they took either spironolactone (the active drug in Aldactone) alone or with the drug furosemide (Lasix). Researchers wanted to see which treatment was better at relieving edema.

At the end of the study, the researchers found that the two treatments were similarly effective. Edema was eased in:

  • 94% of people who took spironolactone alone
  • 98% of people who took furosemide with spironolactone

Aldactone for primary hyperaldosteronism

Aldactone is FDA-approved to treat primary hyperaldosteronism in adults in these situations:

  • For a short time to manage symptoms before surgery for primary hyperaldosteronism.
  • For long-term use in people with a type of noncancerous tumor called an adrenal adenoma. (This kind of tumor is found on the adrenal glands.) The tumor must be making a hormone called aldosterone. For this purpose, the drug is used for people who:
    • aren’t able to have surgery to remove the tumor for primary hyperaldosteronism according to their doctor, or
    • have bilateral micro- or macronodular adrenal hyperplasia (These are lumps on the adrenal gland that may cause the glands to grow and produce too much of a hormone called cortisol.)

Primary hyperaldosteronism explained

Primary hyperaldosteronism is a condition in which the adrenal glands produce too much aldosterone hormone. Aldosterone plays an important role in controlling your blood pressure. Specifically, aldosterone affects how much water, sodium, and potassium are in your blood. It can also change how much of these substances your body holds on to or gets rid of.

When you have a high level of aldosterone, your body holds on to too much sodium. This leads to water retention, which can increase blood pressure. And a high aldosterone level can cause your body to get rid of too much potassium.

“Primary hyperaldosteronism” refers to hyperaldosteronism that’s due to a problem in one adrenal gland or both of them. (“Secondary hyperaldosteronism” is due to a different cause, such as diuretic drugs or heart failure.)

Symptoms of hyperaldosteronism can include:

  • fatigue (lack of energy)
  • hypertension (high blood pressure)
  • being more thirsty than usual
  • frequent urination
  • low level of potassium in the blood
  • muscle weakness

Effectiveness for primary hyperaldosteronism

For more than 50 years, spironolactone (the active drug in Aldactone) has been the medication of choice for the nonsurgical treatment of primary aldosteronism. This is according to guidelines from the Journal of Clinical Endocrinology & Metabolism.

The guidelines also state that the drug is effective at lowering blood pressure. And it may help reduce the need for other blood pressure medicines in people with primary aldosteronism.

Off-label uses for Aldactone

In addition to the uses listed above, Aldactone may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one or more use(s) is prescribed for a different one that’s not approved. Below are examples of off-label uses for Aldactone.

Aldactone for acne

Aldactone isn’t FDA-approved to treat acne. But the drug is sometimes used off-label in certain women with this condition. To learn more, see the “Aldactone off-label use for acne” section above.

Aldactone for hair loss

Aldactone isn’t FDA-approved to treat hair loss, but the drug may be used off-label for this purpose.

Spironolactone (the active drug in Aldactone) has been used to treat a specific type of hair loss called androgenic alopecia. This condition can refer to male or female pattern baldness. Spironolactone was used for female pattern hair loss. One study noted that women who took spironolactone noticed improvement in their hair loss.

It’s also important to note that hair loss has been reported as a side effect of Aldactone. But it’s not known exactly how many people may have had this side effect in clinical studies.

If you’re interested in using Aldactone for female pattern hair loss, talk with your doctor.

Aldactone for PCOS

Aldactone isn’t FDA-approved to treat polycystic ovary syndrome (PCOS), but the drug may be used off-label for this purpose.

PCOS is a type of hormone disorder.

In one study, women with PCOS were given spironolactone (the active drug in Aldactone), metformin, or both drugs together. The use of both drugs together was more effective than the use of either drug on its own.

If you’re interested in using Aldactone for PCOS, talk with your doctor.

Aldactone for weight loss

Aldactone isn’t FDA-approved for weight loss, but the drug may be used off-label for this condition.

Aldactone is a diuretic (water pill). Diuretics work by causing your body to get rid of sodium and water. This can cause you to lose weight.

There aren’t any studies on using Aldactone for weight loss. However, based on how the drug works, it makes sense that Aldactone could help reduce weight in some people, especially if they have fluid retention.

If you have questions about Aldactone and weight loss, talk with your doctor. If they determine that the drug is the right treatment for you, your doctor can recommend a potential dosage.

Aldactone for hirsutism

Aldactone isn’t FDA-approved for hirsutism, but the drug may be used off-label for this condition. With hirsutism, women have excessive body hair, facial hair, or both.

According to a clinical guideline by the Endocrine Society, Aldactone can be used as a treatment for hirsutism.

If you’re interested in using Aldactone for hirsutism, talk with your doctor.

Aldactone for ascites

Ascites is a buildup of excessive amounts of fluid inside your abdomen (belly). Aldactone isn’t FDA-approved for treating ascites. However, the drug is FDA-approved for treating edema in certain situations.* Edema refers to swelling and fluid retention.

Aldactone is a diuretic (water pill). Diuretics work by causing your body to get rid of sodium and water. Therefore, it makes sense that Aldactone would also work to treat ascites.

Spironolactone, the active drug in Aldactone, has been used to treat ascites since at least 1961. Clinical trials have shown the drug to be effective for treating this condition, and guidelines recommend Spironolactone as a preferred treatment.

If you’re interested in using Aldactone for ascites, talk with your doctor.

* To learn more, see “Aldactone for heart failure” and “Aldactone for edema in people with certain liver or kidney problems” above.

Aldactone and children

It isn’t known if Aldactone is safe or effective for use in children. This is because the drug hasn’t been studied in people younger than age 18 years.

The Aldactone dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Aldactone to treat
  • your age
  • the form of Aldactone you take
  • other medical conditions you may have
  • how well Aldactone works for your condition
  • any side effects you have while taking Aldactone

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Aldactone comes as a tablet that you swallow. It’s available in three different strengths: 25 milligrams (mg), 50 mg, and 100 mg.

Dosage for heart failure

For treating heart failure with reduced ejection fraction, your doctor will likely have you start with an Aldactone dosage of 25 mg, once a day.

If this dose works well for you, your doctor may increase the dosage to 50 mg, once per day.

However, if you develop hyperkalemia (a high level of potassium in your blood), your doctor will likely lower the dosage to 25 mg, every other day. Or they may recommend a medication other than Aldactone.

Dosage for high blood pressure

For hypertension (high blood pressure), the typical Aldactone dosage is 25 to 100 mg, once per day. Your doctor may have you take this as one single dose or divided into multiple doses. It depends on what they think will work best for you and any side effects you may have.

Dosage for edema in people with certain liver or kidney problems

Aldactone is used to treat edema (swelling and fluid retention) in people with certain liver or kidney problems. These include cirrhosis and nephrotic syndrome.

For this purpose, your doctor will likely have you start with an Aldactone dosage of 100 mg per day. They may have you take this in one single dose or divide it into two or three doses depending on what they think will work best for you.

While taking Aldactone for edema, the dosage may range from 25 to 200 mg daily. This may be taken as one single dose or divided into multiple doses. It depends on what they think will work best for you and any side effects you may have.

If you have cirrhosis, you’ll start taking Aldactone in a hospital. The drug may cause problems with the blood levels of fluids and electrolytes in people with cirrhosis. This can cause neurological (nervous system) side effects such as confusion, hand tremors, and, rarely, coma. By having you in the hospital when you start taking Aldactone, your doctor will be able to monitor you for these side effects.

Dosage for primary hyperaldosteronism

Aldactone is approved to treat primary hyperaldosteronism in certain situations.

Short-term use before surgery

Aldactone may be used for a short time to manage your symptoms before surgery for primary hyperaldosteronism. Specifically, Aldactone may be used to reduce your risk for low blood potassium (hypokalemia) as a side effect of anesthesia used during surgery.

For this purpose, the typical dosage of Aldactone is 100 mg to 400 mg daily. Your doctor will give you more specific information on how much Aldactone to take.

Long-term use

Aldactone may be used long-term in people with a type of noncancerous tumor called an adrenal adenoma.* For this purpose, you must be unable to have surgery for primary hyperaldosteronism according to your doctor.

Your doctor will prescribe the lowest effective dose of Aldactone to treat your condition. To learn more, talk with your doctor.

* For details, see “Aldactone for primary hyperaldosteronism” in the “Aldactone uses” section above.

Dosage questions

Here are some questions you may have about taking Aldactone.

What if I miss a dose?

If you miss a dose, try to take it as soon as you remember. But if it’s almost time for your next dose, simply skip the missed dose and wait to take your next regular dose. You shouldn’t “double up” or take two doses at once. This may increase your risk for side effects from Aldactone. (For more information on side effects, see the “Aldactone side effects” section above.)

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

Will I need to use this drug long term?

For most of the conditions Aldactone is used for, the drug is meant to be used as a long-term treatment. If you and your doctor determine that Aldactone is safe and effective for you, you’ll likely take it long term.

If you’re using Aldactone before surgery for primary hyperaldosteronism, your doctor will advise you on any medications you’ll need to take afterward.

Here are answers to some frequently asked questions about Aldactone.

Is Aldactone a diuretic?

Yes, Aldactone is a diuretic (water pill), but the medication isn’t like other diuretics.

Diuretics work by causing your body to get rid of sodium and water. During this process, your body also gets rid of potassium. In some cases, the loss of potassium can cause the level of potassium in your blood to become low. This is known as hypokalemia.

Aldactone works in a different area in the kidneys than other diuretics commonly used to lower blood pressure. Aldactone still causes your body to get rid of sodium and water, but it helps your body hold on to potassium.

Aldactone does lower blood pressure as well. But its effect on blood pressure isn’t very strong, so Aldactone is meant to be used with other drugs for lowering blood pressure. (To learn more, see the “Aldactone use with other drugs” section below.)

If you have questions about Aldactone or other diuretics, talk with your doctor.

Can I eat salt or salt substitutes while I’m taking Aldactone?

There aren’t any known interactions between eating salt and taking Aldactone. However, some of the conditions Aldactone is used to treat are affected by how much salt you eat. Even though salt doesn’t interact with Aldactone, you should still talk with your doctor about how much salt is safe for you to consume.

While taking Aldactone, you should avoid foods that contain high levels of potassium. This includes many salt substitutes, which often contain potassium chloride.

Aldactone causes your body to hold on to potassium in the kidneys. Consuming high amounts of potassium while you take Aldactone could lead to hyperkalemia. This is a high level of potassium in your blood.

If you have more questions about salt or salt substitutes and Aldactone, talk with your doctor.

Is it OK to use Aldactone if I have Addison’s disease?

No, it isn’t OK to use Aldactone if you have Addison’s disease.

People with Addison’s disease don’t produce enough cortisol or aldosterone, two hormones important to many body functions. Aldactone lowers aldosterone levels in your body, so it can make Addison’s disease worse.

If you have Addison’s disease, ask your doctor what medications other than Aldactone are right for you.

Will I need regular monitoring or testing during my Aldactone treatment?

While you’re being treated with Aldactone, your doctor will likely want to monitor you using lab tests. This helps them determine whether the drug is working and see if you’re developing side effects.

Within one week of starting Aldactone treatment, your doctor will test the level of potassium in your blood. This is because the drug can cause hyperkalemia (high blood levels of potassium). Your doctor will likely perform this test on a regular basis while you take Aldactone.

Your doctor will also likely order the following tests while you’re being treated with Aldactone:

  • Kidney function. This exam checks how well your kidneys are working.
  • Volume status. This test shows whether your body has too much, too little, or the right amount of fluids. Aldactone can affect your fluid volume.
  • Electrolytes and other measures of body function. Besides potassium, your doctor may monitor levels of other electrolytes in your blood. (Electrolytes are minerals that are electrically charged.) This includes sodium. In addition, your doctor may look at your blood work to make sure other levels are within normal range.

Your doctor will determine how often you’ll need to have each test completed.

Does Aldactone cause weight gain?

Weight gain wasn’t a reported side effect of Aldactone in clinical studies.

However, Aldactone can cause hyperglycemia (high blood sugar).* If your blood sugar stays high for a long period of time, it can lead to weight gain.

Symptoms of high blood sugar can include:

If you notice any of the above symptoms, talk with your doctor. If you’re taking Aldactone, your doctor can help determine if these are side effects of the drug and advise you on treatment.

* It’s not known exactly how often people in clinical trials may have had high blood sugar, but this side effect is rare.

Will Aldactone cure my condition?

Aldactone is used to treat several conditions, but the drug isn’t a cure for any of them.

To be more specific, Aldactone is approved to treat certain forms of the following:

For more information on how Aldactone treats your condition, see the “Aldactone uses” section above.

If you’re interested in Aldactone or other treatments for your condition, talk with your doctor.

You shouldn’t use Aldactone while pregnant.

The drug hasn’t been studied in humans during pregnancy. However, in studies of pregnant animals given spironolactone (the active drug in Aldactone), hormone problems caused some male fetuses to become female.

If you’re taking Aldactone and are interested in becoming pregnant, be sure to talk with your doctor first. They may prescribe a different medication to treat your condition.

If you have more questions about using Aldactone during pregnancy, talk with your doctor.

You shouldn’t take Aldactone while pregnant. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Aldactone.

For more information about taking Aldactone during pregnancy, see the “Aldactone and pregnancy” section above. And if you have questions about birth control and Aldactone, talk with your doctor.

According to the drug’s manufacturer, it isn’t known whether Aldactone is safe to use while breastfeeding. However, the National Institutes of Health says that spironolactone, the active drug in Aldactone, appears to be acceptable to use while breastfeeding.

Spironolactone doesn’t seem to be present in human breast milk. A metabolite (a chemical created when your body breaks down a drug) of spironolactone called canrenone may be present in human breast milk. However, it isn’t believed that canrenone occurs in levels high enough to cause harm to a breastfed child.

If you have questions about taking Aldactone while breastfeeding, talk with your doctor.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Aldactone, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for heart failure

Examples of other drugs that may be used to treat heart failure include:

Alternatives for high blood pressure

Examples of other drugs that may be used to treat hypertension (high blood pressure) include:

  • ACE inhibitors, such as:
    • benazepril (Lotensin)
    • enalapril (Vasotec)
    • lisinopril (Prinivil, Zestril)
    • quinapril (Accupril)
    • ramipril (Altace)
  • ARBs, such as:
    • irbesartan (Avapro)
    • losartan (Cozaar)
    • olmesartan (Benicar)
    • telmisartan (Micardis)
    • valsartan (Diovan)
  • beta-blockers, such as:
    • bisoprolol
    • carvedilol (Coreg, Coreg CR)
    • metoprolol succinate (Toprol-XL)
  • calcium channel blockers, such as:
  • diuretics (water pills), such as:
    • furosemide (Lasix)

Alternatives for edema in people with certain liver or kidney problems

Examples of other drugs that may be used to treat edema in people with certain liver or kidney problems include:

  • amiloride (Midamor)
  • furosemide (Lasix)
  • hydrochlorothiazide (Microzide)
  • metolazone (Zaroxolyn)

Alternatives for primary hyperaldosteronism

Examples of other drugs that may be used to treat primary hyperaldosteronism include:

  • amiloride (Midamor)
  • eplerenone (Inspra)
  • triamterene (Dyrenium)
  • medications for high blood pressure, such as:
    • hydrochlorothiazide (Microzide)
    • lisinopril (Prinivil, Zestril)
    • valsartan (Diovan)

You may wonder how Aldactone compares with other medications that are prescribed for similar uses. Here we look at how Aldactone and Lasix are alike and different.

Ingredients

Aldactone contains the active drug spironolactone. Lasix contains the active drug furosemide.

Both Aldactone and Lasix belong to a class of drugs called diuretics. (A drug class is a group of medications that work together in a similar way.)

To be specific, Aldactone belongs to a class of diuretics called aldosterone antagonists, or potassium-sparing diuretics. Lasix belongs to a class of diuretics called loop diuretics.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Aldactone and Lasix to treat.

  • Aldactone is FDA-approved to treat certain forms of the following in adults:
    • edema (swelling and fluid retention) in people with certain liver or kidney problems
  • Lasix is FDA-approved to treat the following in certain situations:
    • high blood pressure in adults when used alone or with other blood pressure drugs

For details on Aldactone’s uses, see the “Aldactone uses” section above. To learn more about the uses of Lasix, talk with your doctor.

Drug forms and administration

Aldactone comes as a tablet that you swallow. How often you take Aldactone depends on which condition it’s treating. (To learn more, see the “Aldactone dosage” section above.)

Lasix comes as a tablet that you swallow. A generic version is available under the name furosemide, which comes in two forms. One is a tablet and the other is a liquid solution for intravenous (IV) infusion. (An infusion is an injection into your vein that’s given over a period of time.) How often you take Lasix depends on which condition it’s treating.

Side effects and risks

Aldactone and Lasix can cause similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Aldactone and Lasix (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Aldactone, with Lasix, or with both drugs (when taken individually).

Effectiveness

Aldactone and Lasix have different FDA-approved uses, but they’re both used to treat high blood pressure and edema.

These drugs haven’t been directly compared in clinical studies. But studies have found both Aldactone and Lasix to be effective for treating high blood pressure and edema.

Costs

According to estimates on GoodRx.com, the costs of Aldactone and Lasix may vary depending on your treatment plan. The actual price you’ll pay for either drug also depends on your insurance plan, your location, and the pharmacy you use.

Aldactone and Lasix are both brand-name drugs. Aldactone is available as the generic medication spironolactone. Lasix is available as the generic medication furosemide. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Brand-name medications usually cost more than generics.

Like Lasix (above), the drug Entresto has uses similar to those of Aldactone. Here’s a comparison of how Aldactone and Entresto are alike and different.

Ingredients

Aldactone contains the active drug spironolactone and belongs to a class of drugs called diuretics. (A drug class is a group of medications that work together in a similar way.)

Entresto contains two active drugs: sacubitril and valsartan. Sacubitril belongs to a drug class known as neprilysin inhibitors. Valsartan belongs to a drug class called angiotensin II receptor blockers (ARBs).

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Aldactone and Entresto to treat.

For details on Aldactone’s uses, see the “Aldactone uses” section above. To learn more about the uses of Entresto, talk with your doctor.

* Aldactone is approved to treat New York Heart Association (NYHA) Class III or IV heart failure in adults. Entresto is approved to treat NYHA Class II, III, or IV heart failure in adults. Entresto is also used to treat children ages 1 year and older with heart failure that includes left ventricular systolic dysfunction.

Drug forms and administration

Aldactone comes as a tablet that you swallow. How often you take Aldactone depends on which condition it’s treating. (To learn more, see the “Aldactone dosage” section above.)

Entresto also comes as a tablet that you swallow. You’ll likely take Entresto two times per day. If you aren’t able to swallow tablets, you can ask your pharmacist to prepare the drug as an oral suspension. They’ll crush Entresto and mix it with a liquid that you drink. You then take the drug using an oral syringe.

Side effects and risks

Aldactone and Entresto can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Aldactone and Entresto (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Aldactone, with Entresto, or with both drugs (when taken individually).

Effectiveness

The only condition both Aldactone and Entresto are used to treat is heart failure.

These drugs haven’t been directly compared in clinical studies, but studies have found both Aldactone and Entresto to be effective for treating heart failure.

Costs

According to estimates on GoodRx.com, the costs of Aldactone and Entresto may vary depending on your treatment plan. The actual price you’ll pay for either drug also depends on your insurance plan, your location, and the pharmacy you use.

Aldactone and Entresto are both brand-name drugs.

Aldactone is available as a generic drug called spironolactone. A generic drug is an exact copy of the active drug in a brand-name medication. Brand-name medications usually cost more than generics.

Entresto isn’t available as a generic drug.

As with all medications, the cost of Aldactone can vary. To find current prices for Aldactone tablets in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Aldactone, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Aldactone, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Aldactone, or if you need help understanding your insurance coverage, help is available.

Pfizer, the manufacturer of Aldactone, offers Pfizer RxPathways, which can link you to assistance programs. For more information and to find out if you’re eligible for support, call 866-706-2400 or visit the program website.

Generic version

Aldactone is available in a generic form called spironolactone. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of spironolactone compares with the cost of Aldactone, visit GoodRx.com.

If your doctor has prescribed Aldactone and you’re interested in using spironolactone instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

Aldactone can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Aldactone and other medications

Below are examples of medications that can interact with Aldactone. This section doesn’t contain all drugs that may interact with Aldactone.

Before taking Aldactone, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Aldactone and potassium

Aldactone can interact with other medications that affect the level of potassium in your blood. Because Aldactone can increase the level of potassium in your blood, taking other drugs that also do this may raise your risk for hyperkalemia (high level of potassium in the blood).

Other medications that can increase the level of potassium in your blood include:

If you’re taking any of the medications listed above, be sure to talk with your doctor before using Aldactone. They may want to monitor your blood potassium level more closely than usual. Or they may recommend that you take a different medication to treat your condition.

Aldactone and eplerenone

You shouldn’t use Aldactone and eplerenone (Inspra) together. This is because the two drugs belong to the same drug class: aldosterone antagonists. A drug class is a group of medications that work in the same way. Using Aldactone and eplerenone at the same time may increase your risk for side effects and not help treat your condition. (For more about side effects, see the “Aldactone side effects” section above.)

If you’re taking eplerenone, be sure to tell your doctor before you use Aldactone. They can help decide which medication is best for your condition.

Aldactone and NSAIDs, especially aspirin

Aldactone may interact with nonsteroidal anti-inflammatory drugs (NSAIDs), especially aspirin. It’s believed that NSAIDs could prevent Aldactone from working well to treat blood pressure and fluid retention.

Examples of NSAIDs include:

If you’re using an NSAID, make sure your doctor knows this before you take Aldactone. Most likely, they’ll simply monitor your condition more closely than usual to make sure Aldactone is working correctly. They can also help decide whether you should use different medications instead.

Aldactone and cholestyramine

The use of Aldactone and the drug cholestyramine (Prevalite) may result in hyperkalemia and metabolic acidosis. Hyperkalemia is a high level of potassium in the blood. And metabolic acidosis occurs when there’s too much acid in the body. This condition can lead to many health problems, such as diabetes. Metabolic acidosis can even be life threatening, especially if it isn’t treated.

If you’re taking cholestyramine, talk with your doctor before taking Aldactone. They’ll help determine the best treatment for you.

Aldactone and herbs and supplements

You’ll likely need to avoid using potassium supplements while taking Aldactone.

Aldactone can interact with potassium supplements. This is because taking Aldactone increases the level of potassium in your blood. Using potassium supplements with Aldactone could cause the potassium to reach an unsafe level.

If you use a potassium supplement, be sure to tell your doctor before you take Aldactone. They’ll likely have you stop taking the supplement during your treatment.

Aldactone and foods

It’s important to note that you should avoid salt substitutes that contain potassium while taking Aldactone. This is because taking Aldactone increases the level of potassium in your blood. Using salt substitutes that contain potassium could cause the potassium to reach an unsafe level.

If you use a salt substitute, be sure to talk with your doctor before taking Aldactone. They can determine if it’s safe for you to use during your treatment.

There aren’t any known interactions between Aldactone and alcohol.

However, certain side effects of Aldactone can be worsened if you drink alcohol while taking this drug. These side effects include dizziness and low blood pressure.

If you drink alcohol, talk with your doctor about how much is safe for you to drink during Aldactone treatment.

Using more than the recommended dosage of Aldactone can lead to serious side effects.

Do not use more Aldactone than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

Although rare, an overdose could lead to severe side effects in people with severe liver disease. However, these side effects are more likely to be caused by high doses over a long period of time. These side effects can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

In certain cases, Aldactone may be used with other medications.

Other heart failure drugs

Aldactone is approved to treat heart failure and reduced ejection fraction (a condition in which the left side of the heart pumps out less blood than usual).* For this purpose, Aldactone can be used alone or with other heart failure drugs.

Examples of other heart failure drugs that may be used with Aldactone include:

* For details on this use, see “Aldactone for heart failure” in the “Aldactone uses” section above.

Other blood pressure drugs

Aldactone is approved to treat hypertension (high blood pressure) when used with other blood pressure drugs.

Examples of other blood pressure drugs that may be used with Aldactone include:

  • ACE inhibitors, such as lisinopril (Prinivil, Zestril)
  • angiotensin receptor blockers (ARBs), such as losartan (Cozaar)
  • beta-blockers, such as:
    • metoprolol succinate (Toprol-XL)
  • calcium channel blockers, such as amlodipine besylate (Norvasc, Lotrel)
  • diuretics (water pills), such as furosemide (Lasix)

* For details on this use, see “Aldactone for high blood pressure” in the “Aldactone uses” section above.

Other medications

For Aldactone’s other approved uses,* the medication may be used with certain other drugs, depending on your doctor’s recommendation. If you have any questions, talk with your doctor.

* For details, see the “Aldactone uses” section above.

Aldactone comes as tablets that you swallow. You should take Aldactone according to your doctor’s or healthcare provider’s instructions.

When to take

When you take Aldactone depends on the dose your doctor prescribes. You may take Aldactone once or twice per day. Or you may take a dose every other day. It doesn’t matter exactly what time of day you take Aldactone, as long as you’re consistent.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

Taking Aldactone with food

You can take Aldactone with or without food. But you should take the drug consistently for every dose.

This means that if you start taking Aldactone with food, you should take the drug with food for the rest of your doses. And if you take Aldactone without food, you should keep taking it without food for your other doses.

Can Aldactone be crushed, split, or chewed?

If your doctor approves, Aldactone tablets can be split, cut in half, or crushed. However, it’s not recommended that you chew the tablets. Aldactone should be swallowed.

Aldactone is approved to treat certain forms of the following in adults:

Aldactone is approved to treat these conditions in certain situations. For details on the uses and how the conditions occur in the body, see the “Aldactone uses” section above.

The hormone aldosterone

Aldosterone is a hormone that plays an important role in controlling blood pressure. To be specific, it affects how much water, sodium, and potassium are in your blood. Aldosterone can change how much of these substances your body holds on to or gets rid of.

If you have a high level of aldosterone, your body starts to retain too much sodium. This leads to water retention, which increases blood pressure. Also, having a high level of aldosterone causes your body to get rid of too much potassium.

What Aldactone does

Aldactone lowers aldosterone levels in your body. Aldactone is a diuretic (water pill).

Diuretics work by causing your body to get rid of sodium and water. During this process, your body also gets rid of potassium.

Aldactone works in a different area of the kidneys than other diuretics commonly used to lower blood pressure. Aldactone still causes your body to get rid of sodium and water, but it helps your body hold on to potassium.

How long does it take to work?

Aldactone begins working as soon as you take a dose. However, depending on the condition you’re using Aldactone to treat, you may not notice the drug working right away.

In fact, you may not notice Aldactone working at all when used to treat some conditions, such as heart failure. But the drug is working in your body to treat your condition.

If you have concerns about whether Aldactone is working for your condition, talk with your doctor.

This drug comes with several precautions. Before taking Aldactone, talk with your doctor about your health history. Aldactone may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Kidney disease. If you have kidney disease and take Aldactone, you may be at a higher risk for certain side effects, such as hyperkalemia. Be sure to talk with your doctor before taking Aldactone if you have kidney disease. They may monitor you more often than usual during your treatment.
  • Allergic reaction. If you’ve had an allergic reaction to Aldactone or any of its ingredients, you shouldn’t take Aldactone. Ask your doctor what other medications are better options for you.
  • Pregnancy. You shouldn’t use Aldactone during pregnancy. For more information, see the “Aldactone and pregnancy” section above.
  • Breastfeeding. According to the drug’s manufacturer, it isn’t known whether Aldactone is safe to use while breastfeeding. However, the National Institutes of Health says that spironolactone, the active drug in Aldactone, appears to be acceptable to use while breastfeeding. For more information, see the “Aldactone and breastfeeding” section above.

Note: For more information about the potential negative effects of Aldactone, see the “Aldactone side effects” section above.

When you get Aldactone from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Aldactone tablets should be stored at temperatures below 77°F (25°C) in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Aldactone and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Aldactone is approved by the Food and Drug Administration (FDA) to treat the following in adults:

  • New York Heart Association Class III and IV heart failure with reduced ejection fraction with the goals of treating edema, lowering the risk of a hospital stay due to heart failure, and helping patients survive.
  • Hypertension when used with other drugs for blood pressure. A decrease in blood pressure can lower the risk of cardiovascular problems, such as myocardial infarction and stroke, which can be fatal or nonfatal.
  • Edema in people with:
    • Cirrhosis. For this purpose, Aldactone should be used only if fluid and salt restrictions were not able to successfully treat the edema.
    • Nephrotic syndrome. For this purpose, Aldactone should be used only if treatment with fluid and salt restrictions, other diuretics, and treatment of the underlying disease causing nephrotic syndrome do not provide an adequate response.
  • Primary hyperaldosteronism in the following situations:
    • Short-term use before surgery for primary hyperaldosteronism.
    • Long-term use in people with discrete adrenal adenomas that are making aldosterone. For this purpose, the drug is used for people who aren’t able to have surgery for primary hyperaldosteronism, or who have bilateral micro- or macronodular adrenal hyperplasia.

Administration

Aldactone comes as a tablet that’s taken by mouth.

When used for hypertension or edema, the medication may be taken in single or divided doses.

Patients with cirrhosis taking Aldactone for edema should begin therapy in a hospital for the monitoring of neurological side effects.

Mechanism of action

The active drug in Aldactone, spironolactone, is classified as an aldosterone antagonist. Spironolactone acts on aldosterone receptors in the distal convoluted tubule, causing sodium and water excretion and potassium retention.

Pharmacokinetics and metabolism

After an oral dose, spironolactone levels in the blood peak after 2.6 hours. Spironolactone as well as its metabolites bind with plasma proteins at a rate above 90%.

Spironolactone forms active metabolites, with one-third the potency but longer half-lives. Spironolactone has a half-life of approximately 1.4 hours, while metabolites can have half-lives of up to 16.5 hours.

Spironolactone and its active metabolites are mainly excreted in the urine.

Contraindications

Aldactone is contraindicated in persons with the following conditions:

In addition, Aldactone use is contraindicated in people who are also taking the drug eplerenone (Inspra).

Storage

Store Aldactone tablets at temperatures below 77°F (25°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.