Aldactone is a brand-name oral tablet that’s prescribed for heart failure, high blood pressure, and other conditions. Aldactone contains the active drug spironolactone. It’s a type of drug called a potassium-sparing diuretic.

Aldactone is FDA-approved to treat certain forms of the following conditions in adults:*

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

Drug details

You’ll find key information about Aldactone below.

  • Drug form: oral tablet
  • Generic available? Yes
  • Prescription required? Yes
  • Controlled substance? No
  • Year of FDA approval: 1960

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 manage any side effects that may be concerning or 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

Below is a partial list of mild side effects of Aldactone. To learn about other mild side effects, talk with your doctor or pharmacist, or view Aldactone’s prescribing information.

Mild side effects of Aldactone can include:

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

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 can include:

* Sex and gender exist on spectrums. Use of the term “male” in this article refers to sex assigned at birth.
† For details about allergic reaction and Aldactone, see “Allergic reaction” below.

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:

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 an 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.

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, as with other similar drugs, is not a cure for any of the conditions it’s used to treat.

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.* It’s prescribed for adults who have heart failure with reduced ejection fraction, which means that the left side of the heart pumps out less blood than usual.

For this purpose, Aldactone may be prescribed alone or with other heart failure drugs. Examples of other heart failure drugs that may be used with Aldactone include:

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.

Aldactone for high blood pressure

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

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.

Aldactone for edema in people with certain liver or kidney problems

Aldactone is FDA-approved to treat edema (swelling and fluid retention in the legs and abdomen). It’s prescribed for adults who have edema caused by:

  • A liver condition called cirrhosis (reduced liver function with severe scarring). For this purpose, Aldactone should be used only if a diet low in salt and fluids doesn’t treat the edema.
  • A kidney condition known as nephrotic syndrome (occurs when your body is unable to balance fluid levels due to symptoms of kidney damage). For this purpose, Aldactone should be used only if the following weren’t able to treat the edema:
    • a diet low in salt and fluids
    • treating nephrotic syndrome itself

For this use, Aldactone may be prescribed by itself or with certain other drugs, depending on your doctor’s recommendation.

Aldactone for primary hyperaldosteronism

Aldactone is FDA-approved to treat primary hyperaldosteronism in certain adults. This is a condition in which your body produces too much of a hormone called aldosterone. Your body needs this hormone to manage your blood pressure. Aldactone’s prescribed 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. The tumor must be making the hormone 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.)

For this use, Aldactone may be prescribed by itself or with certain other drugs, depending on your doctor’s recommendation.

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.

Off-label uses for Aldactone

In addition to the uses listed above, Aldactone may be prescribed 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 prescribed 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 females.*

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

If you have acne and are interested in using Aldactone or finding a different treatment, talk with your doctor. If you’d like to know the Aldactone dosage for acne, ask your doctor for more information.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Aldactone for hair loss

Aldactone isn’t FDA-approved to treat hair loss, but the drug may be prescribed 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.

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 trials.

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

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Aldactone for PCOS

Aldactone isn’t FDA-approved to treat polycystic ovary syndrome (PCOS), but the drug may be prescribed off-label for this purpose. PCOS is a type of hormone disorder.

Spironolactone (the active drug in Aldactone) has been studied for PCOS treatment, in combination with other drugs and by itself. Results have varied across studies, but most studies found that spironolactone can be effective at treating PCOS.

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

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
  • other medical conditions you may have
  • how well Aldactone works for your condition
  • any side effects you have while taking Aldactone

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 an oral tablet. It’s available in three 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.

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. 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.

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 in people with adrenal adenoma

Aldactone may be used long term in certain people with a type of noncancerous tumor called an adrenal adenoma.*

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

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

About taking Aldactone

Below you’ll find information about key dosage issues.

  • 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. Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Aldactone work effectively.
  • If you 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, skip the missed dose and wait to take your next regular dose. Do not “double up” or take two doses at once. This may increase your risk of side effects from Aldactone. (For more information on side effects, see the “Aldactone side effects” section above.)
  • Taking Aldactone with food: You can take Aldactone with or without food. But you should take the drug consistently for every dose. So, if you start taking Aldactone with food, you should take the drug with food for the rest of your doses (and vice versa).
  • Crushing, splitting, or chewing Aldactone: 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.
  • Length of use: Aldactone may be used short term to manage symptoms of primary hyperaldosteronism before surgery. For the drug’s other purposes, Aldactone 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.

Overdose

Taking more than the recommended dosage of Aldactone can lead to serious side effects. Do not take 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. These include:

These side effects are more likely to be caused by high doses over a long period of time.

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 America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Here are answers to some frequently asked questions about Aldactone.

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

No, it’s not recommended 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 typical 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 trials.

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 whether 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.

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

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.

Below is a list of medications, supplements, and foods that can interact with Aldactone. This list doesn’t contain all drugs that may interact with Aldactone. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Medications that can interact with Aldactoneangiotensin converting enzyme inhibitors, such as lisinopril (Prinivil, Zestril)
angiotensin receptor blockers, such as valsartan (Diovan)
nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen (Advil, Motrin)
cholestyramine (Prevalite)
eplerenone (Inspra)
heparin and low molecular weight heparin
• trimethoprim
Vitamins or supplements that can interact with Aldactone• multivitamins that contain potassium
• potassium supplements
Foods that can interact with Aldactone• salt substitutes that contain potassium

Aldactone and alcohol

There aren’t any known interactions between Aldactone and alcohol. However, certain side effects can be worsened if you drink alcohol while taking Aldactone, including dizziness and low blood pressure. If you drink alcohol, talk with your doctor about how much, if any, is safe for you to drink during Aldactone treatment.

As with all medications, the cost of Aldactone can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons: You can visit Optum Perks* for price estimates of Aldactone. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.

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.

A program called Pfizer RxPathways is available for Aldactone. For more information and to find out if you’re eligible for support, call 866-706-2400 or visit the program website.

To learn more about saving money on prescriptions, check out this article.

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 to the cost of Aldactone, talk with your doctor or pharmacist.

* Optum Perks is a sister site of Medical News Today.

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.

The following drugs are similar to Aldactone:

  • diuretics (water pills), such as:
    • bumetanide (Bumex)
    • hydrochlorothiazide (Microzide)
  • other aldosterone antagonists, such as:
    • amiloride (Midamor)

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

AldactoneLasix
Active drugspironolactonefurosemide
Formoral tabletoral tablet
UsesAldactone is approved to treat certain forms of the following in adults:
heart failure with reduced ejection fraction
hypertension when used with other blood pressure drugs
edema in people with certain liver or kidney problems
• primary hyperaldosteronism
Lasix is approved to treat the following in certain situations:
• high blood pressure in adults when used alone or with other blood pressure drugs
• edema in adults and children with congestive heart failure or certain liver or kidney problems

Aldactone and Lasix can cause similar side effects, but some different ones as well. To learn more about these drugs, including their potential side effects, you can refer to the prescribing information for Aldactone and Lasix.

Talk with your doctor or pharmacist if you have questions about your medication.

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

AldactoneEntresto
Active drug(s)spironolactonesacubitril and valsartan
Formoral tabletoral tablet
UsesAldactone is approved to treat certain forms of the following in adults:
heart failure with reduced ejection fraction
hypertension when used with other blood pressure drugs
edema in people with certain liver or kidney problems
• primary hyperaldosteronism
Entresto is approved to treat certain forms of heart failure in adults and children.

Aldactone and Entresto can cause very similar side effects, but some different ones as well. To learn more about these drugs, including their potential side effects, you can refer to the prescribing information for Aldactone and Entresto.

Talk with your doctor or pharmacist if you have questions about your medication.

If you can become pregnant, consider the following information about pregnancy, birth control, and breastfeeding.

Aldactone and pregnancy

Aldactone should not be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with Aldactone.

Aldactone and birth control

You should not 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 taking Aldactone.

Aldactone and 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 (NIH) says that spironolactone, the active drug in Aldactone, appears to be safe to use while breastfeeding.

If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication.

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. Be sure to talk with your doctor about the following factors if they apply to you:

  • kidney disease
  • previous allergic reaction to this or a similar drug
  • pregnancy
  • breastfeeding

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

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 another 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.

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