Spironolactone oral tablets are a prescription medication. They’re FDA-approved for use in adults to treat certain forms of the following conditions:

Spironolactone oral tablets are used to treat these conditions in certain situations. For more information about how the drug is used, see the “Spironolactone oral tablet uses” section below.

Drug details

Spironolactone oral tablets contain the active drug spironolactone. They’re a diuretic medication. Diuretics are sometimes called water pills. They help your body to get rid of excess fluid through your urine.

Specifically, spironolactone belongs to a class of drugs called aldosterone antagonists. These drugs are also called potassium-sparing diuretics. (A class of drugs is a group of medications that work in a similar way.)

Spironolactone oral tablets are taken by mouth. They come in three strengths:

  • 25 milligrams (mg)
  • 50 mg
  • 100 mg

Brand-name versions

Spironolactone is an active drug that comes in oral tablets as a generic medication. Aldactone is a brand-name version of spironolactone oral tablets.

Note: Spironolactone also comes as a brand-name oral suspension (liquid solution) called Carospir. This article only addresses spironolactone oral tablets. For information on spironolactone’s other forms, talk with your doctor or pharmacist.

Effectiveness

For information about the effectiveness of spironolactone oral tablets, see the “Spironolactone oral tablet uses” section below.

Spironolactone oral tablets are a generic drug. A generic drug is an exact copy of the active drug in a brand-name medication. Aldactone is the brand-name medication that spironolactone oral tablets are based on.

A generic drug 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 Aldactone instead of spironolactone oral tablets, talk with your doctor. They can tell you if Aldactone comes in strengths that can be used for your condition. If you have insurance, you’ll also need to check whether your plan will cover Aldactone.

To learn more about how generics compare with brand-name drugs, see this article.

Spironolactone oral tablets can cause mild and serious side effects. The following lists contain some of the key side effects that may occur while taking spironolactone oral tablets. These lists do not include all possible side effects.

For more information about the possible side effects of spironolactone oral tablets, talk with your doctor or pharmacist. They can give you tips on how to deal with 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 spironolactone oral tablets, you can do so through MedWatch.

Mild side effects

Mild side effects* of spironolactone oral tablets 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 spironolactone oral tablets. To learn about other mild side effects, talk with your doctor or pharmacist, or view spironolactone oral tablet’s prescribing information.

Serious side effects

Serious side effects from spironolactone oral tablets 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:

* For more information about this side effect, see “Side effect details” below.

Side effect details

Here’s some detail on certain side effects this drug may cause.

Breast growth

One of the more common side effects of spironolactone oral tablets is gynecomastia, which is breast growth in males.* With this condition, you may notice that your breast tissue becomes swollen and tender.

This side effect is more likely to occur if you take a high dose of spironolactone. And it can start happening any time from 1 month to more than 1 year after you begin taking spironolactone.

Breast changes weren’t reported as side effects in women (females*) during studies of spironolactone oral tablets.

If you notice any breast swelling or growth while you’re taking spironolactone, talk with your doctor. They’ll typically recommend that you switch to a medication other than spironolactone for your condition.

Breast growth from spironolactone usually goes away after you stop taking the drug. At that point, your breast tissue should return to its normal size.

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

Hyponatremia and hyperkalemia

Spironolactone oral tablets can sometimes cause hyponatremia (low sodium level) and hyperkalemia (high potassium level). These conditions are described below.

Hyperkalemia

You can develop hyperkalemia with spironolactone because the medication helps your body retain potassium.

It’s not known how often this side effect occurs. But you’re more likely to have hyperkalemia with spironolactone if you have kidney problems.

You’re also more likely to have this side effect if you take spironolactone with potassium supplements or other medications that increase your potassium level. Eating lots of potassium-rich foods, especially salt substitutes that contain potassium, also increases your risk for hyperkalemia. See the “Spironolactone oral tablet interactions” section below to read more about this risk.

Hyperkalemia doesn’t usually cause symptoms. But if your potassium level is very high, symptoms may include:

  • nausea
  • fatigue (lack of energy)
  • muscle weakness or cramps
  • tingling or numbness in your hands or feet
  • palpitations (feeling like your heart is racing, pounding, or beating irregularly)
  • trouble breathing

Your doctor will typically check your potassium level in the week after you start treatment with spironolactone. And they’ll check your level after any dose increases. You’ll also have blood tests to check your potassium level on a regular basis while you’re taking spironolactone. It’s especially important that your potassium level is monitored if you have kidney problems or you’re taking spironolactone with other medications that increase potassium.

If you have symptoms of hyperkalemia at any time while you’re taking spironolactone, see your doctor right away. This way, your potassium level can be checked.

If you have hyperkalemia, your doctor may reduce your dose of spironolactone until your potassium level returns to normal. If your potassium level doesn’t improve, you may need medication to treat it. Your doctor may also have you stop taking spironolactone temporarily. Or they may switch you to a different medication.

Hyponatremia

You can develop hyponatremia with spironolactone because the medication makes your kidneys filter more sodium out of your body. It’s not known how often this side effect occurs.

Symptoms of hyponatremia can include:

While you take spironolactone, your doctor will order blood tests to check your sodium level on a regular basis. If you have symptoms of hyponatremia, see your doctor right away. This way, your sodium level can be checked.

If you have hyponatremia, your doctor may reduce your dose of spironolactone until your sodium level returns to normal. If your sodium level doesn’t improve, you may need medication to treat it. Your doctor may also have you stop taking spironolactone temporarily. Or they may switch you to a different medication.

Kidney problems

Spironolactone can sometimes cause kidney problems. These include worsening kidney function or more rarely, kidney failure.

It’s not known how often kidney problems occur with spironolactone. But you may have a higher risk for kidney problems if you have low blood pressure or become dehydrated during treatment. (With dehydration, you have a low fluid level in your body.) Spironolactone makes your body lose fluid, so you’re more likely to have low blood pressure or become dehydrated with the drug.

Symptoms of dehydration can include:

Symptoms of low blood pressure can include:

  • lightheadedness
  • dizziness
  • fainting

If you have symptoms of dehydration or low blood pressure while you’re taking spironolactone, see your doctor right away. They may need to lower your dose of spironolactone.

Kidney problems are more likely if you take spironolactone with other medications that can cause kidney problems. See the “Spironolactone oral tablet interactions” section below to read more about this.

Symptoms of kidney problems may include:

  • edema (fluid retention and swelling) in your lower legs and feet
  • muscle cramps
  • loss of appetite
  • headache
  • passing little or no urine

While you take spironolactone, your doctor will order blood tests on a regular basis to check the health of your kidneys. If you have symptoms of kidney problems, see your doctor right away. This way, your kidney function can be checked.

If you have kidney problems with spironolactone, your doctor will likely switch you to a different medication.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking spironolactone oral tablets.

Symptoms of a mild allergic reaction can include:

  • rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

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 spironolactone oral tablets, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Here are answers to some frequently asked questions about spironolactone oral tablets.

Is spironolactone used for acne? If so, what’s the drug’s dosage for acne?

Yes, spironolactone is sometimes used to treat acne in adult females.* But, this is an off-label use of the drug. Off-label drug use means the drug is used for a purpose other than what it’s been approved for by the Food and Drug Administration (FDA).

Acne is sometimes caused by the hormone testosterone. (This condition may be called hormonal acne.) Testosterone stimulates sebaceous glands in your skin, making them produce sebum (oil). This can block your pores and lead to acne. Certain females may produce a lot of testosterone, or have sebaceous glands that are very sensitive to testosterone.

Spironolactone reduces your body’s testosterone production, so it can be effective for treating acne in the situations described.

In guidelines from the American Academy of Dermatology, this drug is recommended as an acne treatment option for certain females. But it’s not recommended for treating acne in males,* as its side effects usually outweigh its benefits in males for this use.

There’s not an FDA-approved dosage of spironolactone for acne, because acne isn’t an approved use for this drug.

If you’re interested in taking spironolactone for acne, talk with your doctor. They can help you decide if this or another treatment is right for you. Examples of FDA-approved acne treatments include isotretinoin (Accutane) and adapalene/benzoyl peroxide (Epiduo).

If your doctor prescribes spironolactone for acne, follow their instructions regarding the dosage to take. And stay on the medication for as long as your doctor recommends that you should do so.

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

Does spironolactone treat hair loss?

Yes, spironolactone is sometimes used to treat hair loss in adult females.* But this is an off-label use of the drug. Off-label drug use means a drug is used for a purpose other than what it’s been approved for by the FDA.

Spironolactone may be prescribed for androgenic alopecia in females. With this condition, you have hair loss that’s caused by too much of the hormone testosterone in your body. In females, it’s called female pattern hair loss.

Androgenic alopecia typically leads to hair thinning over the crown of the head. Females with this type of hair loss may also have hirsutism, which is male pattern hair growth. For example, hirsutism may cause facial hair growth.

Spironolactone reduces your body’s testosterone production, so it can increase hair growth on the scalp in females with androgenic alopecia. But it won’t help treat hair loss that’s caused by other factors. (These could include stress, nutritional deficiencies, or cancer treatments.) And it’s not recommended for hair loss in males.* Spironolactone’s side effects usually outweigh its benefits when used for hair loss in males.

There’s not an FDA-approved dosage of spironolactone for hair loss, because this isn’t an approved use for the drug.

If you’re interested in taking spironolactone for hair loss, talk with your doctor. They can help you decide if this or another treatment is right for you.

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

Is weight loss or weight gain a side effect of spironolactone?

Weight loss and weight gain weren’t reported in people who took spironolactone during clinical studies.

Spironolactone helps your body to get rid of excess fluid. And this can sometimes lead to weight loss. For example, if you take spironolactone for heart failure or edema (fluid retention and swelling) you’re likely to lose weight as your body gets rid of excess fluid.

On the other hand, if spironolactone isn’t working well to treat these conditions, your body may retain more fluid. And this can lead to weight gain. If you have kidney problems with spironolactone, this could also lead to fluid retention that can cause weight gain.

If you have weight gain with spironolactone, talk with your doctor. They can check to see if the medication or something else is causing your weight gain. Weight gain could suggest that spironolactone isn’t working well for you or that it’s causing side effects. Your doctor may need to increase your dosage of the drug or switch you to another medication.

If you have weight loss with spironolactone, it usually indicates that the medication is working for you. But if you’re concerned about weight loss with this drug, talk with your doctor. They can check to see if the medication or something else is causing you to lose weight.

Does spironolactone cause emotional side effects?

It’s not known to. Emotional side effects weren’t reported in people who took spironolactone during clinical studies.

Spironolactone can sometimes cause sexual problems, such as reduced sex drive and erectile dysfunction. It can also cause breast growth in males. These side effects could possibly lead to emotional problems in some people.

If you feel that spironolactone is affecting your mood or emotions, talk with your doctor. They can check to see if the medication or something else is causing the change. They may also be able to suggest ways to help manage it.

How do you safely stop taking spironolactone? Can you stop taking it ‘cold turkey’?

You shouldn’t stop taking spironolactone without first talking with your doctor.

Stopping this medication suddenly won’t cause withdrawal symptoms. But when you stop taking spironolactone it will quickly stop working to manage your condition. As a result:

All of these things can possibly be dangerous for you.

If you and your doctor decide you should stop taking spironolactone, your doctor will explain the best way to do this. Whether you can suddenly stop taking the drug safely will depend on several factors. These include the condition you’re using it to treat, the reason for stopping treatment, and whether you’ll be switching to a different treatment.

What drug class does spironolactone belong to? Is it a blood thinner?

A class of drugs is a group of medications that work in a similar way. Spironolactone belongs to a class of drugs called aldosterone antagonists. These are also called potassium-sparing diuretics.

Diuretics are also sometimes called water pills. They help your body to get rid of excess fluid through your urine. There are a few different types of diuretics. Some diuretics can make your body lose too much potassium. But potassium-sparing diuretics, including spironolactone, help your body get rid of fluid without losing too much potassium.

Spironolactone isn’t a blood thinner. It doesn’t affect your blood’s ability to form clots, which is what blood thinners do.

The spironolactone oral tablet dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re treating
  • your age
  • other medical conditions you may have
  • how well your kidneys work
  • if you have certain side effects with this medication

Typically, your doctor will start you taking 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. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug strengths

Spironolactone oral tablets are taken by mouth. They come in three strengths:

  • 25 milligrams (mg)
  • 50 mg
  • 100 mg

Dosage for high blood pressure

The usual starting dosage of spironolactone for high blood pressure is 25 mg to 100 mg per day.

Your doctor may have you take this as a single dose in the morning. Or they may have you take it as several doses throughout the day. Always follow your doctor’s instructions for your dosage.

Dosage for heart failure

The usual starting dosage of spironolactone for heart failure is 25 mg taken once per day. If needed, your doctor may increase your dosage to 50 mg taken once per day.

If your potassium level increases too much, your doctor may lower your dosage to 25 mg taken once every other day.

Dosage for edema

Spironolactone is used for edema (fluid retention and swelling) that’s related to one of the following conditions:

The usual dosage for edema ranges from 25 mg to 200 mg per day. A typical starting dosage for this use is 100 mg per day. Your doctor may adjust your dosage as needed during treatment.

Your doctor may have you take your daily dosage as one single dose, or they may have you split it up over the day. Always follow your doctor’s instructions for your dosage.

If you’re taking spironolactone for edema related to cirrhosis, you’ll start this treatment in a hospital. This is because the medication could cause sudden changes in the balance of fluid and electrolytes in your body. This could cause problems with your nervous system, such as confusion, tremor, and rarely, coma. Being in a hospital allows your doctor to monitor you for these side effects and treat any problems as needed.

Dosage for hyperaldosteronism

Spironolactone is used to treat primary hyperaldosteronism (a condition in which your adrenal glands produce too much of the hormone aldosterone).

If you’re having surgery for this condition, you’ll take spironolactone for a short time before your surgery. Doing so helps to lower your blood pressure and increase your potassium level before the surgery. The usual dosage of spironolactone oral tablets for this use is 100 mg to 400 mg per day.

If you’re not having surgery for this condition, you’ll take spironolactone as a long-term treatment. There’s no typical dosage of spironolactone oral tablets for this use. Instead, your doctor will prescribe the lowest dosage that best manages your blood pressure and potassium level.

What if I miss a dose?

If you miss a dose of spironolactone oral tablets, take the missed dose as soon as possible. But if it’s nearly time for your next scheduled dose, skip the missed dose and take your next scheduled dose as usual.

Don’t take two doses together to make up for missing a dose. Doing so can increase your risk for side effects.

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

Will I need to use this drug long term?

Spironolactone oral tablets are meant to be used as a long-term treatment for most of their uses. If you and your doctor determine that spironolactone is safe and effective for you, you’ll likely take it long term.

Spironolactone oral tablets are also used as a short-term treatment before surgery for primary hyperaldosteronism. If you’re taking them for this purpose, talk with your doctor about what medications you may need to take after your surgery.

The Food and Drug Administration (FDA) approves prescription drugs such as spironolactone oral tablets to treat certain conditions. Spironolactone oral tablets may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the FDA.

Spironolactone oral tablet for high blood pressure

Spironolactone oral tablets are FDA-approved to treat high blood pressure in adults. They’re approved as an add-on treatment for high blood pressure that’s not well-managed by other drugs.

High blood pressure is typically caused by factors that lead to narrowing or hardening of your arteries. These factors include:

High blood pressure may also be caused by diabetes and certain kidney or hormone problems. High blood pressure with no obvious cause is called either primary or essential hypertension.

High blood pressure doesn’t usually cause symptoms. But over time, high blood pressure can damage your arteries and organs, and it can cause problems throughout your body. In particular, high blood pressure can raise your risk for cardiovascular problems, such as heart attack and stroke. Lowering high blood pressure helps to lower your risk for these problems.

The American Heart Association (AHA) recommends that blood pressure drugs be prescribed to lower the risk of cardiovascular problems in certain people. Specifically, the AHA recommends these drugs be used in people with blood pressure that’s:

  • 140/90 millimeters of mercury (mmHg)* or higher
  • 130/80 mmHg or higher who also:
    • have had a heart attack or stroke, or
    • have a high risk for cardiovascular disease due to factors such as diabetes

Many people need to take more than one medication to lower their blood pressure. Spironolactone is added to other treatment when medications to lower blood pressure haven’t been effective enough.

* Blood pressure is measured in mmHg. The measurement is given as systolic pressure (the pressure when your heart contracts) over diastolic pressure (the pressure when your heart relaxes). Normal blood pressure is below 120/80 mmHg.

Effectiveness for high blood pressure

Spironolactone oral tablets are an effective blood pressure-lowering medication. They’re included in AHA guidelines for treating hypertension. They’re recommended as an add-on treatment option for high blood pressure that’s not well-managed by other drugs.

Spironolactone oral tablet for heart failure

Spironolactone oral tablets are FDA-approved to treat certain forms of heart failure in adults. Specifically, they’re approved to treat heart failure that’s:

With heart failure, your heart isn’t able to effectively pump blood around your body. As a result, your body doesn’t get the oxygen it needs. (Your blood carries oxygen.) Heart failure also causes fluid to build up in your lungs, legs, and abdomen (belly). This fluid buildup is called edema.

Heart failure causes various symptoms that can make everyday activities difficult. These symptoms include:

Doctors use the NYHA scale to describe the severity of heart failure symptoms. The scale has four classes. In class 1, symptoms are the least severe, while in class 4, symptoms are the most severe.

With class 3 heart failure, symptoms such as fatigue, shortness of breath, and palpitations significantly limit your physical ability. But you don’t have symptoms when you’re resting. With class 4, you have symptoms even when you’re resting, and you’re unable to do physical activity without discomfort.

Spironolactone helps your body to get rid of excess fluid. So, it reduces swelling and makes breathing easier for you. Spironolactone also lowers your blood pressure. This makes it easier for your heart to pump blood around your body and supply oxygen to your organs.

Effectiveness for heart failure

Spironolactone is an effective treatment for heart failure. It reduces edema and helps lower your risk for needing treatment in hospital. It also helps reduce your risk for dying from heart failure.

It’s included as a treatment option in guidelines from the AHA for NYHA class 3 or 4 heart failure with reduced ejection fraction.

Spironolactone oral tablet for edema

Spironolactone oral tablets are FDA-approved to treat edema (fluid retention and swelling) in adults with:

  • A kidney problem called nephrotic syndrome. For people with this condition, spironolactone is used when the following treatments haven’t worked:
    • restricting fluid and salt intake
    • treating the underlying problem that’s causing the nephrotic syndrome
    • using other diuretics besides spironolactone
  • Cirrhosis. Spironolactone is used in people with this condition, when restricting fluid and salt intake hasn’t worked.

Nephrotic syndrome can develop when a condition or medication damages the blood vessels in your kidneys. The damage allows a protein called albumin to leak out of your blood into your urine.

Albumin usually helps keep fluid in your bloodstream. When you have low levels of albumin, excess fluid leaks out of your blood vessels into other tissues. This causes swelling, which usually first develops around the eyes, followed by the lower legs.

Cirrhosis is scarring and stiffening of the liver that’s caused by long-term liver damage. It stops your liver from working correctly and makes it harder for blood to flow through your liver. As a result, fluid can leak out of your blood into other tissues, causing swelling. With cirrhosis, swelling can develop in your lower legs. It can also develop in your abdomen (belly), causing a condition called ascites.

In people with these conditions, spironolactone treats edema by helping your body to get rid of excess fluid in your urine. This reduces swelling.

Effectiveness for edema

Spironolactone oral tablets are an effective treatment for edema that’s caused by cirrhosis and nephrotic syndrome. It’s been widely used for edema for many years.

For example, it’s included as a treatment option for ascites due to cirrhosis in guidelines from the American Association for the Study of Liver Diseases.

Spironolactone oral tablet for hyperaldosteronism

Spironolactone oral tablets are FDA-approved to treat primary hyperaldosteronism in adults.

With primary hyperaldosteronism, your adrenal glands produce too much of a hormone called aldosterone. This condition is sometimes called Conn’s syndrome. It may be passed down in families, or it may be caused by a tumor or growth on your adrenal glands.

Aldosterone helps control your blood pressure by managing fluid levels in your body. It affects how much water, sodium, and potassium get filtered out of your blood by your kidneys.

When your adrenal glands make too much aldosterone, your kidneys don’t get rid of as much sodium and water as usual. They also get rid of too much potassium. This can cause:

Spironolactone blocks the effects of aldosterone. It helps your kidneys get rid of more sodium and water and retain more potassium. This lowers your blood pressure and increases your potassium level.

Spironolactone oral tablets are approved for primary hyperaldosteronism in the following situations:

  • for short-term management of symptoms before surgery is done to treat the condition
  • for long-term management of symptoms in people with:
    • adrenal adenoma (a type of noncancerous tumor on the adrenal gland that produces aldosterone), when surgery isn’t possible
    • bilateral micro or macronodular adrenal hyperplasia (lumps on the adrenal glands that cause the adrenal glands to grow and produce more hormones than usual)

Effectiveness for hyperaldosteronism

Spironolactone is an effective treatment for primary hyperaldosteronism. It’s recommended in treatment guidelines from the Endocrine Society for this condition.

Spironolactone oral tablet and children

Spironolactone oral tablets aren’t approved for any uses in children.

Spironolactone doesn’t directly interact with alcohol.

But if you have certain side effects from spironolactone, drinking alcohol could make this worse. These side effects include:

It’s also worth noting that alcohol could worsen the condition you’re taking spironolactone to treat.

For example, regularly drinking large amounts of alcohol can increase your blood pressure. The American Heart Association recommends that people with high blood pressure limit their alcohol intake.

Additionally, if you have cirrhosis (scarring of the liver) that’s a result of alcohol use, its recommended that you don’t drink at all.

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

Spironolactone oral tablets can interact with several other medications. They 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.

Spironolactone oral tablet and other medications

Below is a list of medications that can interact with spironolactone oral tablets. This list does not contain all drugs that may interact with spironolactone oral tablets.

Before taking spironolactone oral tablets, 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, talk with your doctor or pharmacist.

Drugs you should not take with spironolactone oral tablets include:

  • Eplerenone (Inspra). Eplerenone belongs to the same class of drugs as spironolactone does. You shouldn’t take spironolactone oral tablets with eplerenone because doing so could increase your risk for side effects.

Drugs that can interact with spironolactone oral tablets include:

  • Angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors are typically used to treat high blood pressure and heart failure. Taking spironolactone oral tablets with these drugs can increase your risk for hyperkalemia (high potassium level). Doing so can also increase your risk for kidney problems. Examples of these drugs include:
    • captopril
    • enalapril (Epaned, Vasotec)
    • lisinopril (Qbrelis, Prinivil, Zestril)
    • ramipril (Altace)
  • Aliskiren (Tekturna). Aliskiren is used to treat high blood pressure. Taking spironolactone oral tablets with this drug can increase your risk for hyperkalemia and kidney problems.
  • Angiotensin receptor blockers (ARBs). ARBs are typically used to treat high blood pressure and heart failure. Taking spironolactone oral tablets with these drugs can increase your risk for hyperkalemia and kidney problems. Examples of these drugs include:
    • olmesartan (Benicar)
    • telmisartan (Micardis)
  • Cholestyramine (Prevalite). Cholestyramine is a drug that’s mainly used to treat high cholesterol. Taking spironolactone oral tablets with cholestyramine can increase your risk for hyperkalemia and metabolic acidosis (too much acid in your body).
  • Digoxin (Lanoxin). Digoxin is a drug used to treat heart failure and irregular heartbeats. Taking spironolactone oral tablets with digoxin can increase your risk for side effects from digoxin.
  • Heparin and low molecular weight heparin. Heparins are blood thinners used to treat and help prevent blood clots. Taking spironolactone oral tablets with these drugs can increase your risk for hyperkalemia. Examples of these drugs include:
    • dalteparin (Fragmin)
    • enoxaparin (Lovenox)
    • heparin sodium
  • Lithium (Lithobid). Lithium is a drug used to treat certain mental illnesses, such as bipolar disorder. Taking spironolactone oral tablets with lithium can increase your risk for side effects from lithium.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce pain and inflammation. Taking spironolactone oral tablets with these drugs can make spironolactone less effective. It can also increase your risk for kidney problems. Examples of these drugs include:
    • aspirin
    • celecoxib (Celebrex)
  • Potassium-sparing diuretics. Potassium-sparing diuretics are used to treat the same conditions as spironolactone treats. Taking spironolactone oral tablets with these drugs can increase your risk for hyperkalemia. Examples of these drugs include:
    • amiloride (Midamor)
    • triamterene (Dyrenium)
  • Trimethoprim. Trimethoprim is an antibiotic that’s typically used to treat urinary tract infections. Taking spironolactone oral tablets with this drug can increase your risk for hyperkalemia.

Spironolactone oral tablet and herbs and supplements

You shouldn’t usually take spironolactone oral tablets with potassium supplements. Doing so can increase your risk for hyperkalemia (high potassium level). If you take a potassium supplement, your doctor will usually have you stop using it before you start taking spironolactone.

There aren’t any other herbs or supplements that have been specifically reported to interact with spironolactone oral tablets. But you should still check with your doctor or pharmacist before using any of these products while taking spironolactone oral tablets.

Spironolactone oral tablet and foods

While you’re taking spironolactone oral tablets, you should avoid using salt substitutes that contain potassium. This medication increases the level of potassium in your blood. Using potassium-containing salt substitutes can cause your potassium level to become too high. This is called hyperkalemia.

Eating lots of potassium-rich foods while taking spironolactone can also increase your risk for hyperkalemia.

If you have any questions about eating certain foods while taking spironolactone oral tablets, talk with your doctor or pharmacist.

Spironolactone oral tablets are used to treat certain forms of the following conditions:

To learn more about these conditions and the situations when spironolactone is used for them, see the “Spironolactone oral tablets uses” section above.

What spironolactone does

Spironolactone is a type of drug called an aldosterone antagonist. It works by blocking the action of a hormone in your body called aldosterone. How a drug works is called its mechanism of action.

Aldosterone is made by your adrenal glands (glands found on top of both kidneys). This hormone helps regulate your blood pressure by balancing fluids and salts in your body. It tells your kidneys how much water, sodium, and potassium to filter out of your blood and into your urine.

If your adrenal glands produce too much aldosterone, your kidneys keep more fluid and sodium in your blood than usual. And this increases your blood pressure. It also makes your kidneys filter too much potassium out of your blood. And this leads to a low potassium level.

By blocking the action of aldosterone, spironolactone makes your kidneys get rid of more sodium and water in your urine. It also makes your kidneys keep more potassium in your blood.

Spironolactone is called a diuretic medication. These medications are also sometimes called water pills because they help your body to get rid of excess fluid through your urine. This helps to treat edema (fluid retention and swelling). It also helps to lower your blood pressure. And in people with heart failure, treating edema also makes it easier for their heart to pump blood.

Most diuretics also cause your kidneys to get rid of potassium. But because spironolactone has the opposite effect, it’s called a potassium-sparing diuretic.

How long does it take to work?

Spironolactone oral tablets start working soon after you take your first dose. If you’re taking them for high blood pressure or hyperaldosteronism, you’re not likely to notice the drug working. But if you’re taking it for heart failure or edema, you may notice your symptoms reducing after a few days.

How long does it last in your body?

Spironolactone oral tablets have a half-life of 1.4 hours. This means it takes about an hour and a half for your body to clear half of a dose of the drug. In general, a dose of a drug is fully cleared from your body after four to five half-lives.

Spironolactone shouldn’t usually be taken during pregnancy, unless there’s no suitable alternative treatment to be used.

Based on the way this medication works and data from studies in animals, spironolactone could cause a male fetus to become a female.* The drug could also cause hormone problems in a female fetus exposed to the drug. Limited data about spironolactone use in humans hasn’t shown a link with other birth defects.

If you’re pregnant or planning to become pregnant, talk with your doctor before taking spironolactone oral tablets. They’ll likely recommend a different treatment for your condition.

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

Usually, you shouldn’t take spironolactone oral tablets during pregnancy. 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 spironolactone oral tablet.

For more information about taking spironolactone oral tablets during pregnancy, see the “Spironolactone oral tablet and pregnancy” section above.

Spironolactone doesn’t pass into breast milk, but its metabolites may do so. (Metabolites are chemicals created when your body breaks down a drug.)

For instance, a metabolite called canrenone has been found in breast milk. But it’s been found in small amounts that aren’t likely to be harmful to a child who’s breastfed.

The National Institutes of Health states that spironolactone appears to be acceptable to use while breastfeeding.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the best way to feed your child while taking spironolactone.

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 spironolactone oral tablets, talk with your doctor. They can tell you about other medications that may work well for you.

For more information about the conditions listed below, see the “Spironolactone oral tablet uses” section above.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the Food and Drug Administration (FDA).

Alternatives for high blood pressure

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

  • angiotensin converting enzyme (ACE) inhibitors, such as:
    • benazepril (Lotensin)
    • captopril
    • enalapril (Vasotec)
    • quinapril (Accupril)
    • ramipril (Altace)
  • aliskiren (Tekturna)
  • angiotensin receptor blockers (ARBs), such as:
    • irbesartan (Avapro)
    • losartan (Cozaar)
    • olmesartan (Benicar)
    • telmisartan (Micardis)
    • valsartan (Diovan)
  • beta-blockers, such as:
    • bisoprolol
    • propranolol (Inderal LA, Innopran XL)
  • calcium channel blockers, such as:
    • amlodipine besylate (Norvasc, Lotrel)
    • diltiazem (Cardizem CD, Tiazac)
    • felodipine
    • nifedipine (Procardia)
    • verapamil (Verelan)
  • clonidine (Catapres)
  • diuretics other than spironolactone, such as:
    • amiloride (Midamor)
    • bumetanide (Bumex)
    • chlorthalidone
    • furosemide (Lasix)
    • hydrochlorothiazide (Microzide)
    • indapamide
    • metolazone (Zaroxolyn)
  • hydralazine

Alternatives for heart failure

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

  • ACE inhibitors, such as:
    • captopril
    • enalapril (Vasotec)
    • lisinopril (Prinivil, Zestril)
    • quinapril (Accupril)
    • ramipril (Altace)
  • ARBs, such as:
    • candesartan (Avapro)
    • losartan (Cozaar)
    • valsartan (Diovan)
  • beta-blockers, such as:
    • bisoprolol
    • carvedilol (Coreg, Coreg CR)
    • metoprolol succinate (Toprol-XL)
  • digoxin (Lanoxin)
  • diuretics other than spironolactone, such as:
    • amiloride (Midamor)
    • bumetanide (Bumex)
    • furosemide (Lasix)
    • indapamide
    • metolazone (Zaroxolyn)
    • triamterene (Dyrenium)
    • torsemide (Demadex)
  • ivabradine (Corlanor)
  • aldosterone antagonists other than spironolactone, such as:
    • eplerenone (Inspra)
  • combination medications, such as:
    • hydralazine/isosorbide dinitrate (BiDil)

Alternatives for edema

Examples of other drugs that may be used to treat edema (fluid retention and swelling) in people with certain kidney and liver problems include:

  • diuretics, other than spironolactone, such as:
    • amiloride (Midamor)
    • bumetanide (Bumex)
    • furosemide (Lasix)
    • indapamide
    • metolazone (Zaroxolyn)
    • triamterene (Dyrenium)
    • torsemide (Demadex)

Alternatives for hyperaldosteronism

Examples of other drugs that may be used to treat hyperaldosteronism (a condition in which your adrenal glands make too much of the hormone aldosterone) include:

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

As with all medications, the cost of spironolactone oral tablets can vary. To find current prices for spironolactone oral 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.

Keep in mind that you may be able to get a 90-day supply of spironolactone oral tablets. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

Before approving coverage for spironolactone oral tablets, 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 considers covering 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 spironolactone oral tablets, contact your insurance company.

Financial and insurance assistance

Financial assistance to help you pay for spironolactone oral tablets may be available.

Medicine Assistance Tool and NeedyMeds are two websites offering resources that may help decrease the price you pay for spironolactone oral tablets. They also offer tools to help you find low-cost healthcare, as well as educational resources. To learn more, visit their sites.

Mail-order pharmacies

Spironolactone oral tablets may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of spironolactone oral tablets, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Before taking Spironolactone oral tablets, talk with your doctor about your health history. Spironolactone oral tablets may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction. If you’ve had an allergic reaction to spironolactone or any of its other ingredients, you shouldn’t take spironolactone oral tablets. Ask your doctor what other medications are better options for you.
  • Hyperkalemia (high potassium level). Spironolactone oral tablets can increase the amount of potassium in your blood. If you already have a high potassium level, you shouldn’t take this drug. Ask your doctor what other medications are better options for you.
  • Addison’s disease. If you have Addison’s disease (an adrenal gland disorder), you shouldn’t take spironolactone oral tablets because they can worsen your condition. Ask your doctor what other medications are better options for you.
  • Kidney problems. If you have kidney problems, you may have a higher risk for hyperkalemia with spironolactone. This medication could also worsen your kidney problems. Your doctor will frequently monitor your kidney function and your potassium level while you’re taking spironolactone oral tablets.
  • Pregnancy. Usually, spironolactone shouldn’t be taken during pregnancy because it could cause certain problems with fetal development. For more information, see the “Spironolactone oral tablet and pregnancy” section above.
  • Breastfeeding. Spironolactone doesn’t pass into breast milk, but its metabolites may do so. (Metabolites are chemicals created when your body breaks down a drug.) For more information, see the “Spironolactone oral tablet and breastfeeding” section above.

Note: For more information about the potential negative effects of spironolactone oral tablets, see the “Spironolactone oral tablet side effects” section above.

You should take spironolactone oral tablets according to your doctor’s or other healthcare professional’s instructions. The tablets should be swallowed whole.

When to take

When you’ll need to take spironolactone depends on the dosage you’ve been prescribed.

Your doctor may ask you to take your daily dosage as one single dose. Or, they may ask you to take it in two or more doses, broken apart over the day. If you have heart failure, your doctor may have you take spironolactone every other day.

If you’re taking spironolactone oral tablets once each day, try to take your dose at about the same time each day. And if you’re taking the drug more than once each day, try to take your doses at about the same times each day.

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

Taking Spironolactone oral tablet with food

You can take spironolactone oral tablets either with or without food. But try to be consistent either way.

This means if you start taking spironolactone with food you should continue taking it with food, and vice versa.

Can Spironolactone oral tablet be crushed, split, or chewed?

Spironolactone oral tablets are meant to be swallowed whole.

If you have trouble swallowing spironolactone tablets, talk with your doctor. They may suggest a different form of the drug.

Using more than the recommended dosage of spironolactone oral tablets can lead to serious side effects.

Do not take more spironolactone oral tablets than your doctor recommends.

Overdose symptoms

Symptoms of spironolactone oral tablet overdose can include:

  • drowsiness
  • confusion
  • rash
  • nausea
  • vomiting
  • dizziness
  • diarrhea

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 its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get spironolactone oral tablets 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 with your pharmacist about whether you might still be able to use it.

Storage

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

Spironolactone oral tablets should be stored at room temperature (68°F to 77°F, or 20°C to 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 spironolactone oral tablets 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 about how to dispose of your medication.

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.