Spironolactone (Aldactone)
Basics, Side Effects, Reviews & More
Are you looking for information on Aldactazide (spironolactone / hydrochlorothiazide) instead?
Spironolactone (Aldactone) is a diuretic (water pill) used to treat a number of different conditions including primary aldosteronism (an imbalance in hormones that causes high blood pressure), heart failure, high blood pressure, and swelling due to certain liver or kidney problems. Unlike other diuretics, it doesn't lower your body's potassium levels. This medication comes as a tablet and an oral suspension.
COMMON BRANDS
Aldactone, CaroSpir
DRUG CLASS
Aldosterone receptor antagonist
CONTROLLED SUBSTANCE CLASSIFICATION
Not a controlled medication
GENERIC STATUS
Lower-cost generic available
AVAILABILITY
Prescription only
What is spironolactone (Aldactone)?
How spironolactone (Aldactone) works
Spironolactone (Aldactone) is an aldosterone antagonist. It's also referred to as a potassium-sparing diuretic (water pill). It blocks aldosterone (a hormone), so your kidneys can remove extra water and sodium. This helps lower the amount of fluid in your blood vessels and other areas of your body. It makes you urinate more without lowering the amount of potassium in your body, unlike other diuretics (water pills).
What is spironolactone (Aldactone) used for?
- Heart failure
- High blood pressure
- Swelling due to liver damage (cirrhosis)
- Swelling due to nephrotic syndrome (a rare kidney condition) - tablets only
- Primary aldosteronism (a hormone imbalance that causes high blood pressure) - tablets only
Typical dosing for spironolactone (Aldactone)
The dose that your provider prescribes can vary greatly due to your underlying health conditions and the specific reason for taking this medication. You should take the dosage as prescribed by your provider.
Please note: The tablets and oral suspension are not the same and may not have the same dosing. They cannot be substituted for each other. See FAQs for more information.
Tablets: For most conditions, the dose is between 25 mg and 100 mg by mouth once daily. Certain conditions may require doses up to 200 mg or 400 mg daily.
Oral suspension (CaroSpir): For most conditions, the dose is between 20 mg and 75 mg by mouth once daily. Don't take doses greater than 100 mg.
Frequently asked questions about spironolactone (Aldactone)
What's the difference between spironolactone (Aldactone) and CaroSpir (spironolactone)?
Both Aldactone and CaroSpir contain the same active ingredient of spironolactone, but they don't have the same medication effects in your body (not therapeutically equivalent). This means the two medications cannot be substituted (or interchanged) for each other at the pharmacy. Spironolactone (Aldactone) is available in tablet form, while CaroSpir is available as an oral suspension. Spironolactone (Aldactone) can treat two additional medical conditions (swelling due to kidney problem and primary aldosteronism) that CaroSpir isn't approved to treat. Make sure you're taking the correct dose and form that your provider prescribed for you.
Does spironolactone (Aldactone) cause weight loss?
Can I eat bananas with spironolactone (Aldactone)?
Can I stop spironolactone (Aldactone) without warning?
Is it better to take spironolactone (Aldactone) in the morning or at night?
Pros and cons of spironolactone (Aldactone)
Pros
Causes less muscle problems than other diuretics (water pills)
Can be used alone or together with other medications to lower blood pressure
Lowers the risk of death in people with heart failure
Tablets available in a lower-cost generic form (oral suspension is brand only)
Oral suspension is a good option for adults who have difficulty swallowing tablets
Cons
Has many possible side effects, especially at higher doses
Can make you urinate more often
Requires regular blood tests to check your electrolytes and kidney health
Breast growth in men is common, especially at higher doses.
Cannot be taken if you have high potassium levels, have Addison's disease, or are taking eplerenone (Inspra)
Pharmacist tips for spironolactone (Aldactone)
The tablets and oral suspension are not the same and cannot be substituted for each other. Make sure to follow the dosing instructions your provider gave you.
Spironolactone (Aldactone) can be taken with or without food, but make sure to do so consistently. Some people experience stomach upset and nausea after taking the medication. If this happens to you, take it with food to lessen these side effects.
If you're taking the oral suspension, store the medication at room temperature, and shake the bottle well before use. Use the dosing cup or syringe provided by your pharmacy to measure your doses. Don't use household kitchen or measuring spoons to measure your dose, since they might not be accurate and cause you to take the wrong amount of medication.
Spironolactone (Aldactone) can make you urinate more often, so try to take the medication in the morning or afternoon.
Like many blood pressure medications, spironolactone (Aldactone) can cause dizziness the first few days you're taking it. This is because your body hasn't gotten used to having lower blood pressure. Be careful when getting up from a lying down or seated position so you don't get too dizzy or fall.
If any side effects (e.g., leg cramps, diarrhea, breast growth in men) become excessive or bothersome, please let your healthcare provider know. Together, you and your provider can decide if continuing spironolactone (Aldactone) is the best option to treat your condition.
It's very important to keep up with any regular blood tests your provider asks you to have done. This helps make sure that spironolactone (Aldactone) isn't causing problems with your electrolytes or kidneys.
Avoid using potassium supplements or salt substitutes that contain potassium while taking spironolactone (Aldactone), unless your healthcare provider or dietitian tells you to do so. This can cause high levels of potassium in your blood, which can cause heart problems.
Prices for spironolactone (Aldactone) start at just $5.00 with a GoodRx coupon. They’re fast, easy-to-use and free!
What are the side effects of spironolactone (Aldactone)?
With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.
Contact your doctor immediately if you experience any of the following:
- High potassium levels: racing heart, shortness of breath, chest pain, nausea, vomiting
- Abnormal electrolyte levels: muscles cramps, fainting, irregular heart beats, seizures
- Kidney failure: not urinating as much as usual
The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.
Common side effects
- Enlargement of a male's breasts (9%)
Other side effects
- Difficulty getting or maintaining an erection
- Low sex drive
- Irregular or no menstrual periods
- Leg cramps
- Tiredness
- Changes to electrolytes (e.g., sodium, magnesium, calcium)
- Headache
- Diarrhea
- Nausea or vomiting
Source: DailyMed
The following side effects have also been reported:
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: Incidence not known Bleeding gums bloody or black, tarry stools bloody urine blurred vision breast pain clay-colored stools clear or bloody discharge from the nipple cloudy urine confusion dark urine decrease in urine output or decrease in urine-concentrating ability difficulty with swallowing dimpling of the breast skin dizziness dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position drowsiness fast or irregular heartbeat fever with or without chills general feeling of tiredness or weakness headache hoarseness increased thirst indigestion inverted nipple loss of appetite loss of consciousness lower back or side pain lump in the breast or under the arm muscle pain or cramps muscle spasms or twitching painful or difficult urination persistent crusting or scaling of the nipple pinpoint red spots on the skin puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue redness or swelling of the breast seizures severe stomach pain shakiness and unsteady walk sore on the skin of the breast that does not heal sores, ulcers, or white spots on the lips or in the mouth stomach cramping, burning, or tenderness swelling of the face, fingers, feet, ankles, or lower legs swollen, painful, or tender lymph glands in the neck, armpit, or groin tightness in the chest trembling troubled breathing unpleasant breath odor unsteadiness, trembling, or other problems with muscle control or coordination unusual bleeding or bruising unusual tiredness or weakness vomiting vomiting of blood or material that looks like coffee grounds yellow eyes or skin Get emergency help immediately if any of the following symptoms of overdose occur: Symptoms of overdose Irregular heartbeat nervousness numbness or tingling in the hands, feet, or lips rash with flat lesions or small raised lesions on the skin reddened skin weakness or heaviness of the legs Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Incidence not known Burning feeling in the chest or stomach decreased interest in sexual intercourse hair loss or thinning of the hair inability to have or keep an erection leg cramps loss in sexual ability, desire, drive, or performance pain in the nipples sores, welts, or blisters stomach upset swelling of the breasts or breast soreness in both females and males unusual dullness or feeling of sluggishness Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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What are the risks and warnings for spironolactone (Aldactone)?
Spironolactone (Aldactone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options
High blood potassium levels
- Risk factors: Current kidney problems | Diabetes | Taking other medications that increase potassium | Use of potassium-based salt substitutes
Spironolactone (Aldactone) can increase the amount of potassium in your body. Kidney problems, diabetes, certain medications, and the use of potassium-based salt sustitutes can raise your risk of this happening. High potassium can cause a racing heart, shortness of breath, chest pain, nausea, vomiting, or more serious heart problems, such as a heart attack. Your healthcare provider will be checking your potassium levels before you start spironolactone (Aldactone) and regularly after starting to make sure it's safe to keep taking it.
Kidney problems
- Risk factors: Low blood sodium levels | Current kidney problems | Taking medications known to be hard on the kidneys | Taking an ACE inhibitor or ARB
Rarely, spironolactone (Aldactone) can damage the kidneys or cause kidney failure. This is more likely to happen if you already have kidney problems or regularly take other medications that also have a risk of damaging the kidneys, such as nonsteroidal anti-inflammatory drugs or NSAIDs (e.g., ibuprofen (Advil), naproxen (Aleve)), certain cancer treatments, and certain antibiotics. It's important that you have all blood tests ordered by your healthcare provider done on time, so they can make sure your kidneys are healthy while you're taking spironolactone (Aldactone).
Abnormal electrolyte levels (e.g., sodium, calcium, and magnesium)
Spironolactone (Aldactone) can lower sodium, calcium, and magnesium levels in your blood. These electrolytes are important for many bodily functions. When they're too low, you can experience muscles cramps, fainting, irregular heart beats, or even seizures. Your healthcare provider will be checking these electrolytes before you start spironolactone (Aldactone) and regularly after starting to make sure it's safe to keep taking it.
Breast pain or swelling
- Risk factors: Taking high doses of spironolactone (Aldactone)
Spironolactone (Aldactone) can cause breast pain or swelling, especially with higher doses of the medication. This is more common and noticeable for males. Some people have this side effect within 1 to 2 months of starting spironolactone (Aldactone), while others might not experience it until they've been taking the medication for a year. It usually goes away when you stop taking spironolactone (Aldactone). If this side effect is excessive or if it bothers you, talk to your healthcare provider about other options to treat your condition.
Interactions between spironolactone (Aldactone) and other medications
Spironolactone (Aldactone) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with spironolactone (Aldactone). Please note that only the generic name of each medication is listed below.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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How much does spironolactone (Aldactone) cost?
Spironolactone (Aldactone) is available as a generic medication and may be significantly cheaper compared to the brand version. Unless there is a specific reason you need the brand, the generic medication will be a better value. For even more savings, use a GoodRx coupon and pay just a fraction of the retail price.
Aldactone, CaroSpir (brand)
$87.25
spironolactone (generic)
$5.00
Pricing based on most commonly-filled versions: 30 tablets of spironolactone 25mg
What are alternatives to spironolactone (Aldactone)?
There are a number of medications that your doctor can prescribe in place of spironolactone (Aldactone). Compare a few possible alternatives below.
View more drug info
$5.00
lowest GoodRx price
View more drug info
$3.44
lowest GoodRx price
View more drug info
$4.00
lowest GoodRx price
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