Spironolactone

Easy-to-read medicine information about spironolactone – what it is, how to take it safely and possible side effects. Spironolactone is commonly called Spiractin or Spirotone.

Type of medicine	Also called
Diuretic (causes you to pee more) 'Water' tablet or 'water pill' Potassium-sparing diuretic	Spiractin® Spirotone®

What is spironolactone?

Spironolactone is used to treat a number of different conditions and related symptoms, including:

to reduce extra fluid in the body (called oedema) caused by conditions such as heart failure, liver disease or problems with your kidneys – it can reduce swelling in your ankles or feet, and shortness of breath
high blood pressure
primary hyperaldosteronism (in hyperaldosteronism, the adrenal glands produce too much of a hormone called aldosterone. Spironolactone works by stopping the effects of aldosterone).
facial hair growth and acne in women, as in polycystic ovary syndrome (PCOS).

Dose

In New Zealand spironolactone is available as tablets (25 mg and 100 mg).
The dose of spironolactone will be different for different people depending your medical condition and response to treatment.
Always take your spironolactone exactly as your doctor has told you.
The pharmacy label on your medicine will tell you how much spironolactone to take, how often to take it and any special instructions.

How to take spironolactone

Timing: Spironolactone is usually taken once a day, in the morning. Some people, taking higher doses may need to take a second dose later in the day. You can take spironolactone with or without food.
Limit or avoid alcohol while taking spironolactone: Alcohol may increase your chance of side effects such as dizziness.
Missed dose: If you forget to take your dose, take it as soon as you remember that day. If it is nearly time for your next dose, skip the missed dose and take your next dose at the usual time. Do not take 2 doses at the same time.

Precautions when taking spironolactone

Before starting spironolactone

Are you pregnant or breastfeeding?
Do you have problems with your kidneys?
Do you have Addison’s disease?
Are taking any other medicines? This includes any medicines you are taking that you can buy without a prescription, as well as herbal and complementary medicines and medicines you can buy for pain relief.

If so, it’s important that you tell your doctor or pharmacist before you start spironolactone. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

While taking spironolactone

You may need blood tests while taking spironolactone to check the amount of potassium and sodium in your blood, and to see how well your kidneys are working.

Side effects

Like all medicines, spironolactone can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

High potassium levels in your blood

Spironolactone can cause high potassium levels in your blood (also called hyperkalaemia). You are at increased risk of hyperkalaemia if you:

have problems with your kidneys or liver
are elderly
are dehydrated
are taking other medicines that can increase potassium such as angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs) and non-steroidal anti-inflammatory drugs (NSAIDs).

You will need blood tests while you are taking spironolactone to check the amount of potassium in your blood, especially when you first start spironolactone, during dose changes, or if you become unwell with any illness that affects your kidneys.

Try to avoid things with a high potassium content, such as 'salt substitutes' or low-sodium salt. This is so the level of potassium in your body does not become too high.

Contact your doctor immediately or phone Healthline 0800 611 116 if you develop signs of too much potassium in your blood such as irregular heart beat (heart beat feels fluttery), tingling feelings, paralysis (difficulty moving) or difficulty breathing.

Other side effects

Side effects	What should I do?
Feeling sick (nausea) Stomach upset	These are quite common when you first start taking spironolactone and usually go away after the first few days. Try taking your spironolactone dose with or after food. Tell your doctor if troublesome.
Dizziness Feeling light headed Feeling faint when you stand up	Be careful when getting up from either lying down or sitting to avoid falls. These effects puts you at risk of falls and injuries, especially if you are elderly. Be careful when driving or using tools until you know how this medicine affects you.
Signs of too much potassium in your blood such as irregular heart beat (heart beat feels fluttery), tingling feelings, paralysis (difficulty moving) or difficulty breathing	Spironolactone may cause increased potassium in your blood. Tell your doctor immediately or phone Healthline 0800 611 116.
Signs of dehydration (losing too much salt and water) such as muscle cramps, weakness, dry mouth, thirst or passing unusually reduced amounts of pee	Tell your doctor immediately or phone Healthline 0800 611 116.
Signs of hormone changes such as breast development (in men), changes in menstrual cycle (periods) in women, sexual function problems	Tell your doctor.

Interactions

Spironolactone may interact with a number of medicines and herbal supplements so check with your doctor or pharmacist before starting spironolactone and before starting any new medicines.

Also check with your pharmacist before taking anti-inflammatories that can be bought over the counter, such as diclofenac (eg, Voltaren Rapid), ibuprofen (eg, Nurofen), naproxen (eg, Naprogesic).