What is spironolactone?

Spironolactone is a medication often used to treat patients with heart and kidney problems. It is part of the so-calledpotassium-sparing diuretics, because it prevents the massive loss of potassium (an important electrolyte). (1)

Its mechanism of action is theinhibition of aldosterone (hormone produced in the adrenal gland responsible for inducing potassium excretion) by binding to its receptors. As for its presentations, spironolactone comes in tablets of 25, 50 and 100 mg, or oral suspension of 5 mg / mL.

Important: The amount of the drug absorbed in the gastrointestinal tract is almost 100% if consumed with food or at very close hours to meals.

What is spironolactone for?

Spironolactone is a trusted diuretic, used in conjunction with otherdiuretics, that stabilizes water levels in the patient. This therapeutic goal is vital for certain diseases, as we will see below:

1. Hyperaldosteronism

Primary hyperaldosteronism is a condition in which the adrenal gland produces excess aldosterone , the hormone responsible for sodium retention and potassium excretion.

Therefore, patients have low potassium levels or Hypokalemiatag. A potassium-sparing diuretic, such as spironolactone, is indicated as part of the treatment.

2. Heart failure

According to the New York Association functional classification , patients in advanced stages of chronic heart failure should take spironolactone to manage edema, increase survival chances, and prevent heart failure. (two)

3. High blood pressure

A potassium saver is used to treat chronic potassium loss , a feared side effect in patients taking high blood pressure medications and other types of diuretics.

Note : Antihypertensive treatments seek to reduce sodium and water overload in the body, by stimulating the amount of urine excreted.

However, this brings side effects such as potassium losstag. Potassium-sparing diuretics, such as spironolactone, seek to cushion these adverse effects.

4. Fluid retention

Fluid retention causes oedema(localized or generalized swelling of the body). It can be caused by liver cirrhosis, liver failure, kidney failure, or nephrotic syndrome.

When the patient does not respondto treatments to reduce fluid overload, spironolactone is administered. 100 mg is administered daily for 5 days, although the dose can be increased up to 200 mg if necessary.

Important : If you notice that parts of your body, such as ankles or feet, swell, see your doctor immediately.

Spironolactone Contraindications

It is essential, both for the doctor and for the people, to understand that spironolactone can be harmful under certain circumstances , which we will explain below:

1. Sensitivity to components

If a few days after starting treatment with the drug, you notice the appearance of skin rashes, spots, nausea and vomiting, you may be allergic to spironolactone or any of its components.

Important: If you experience any of these symptoms, tell your doctor as soon as possible.

2. Kidney and liver failure

Most drugs are metabolized and inactive, once they complete their function in the liver and are excreted in the urine. In patients with cirrhosis or chronic kidney disease, the use of spironolactone should be adjusted. Otherwise, there is a risk of accumulation toxicity.

3. High potassium levels

Care should be taken when taking spironolactone, if you consume a diet high in potassium or potassium supplements, since both factors could trigger hyperkalemia (very high amounts of potassium in the blood).

4. Addison’s disease

It is a disorder caused by the destruction or failure of the adrenal gland, unable to produce certain hormones, such as aldosterone. Without it, the body retains too much potassium (hyperkalemia).

Note: Administering a drug such as spironolactone, which helps conserve potassium, is counterproductive.

5. Pregnancy and lactation

Pregnant women with Congestive Heart Failure, Cirrhosis, or Hypertension who take spironolactone are at increased risk of premature birth or complications during delivery.

What adverse effects does spironolactone produce?

Take into account that there are possible adverse effects when consuming this type of medication, such as those that we will explain below:

1. Headache, drowsiness and fatigue

It occurs mainly in patients who experience an overdosetag. To treat them, a therapy based on hydration is used, maintaining electrolyte balance and vital functions, since they could be symptoms of hyperkalemia.

2. Gastrointestinal upsets

They manifest as nausea, vomiting, and diarrheatag. These symptoms are products of a high consumption of the drug. Depending on the severity, gastric lavage is used to treat these effects.

3. Impotence and gynecomastia

Gynecomastia is the abnormal enlargement of the breasts in mentag. This is because spironolactone is chemically similar to progesterone, one of the main female hormones. However, these effects are reversible upon discontinuation of treatment.(3)

4. Menstrual disturbances

Research, published in the Journal of Clinical Endocrinology and Metabolism , revealed that women with hirsutism treated with spironolactone may develop metrorrhagia , which is vaginal bleeding that occurs between menstrual periods. (4)

Key Conclusions

  • Spironolactone is a diuretic that decreases potassium excretion by acting on aldosterone function .
  • It is used in people with primary hyperaldosteronism , high blood pressure, heart failure and edematous diseases.
  • The most notorious adverse effects are neurological, gastrointestinal and on the sexual characteristics of men and women.

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