Brand name: Aldactone

Generic name: Spironolactone

Indication: management of edema associated with excessive aldosterone excretion, hypertension,
primary hyperaldosteronism, hypokalemia, treatment of hirsutism, cirrhosis of liver
accompanied by edema or ascites
Drug classification: anti-hypertensive agent, diuretic, potassium sparing
Mechanism of action: competes with aldosterone for receptor sites in the distal renal tubules,
increasing sodium chloride and water excretion while conserving potassium and
hydrogen ions, may block the effect of aldosterone on arteriolar smooth muscle as well
Dosage: essential hypertension
Adult 50-100mg/day. Severe case: may be gradually increased at 2weekly intervals up to
200mg/day
Edematous disorders
Total daily dose may be given either in divided doses or as single daily dose. CHF adult
100mg/day. Maintenance: 25-200mg/day. Cirrhosis urinary Na+/K+ ratio
> 1:100 mg/day, ratio <1:200-400mh/day. Nephritic syndrome 100-200mg/day. Edema in
children initially 3mg/kg body wt daily in divided dose, reduced to 1-2mg/kg for
maintenance therapy. Malignant hypertension adjunctive therapy, initially 100mg/day
increased as necessary at 2weekly intervals to 400mg/day.
 Hypokalemia/hypomagnesaemia 25-100mg daily. Diagnosis and treatment of primary
aldosteronism: long test:400mg/day for 3-4 wks. Short test 400 mg/day for 4 days.
Special precaution: concomitant use with other K-retaining drugs pr K- supplements; impaired
renal function; lactation; anaesthesia
Pregnancy risk factor D
Adverse reactions: gynecomastia; GI symptoms; drowsiness; lethargy; headache; mental
condusion; ataxia; impotence; menstrual irregularities; post menopose bleedidng; rarely
agranulocytosis; usticaria; fever;
Contraindications: acute renal insufficiency, anuria, hyperkalemia. pregnancy
Form: tab 25mg x 100s, 50mg x 100s; 100mg x 100s
Nursing responsibilities:
 Educate patient to avoid hazardous activity such as driving until response to drug is
known. Take with meals or milk; avoid excessive ingestion of food high in potassium or
use of salt substitutes
 Diuretic effect may be delayed 2-3 days and maximum hypertensive may be delayed 2-
3weeks; monitor I and O ratios and daily weight, BP, serum electrolytes (K, Na) and renal
function