Aldactone

Generic name: Spironolactone
Brand names: Aldactone

Why is Aldactone prescribed?

Aldactone flushes excess salt and water from the body and controls high blood pressure. It is used in the diagnosis and treatment of hyperaldosteronism, a condition in which the adrenal gland secretes too much aldosterone (a hormone that regulates the body's salt and potassium levels). It is also used in treating other conditions that require the elimination of excess fluid from the body. These conditions include congestive heart failure, high blood pressure, cirrhosis of the liver, kidney disease, and unusually low potassium levels in the blood. When used for high blood pressure, Aldactone can be taken alone or with other high blood pressure medications.

Most important fact about Aldactone

If you have high blood pressure, you must take Aldactone regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Aldactone; and you must continue taking it even if you are feeling well. Aldactone does not cure high blood pressure; it merely keeps it under control.

How should you take Aldactone?

Take Aldactone exactly as prescribed by your doctor. Stopping Aldactone suddenly could cause your condition to worsen.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Aldactone.

• More common side effects may include:
  Abdominal cramps, breast development in males, change in potassium levels (leading to such symptoms as dry mouth, excessive thirst, weak or irregular heartbeat, and muscle pain or cramps), deepening of voice, diarrhea, drowsiness, excessive hairiness, fever, headache, hives, irregular menstruation, kidney problems, lack of coordination, lethargy, liver problems, mental confusion, postmenopausal bleeding, severe allergic reaction, sexual dysfunction, skin eruptions, stomach bleeding, stomach inflammation, ulcers, vomiting

Why should Aldactone not be prescribed?

You should not take Aldactone if you have kidney disease, an inability to urinate, difficulty urinating, or high potassium levels in your blood.

Special warnings about Aldactone

Potassium supplements or other diuretics that leave your potassium levels high, such as Maxzide, should not be used while taking Aldactone, unless specifically indicated by your doctor. Symptoms of excess potassium include tingling sensations, fatigue, muscle weakness or paralysis, and a slow heartbeat. If you develop these problems, call your doctor immediately.

ACE inhibitors (Vasotec, Capoten), used for blood pressure and heart failure, should not be taken while using Aldactone.

If you are taking Aldactone, your kidney function should be given a complete assessment and should continue to be monitored.

If you have liver disease, your doctor will be cautious about using Aldactone.

Excessive sweating, severe diarrhea, or vomiting could cause you to lose too much water and cause your blood pressure to become too low. Signs of dehydration include thirst, dry mouth, weakness, drowsiness, muscle fatigue, muscle cramps, restlessness, reduced urination, and a rapid heartbeat. Be sure to drink plenty of fluids whenever dehydration threatens, and be careful when exercising in hot weather.

Notify your doctor or dentist that you are taking Aldactone if you have a medical emergency, and before you have surgery or dental treatment.

Possible food and drug interactions when taking Aldactone

If Aldactone is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Aldactone with the following:

ACE inhibitors such as Vasotec and Capoten
Alcohol
Barbiturates such as phenobarbital and Seconal
Digoxin (Lanoxin)
Indomethacin (Indocin)
Lithium (Lithonate)
Narcotic drugs such as those containing codeine
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil, Aleve, and Motrin
Norepinephrine (Levophed)
Other water pills such as Lasix and HydroDIURIL
Other high blood pressure medications such as Aldomet and Procardia XL
Steroids such as prednisone

Special information if you are pregnant or breastfeeding

The effects of Aldactone during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Aldactone appears in breast milk and could affect a nursing infant. If Aldactone is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Aldactone is finished.

Recommended dosage

ADULTS

Primary Hyperaldosteronism

Initial dosages of Aldactone are used to determine the presence of primary hyperaldosteronism (too much secretion of the adrenal hormone aldosterone). People can be tested with Aldactone over either a long or a short period of time.

In the long test, you take 400 milligrams per day for 3 to 4 weeks. If your potassium levels and blood pressure are corrected with this dosage in this time period, your physician may assume you have this condition.

In the short test, you receive 400 milligrams per day for 4 days. A laboratory test compares potassium levels while you are on Aldactone and after the medication is stopped. Your doctor may then make a diagnosis.

After the diagnosis of primary hyperaldosteronism is made and confirmed by more tests, the usual dose is 100 to 400 milligrams per day, prior to surgery. In those who are not good candidates for surgery, Aldactone is given over the long term at the lowest effective dose.

Fluid Retention (Congestive Heart Failure, Cirrhosis of the Liver, or Kidney Disorders)

The usual starting dosage is 100 milligrams daily either in a single dose or divided into smaller doses. However, your doctor may have you take daily doses as low as 25 milligrams or as high as 200 milligrams.

Your doctor may choose to adjust your dosage after an initial 5-day trial period or add another diuretic medication to this one.

Essential Hypertension (High Blood Pressure)

The usual starting dosage is 50 to 100 milligrams daily in a single dose or divided into smaller doses. This medication may be given with another diuretic or with other high blood pressure medications.

It may be up to 2 weeks before the full effect of Aldactone is seen. Your doctor can then adjust the dosage according to your response.

Hypokalemia (Potassium Loss)

Your doctor may have you take daily dosages of 25 milligrams to 100 milligrams when potassium loss caused by the effects of a diuretic cannot be treated by a potassium supplement.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Aldactone overdose may include:
  Confusion, diarrhea, dizziness, drowsiness, nausea, patchy raised skin rash, vomiting