Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Aldactone, Spirobene, Spirohexal, Spironolacton; Belgium: Aldactone, Docspirono, Spironolactone; Bulgaria: Spironolacton, Verospiron; Cyprus: Spiro, Spirolon, Uractonum; Czech Republic: Verospiron; Denmark: Hexalacton, Prilactone, Spirix, Spiron; Estonia: Spirix, Spirogamma, Spironolacton, Verospiron; Finland: Spiresis, Spiridon, Spirix; France: Aldactone, Spiroctan, Spironolactone, Spironone; Germany: Aldactone, Jenaspiron, Osyrol, Spirobeta, Spirogamma, Spirono, Spironolacton, Spironolactone, Verospiron; Greece: Aldactone, Lactone; Hungary: Huma-Spiroton, Spiron, Verospiron; Ireland: Aldactone; Italy: Aldactone, Spirolang, Uractone; Latvia: Spirix, Spirogamma, Verospiron; Lithuania: Spirix, Spironolacton, Verospiron; Luxembourg: Aldactone, Spiroctan, Spironolacton, Spironolactone, Uractone; Malta: Aldactone, Spirolon, Spironolactone, Uractonum; Netherlands: Spironolacton; Poland: Polspiron, Spirogamma, Spironol, Spironolacton, Verospiron; Portugal: Aldactone; Romania: Alspiron, Spironolactona, Verospiron; Slovakia: Verospiron; Spain: Aldactone, Espironolactona; Sweden: Aldactone, Spironolakton; UK: Aldactone, Spironolactone.

North America

Canada: Aldactone, Spiroton; USA: Aldactone, Spironolactone.

Latin America

Argentina: Aldactone A, Drimux A, Espimax, Espironolactona, Expal, Lanx, Modulactone, Normital, Rediun-E; Brazil: Aldactone, Espironolactona, Spiroctan; Mexico: Aldactone, Biolactona, Espironolactona, Vivitar.


Japan: Aldactone, Almatol, Aporasnon, Lacalmin, Macacy-A, Merlactone, Noidouble, Pirolacton, Rakudeen, Spilactone, Spironolactone, Urosonin, Youlactone.

Drug combinations

Spironolactone and Altizide

Spironolactone and Furosemide

Spironolactone and Hydrochlorothiazide


Spironolactone: C~24~H~32~O~4~S. Mw: 416.57. (1) Pregn-4-ene-21-carboxylic acid, 7-(acetylthio)-17-hydroxy-3-oxo-, γ-lactone, (7α,17α)-; (2) 17-Hydroxy-7α-mercapto-3-oxo-17α-pregn-4-ene-21-carboxylic acid, γ-lactone acetate. CAS-52-01-7.

Pharmacologic Category

Mineralocorticoid (Aldosterone) Receptor Antagonists. Potassium-sparing Diuretics. (ATC-Code: C03DA01).

Mechanism of action

Synthetic steroid mineralocorticoid receptor antagonist (aldosterone antagonist). Exhibits magnesium- and potassium-sparing, natriuretic, diuretic, and hypotensive effects by competitively inhibiting physiologic effects of adrenocorticortical hormone aldosterone on distal renal tubules, myocardium, and vasculature. Does not generally cause potassium depletion or affect glucose metabolism or uric acid excretion. Androgen and progesterone receptor antagonist.

Therapeutic use

Edema associated with excessive aldosterone excretion. Hypertension. Primary hyperaldosteronism. Hypokalemia. Cirrhosis accompanied by edema or ascites. Nephritic syndrome. Severe heart failure.

Pregnancy and lactiation implications

Teratogenic effects not observed in animals. Antiandrogen effects of spironolactone shown to cause feminization of male fetus in animal studies. Diuretics should not be used during pregnancy in presence of reduced placental perfusion. Enters breast milk (not recommended in nursing women).

Unlabeled use

Female acne. Hirsutism. Hypertension (pediatric). Diuretic (pediatric).


Anuria. Acute renal insufficiency. Significant impairment of renal excretory function. Hyperkalemia. Known hypersensitivity to spironolactone or any ingredient in the formulation.

Warnings and precautions

Excess amounts can lead to profound diuresis with fluid and electrolyte loss. Risk for gynecomastia. Shown to be a tumorigen in animals. Discontinue use prior to adrenal vein catheterization. In cirrhosis, avoid electrolyte and acid/base imbalances which might lead to hepatic encephalopathy. Discontinue or interrupt therapy if serum potassium >5 mEq/L or serum creatinine >4 mg/dL. Avoid concurrent use of ACEIs, ARBs, and spironolactone. Avoid potassium supplements, potassium-containing salt substitutes, diet rich in potassium, or other drugs which can cause hyperkalemia. May cause false elevation in serum digoxin concentrations measured by radio immunoassay.



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