Aldactone (Spironolactone) - Oral

What Is Aldactone?

Aldactone (spironolactone) is a prescription medication that belongs to a class of drugs known as aldosterone antagonists or potassium-sparing diuretics. It has various uses, including blood pressure, heart failure, hyperaldosteronism, and fluid retention.

Aldosterone is a hormone made in the body that causes water retention. By blocking aldosterone, this medication treats fluid retention (edema). This process stops potassium from leaving the body, hence the name potassium-sparing diuretics. Aldactone can also lower blood pressure by blocking aldosterone’s effect on your blood vessels.

Spironolactone's ability to block androgen (male hormone) receptors has led to its off-label use for acne, hirsutism in females (sex assigned at birth), and hormone therapy. However, these anti-androgenic properties mean this medication should be avoided during pregnancy.

Spironolactone is available in tablet form under the brand name Aldactone and suspension (liquid) form under the brand name Carospir. These dosage forms are not interchangeable; the tablet and suspension release the medication differently in the body. Only take the dosage form prescribed by your healthcare provider.

Drug Facts

Generic Name: Spironolactone

Brand Name(s): Aldactone (tablets), Carospir (liquid)

Drug Availability: Prescription

Therapeutic Classification: Diuretic

Available Generically: Yes, only in tablet form

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Spironolactone

Dosage Form: Tablet, liquid

What Is Aldactone Used For?

The Food and Drug Administration (FDA) has approved spironolactone to treat:

Because of its anti-androgenic properties, spironolactone is commonly used off-label (for purposes not approved by the FDA) to treat:

How to Take Aldactone

Spironolactone is available as an oral tablet and liquid suspension. These are meant to be taken by mouth. How often you take it depends on what condition you are treating and how your body reacts to the medication.

This medication can be taken with or without food, but the administration should stay consistent. If you take it with food, then continue to do so. If you take it without food, you should continue doing so.

The liquid suspension should be shaken well before each use.

Storage

People should store spironolactone at a controlled room temperature of about 68 F to 77 F.

Always carry your medication with you when traveling. If you are flying, keep the original prescription-labeled bottle or box in your carry-on bag. Don’t leave this medication in your car, especially in cold or hot temperatures.

Off-Label Uses

Healthcare providers may prescribe spironolactone for off-label uses, meaning for conditions not specifically indicated by the FDA.

Some of these off-label uses include:

  • Hirsutism (abnormal facial hair) in females (sex assigned at birth), often associated with PCOS
  • Gender-affirming hormone therapy for individuals transitioning from male (sex assigned at birth) to female
  • Acne in females
  • Female pattern hair loss
  • Precocious puberty, which is a condition that causes children to enter puberty too early
  • Myasthenia gravis, a disease in which the nerves do not function properly

What Are the Side Effects of Aldactone?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Like most medications, spironolactone can cause mild or serious side effects.

Common Side Effects

The most common side effects of spironolactone include:

Talk to your healthcare provider or pharmacist if your side effects persist or become more severe.

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and symptoms can include the following:

  • Allergic reactions: Symptoms can include hives, shortness of breath, rash, fever, or swelling of the lips, mouth, or tongue.
  • Dangerously high potassium levels: Symptoms may include muscle weakness, extreme tiredness, tingling or numbness in your hands or feet, inability to move your arms or legs, and slow heart rate.
  • Electrolyte problems: Symptoms are extreme thirst, dry mouth, dizziness, fast heart rate, inability to urinate, and extreme tiredness.
  • Severe skin reactions: These may include skin redness, blistering, or loose skin.
  • Gynecomastia

Report Side Effects

Aldactone may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Spironolactone Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For edema:
    • For oral dosage form (suspension):
      • Adults—At first, 75 milligrams (mg) (15 milliliters [mL]) per day, taken in either single or divided doses. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults—At first, 100 milligrams (mg) per day, taken in either single or divided doses. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
  • For heart failure:
    • For oral dosage form (suspension):
      • Adults—At first, 20 milligrams (mg) (4 milliliters [mL]) per day. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults—At first, 25 milligrams (mg) once a day. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.
  • For high blood pressure:
    • For oral dosage form (suspension):
      • Adults—At first, 20 milligrams (mg) (4 milliliters [mL]) to 75 mg (15 mL) per day, taken in either single or divided doses. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults—At first, 25 to 100 milligrams (mg) per day, taken in either single or divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 100 mg per day.
      • Children—Use and dose must be determined by your doctor.
  • For too much aldosterone in the body:
    • For oral dosage form (tablets):
      • Adults—Use and dose must be determined by your doctor. The dose is usually 100 to 400 milligrams (mg) per day to prepare for surgery.
      • Children—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, users need to be aware of the following when taking spironolactone.

Dosage adjustment may be required for:

  • Adults 65 and older
  • People with reduced kidney or liver function
  • Hyperkalemia (too much potassium)

Tell your healthcare provider if you have difficulty swallowing pills. A liquid (suspension) form is available under the brand name Carospir. Your healthcare provider may prescribe the liquid formulation, depending on your condition.

Missed Dose

If you miss a dose of Aldactone, take the missed dose as soon as you remember. But if it is almost time for the next scheduled dose, you should skip the dose you missed. Do not take extra to make up for the missed dose. Doing so can increase your risk for side effects.

Overdose: What Happens If I Take Too Much Aldactone?

If you take too much spironolactone, you may begin to experience:

  • Drowsiness
  • Confusion
  • Dizziness
  • Nausea
  • Muscle pain or cramping
  • Diarrhea

Hyperkalemia can occur, especially in people with impaired kidney function. Treatment of an overdose may be supportive for hydration, electrolyte balance, and vital functions.

What Happens If I Overdose on Aldactone?

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Do not take this medicine together with eplerenone (Inspra®). Using these medicines together may cause serious unwanted effects.

Do not take other medicines unless they have been discussed with your doctor. This especially includes potassium supplements or salt substitutes containing potassium, certain diuretics (eg, amiloride, triamterene (Dyazide®, Dyrenium®, Maxzide®, Midamor®, Moduretic®), or other products containing spironolactone (Aldactazide®).

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have the following symptoms: stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, or weakness or heaviness of the legs. Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium. 

Spironolactone may worsen kidney function in patients with low to no salt in their body or in those who take other blood pressure medicines (eg, ARB, ACE inhibitor). Talk to your doctor if you have concerns about this.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up suddenly from a lying or sitting position. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

This medicine may also cause electrolyte imbalances (including low sodium, magnesium, and calcium in the blood, hypochloremic alkalosis) and an increase in your uric acid and blood sugar levels. Talk to your doctor if you have concerns.

Check with your doctor right away if you become sick while taking this medicine, especially if you have severe or continuing nausea, vomiting, or diarrhea that does not stop. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

This medicine may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.

Make sure any doctor or dentist who treats you knows that you are using this medicine.

What Are Reasons I Shouldn’t Take Aldactone?

There are a few reasons why your healthcare provider may not choose Aldactone as part of your treatment plan.

Allergy

A person should not take Aldactone if they are allergic to the ingredients.

Pregnancy

Research has shown adverse effects to the fetus when spironolactone is used during pregnancy. However, there are not enough human studies to be certain how this drug may affect the fetus.

Aldactone should only be used during pregnancy if the benefits outweigh the risks. It is best to talk to your healthcare provider if you are pregnant or plan to become pregnant so that they can decide the best option for you.

Breastfeeding

The active metabolite, a substance that breaks down from the drug, does pass into human milk. As a result, the World Health Organization listed this medication as compatible with breastfeeding, but those considerations should weigh the risks versus the benefits. Talk with your healthcare provider if you are breastfeeding as you may need to decide if you should stop taking Aldactone or stop breastfeeding.

Children

Aldactone should not be used in children under 18.

What Other Medications Interact With Aldactone?

People taking Inspra (eplerenone) or Dyrenium (triamterene) should not take spironolactone. Your healthcare provider may prescribe another medication or change your treatment if you use either.

Spironolactone can interact with several kinds of drugs. However, not all drug interactions may require complete avoidance. Spironolactone may still be administered with these medications to treat certain conditions. A healthcare provider will closely monitor you for side effects in these cases.

Spironolactone can interact with the following drugs:

Taking Aldactone with ACE inhibitors, ARBs, NSAIDs, or heparin can increase potassium levels, which may lead to severe hyperkalemia. NSAIDs can also reduce the effect of Aldactone when taken together. Make sure to let your healthcare provider know if you take these medications, you may need to be monitored closely to ensure spironolactone is working effectively.

Taking drugs like digoxin and lithium during Aldactone treatment can increase exposure to those drugs in the body, leading to toxicity.

This list does not include all drugs that can interact with spironolactone. Despite their interaction, many of these medications may still be administered with Aldactone. Your healthcare provider will monitor you for all medications that you take.

Before taking Aldactone, tell your healthcare provider about all the prescription medications, over-the-counter (OTC) medications, vitamins, supplements, or herbs you take. This will help you avoid potential interactions. Ask your healthcare provider or pharmacist if you are unsure about drug interactions.

What Medications Are Similar?

Aldactone is part of one type class of diuretics, aldosterone antagonists, or potassium-sparing diuretics. There are two other kinds of diuretics: loop diuretics and thiazides diuretics. A few other commonly prescribed diuretics include:

This list is a list of drugs in similar drug classes as Aldactone. It is not a list of drugs recommended to take with Aldactone. Discuss any questions or concerns with your healthcare provider or pharmacist.

Frequently Asked Questions

  • What is Aldactone used for?

    Spironolactone is part of a class of medications called aldosterone antagonists, also known as potassium-sparing diuretics. Spironolactone may be prescribed to treat high blood pressure, heart failure, hyperaldosteronism (excessive secretion of aldosterone), and swelling from kidney or liver problems.

    It is also commonly used off-label for acne, female hair loss, hirsutism in females, and hormone therapy.

  • What are the side effects of Aldactone?

    The most common side effects are dizziness, drowsiness, diarrhea, and leg cramps. Spironolactone also has the potential for serious side effects such as an allergic reaction, dangerously high potassium levels, breast enlargement (gynecomastia), or electrolyte issues. If you are experiencing any serious side effects call your healthcare provider immediately. Call 911 if you are experiencing a medical emergency or life-threatening symptoms.

  • How do I safely stop taking Aldactone?

    Stopping spironolactone abruptly may lead to water retention in your body. You could also have a sudden increase in your blood pressure, which could lead to a heart attack or stroke. It is best to speak with your healthcare provider before you stop taking spironolactone.

How Can I Stay Healthy While Taking Aldactone?

Aldactone is a safe and effective medication when used correctly.

Although  Aldactone does have the potential for serious side effects, the most common side effects tend to be mild. Those might include drowsiness, dizziness, or leg cramps.

Make sure to inform your healthcare provider of all of your other health conditions and prescription medications, OTC medications, vitamins, supplements, or herbs you are taking. This way, your healthcare provider can determine the most appropriate dosage for you.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Kaylea Swearingen, PharmD
Kaylea Swearingen is a registered pharmacist and health and wellness writer.