Spironolactone: what it is and what are its indications

The name is long and a little complicated, but Spironolactone belongs to the class of diuretic drugs that is one of the most used classes in medicine, being indicated in several diseases, such as hypertension, heart failure, liver cirrhosis, etc.

It is worth noting that there are different types of diuretics, but despite the different mechanisms of action, they all have one characteristic in common: they increase the elimination of sodium (salt) and water through the urine.

In this sense, diuretics are especially indicated for the treatment of hypertension and edema (swelling) – problems related to excess salt in the body, which consequently cause water retention.

Spironolactone indications and particularities

Spironolactone (Aldactone®, Spiroctan®, Diacqua®) is an orally administered antihypertensive and potassium-sparing diuretic that reduces body fluid volume and cardiac output.

It is worth noting that one of the side effects of other diuretics (thiazides and furosemide) is the decrease in potassium in the blood due to excessive urinary loss. On the other hand, Spironolactone, which is a sparing of this mineral, works by excreting sodium and decreasing potassium excretion – very important for those who have low potassium and dangerous for those who have high potassium.

Spironolactone also works by inhibiting a hormone called aldosterone, which when increased, worsens heart failure and cirrhosis, so it is widely used in the treatment of these two diseases.

The indications for Spironolactone, according to the drug leaflet, are:

• Essential hypertension;
• Edematous disorders such as edema and ascites from congestive heart failure;
• Hepatical cirrhosis;
• Nephrotic syndrome;
• Idiopathic edema;
• As adjunctive therapy in malignant hypertension;
• In hypokalemia when other measures are considered inappropriate or inadequate;
• Prophylaxis of hypokalemia in patients taking digitalis or when other measures are inadequate or inappropriate.
• Diagnosis and treatment of primary aldosteronism.
• Preoperative treatment of patients with primary hyperaldosteronism.

Contraindications and warnings

Also according to information in the drug leaflet, Spironolactone is contraindicated in acute renal failure, significant decrease in renal function, anuria and hyperkalemia, Addison’s disease or hypersensitivity to the components of the formulation.

Since Spironolactone is a potassium-sparing diuretic, it is worth noting that the administration of potassium supplements or other potassium-sparing agents is not recommended because it can induce hyperkalemia.

Women should inform their doctor if pregnancy occurs during treatment or after treatment has ended. Also, if they are breastfeeding.

Spironolactone can interact with other medications, so it’s important to let your doctor know if you’re taking any other medications.

In case of undesirable reactions, such as nausea, drowsiness, dizziness, tiredness, headache, breast pain, malaise, hives, fever, mental confusion, impotence and menstrual disorders, it is also essential to inform the doctor.

As in the case of any other medication, all other guidelines on the use of Spironolactone must be passed by the doctor and followed strictly by the patient.

Side effects

The most common side effects of Spironolactone are increased potassium, gynecomastia (benign or malignant neoplasm that leads to breast enlargement in men) and menstrual changes.

Spironolactone X Female fertility

Marcello Valle, a specialist in Human Reproduction and director of the Origen clinic (RJ), highlights that there are no studies linking Spironolactone with changes in fertility in women. “Starting Spironolactone use may be associated with changes in menstrual pattern, but it is a temporary situation that improves quickly and spontaneously,” he says.

“Still within the fertility issue, Spironolactone has been used as a treatment for hirsutism (excessive body hair), a very common symptom in patients with Polycystic Ovary Syndrome and other ovulation disorders”, adds the specialist.

Spirinolactone in the treatment of acne

In some cases, specialists use spironolactone as a substance in the treatment of acne through pills.

It is worth remembering that acne is a disease of the pilosebaceous follicle, which usually appears in the following regions: face, neck, back and décolleté. And spirinolactone is then used in cases of Polycystic Ovarian Syndrome – when the ovaries increase hormone production and blood concentration of the male hormone, one of the main causes of acne.

The substance has good results in the treatment of acne, however, it can have some side effects:

• malaise
• nausea
• Dizziness
• Cramps
• Headache
• pain in the breasts

It is also worth remembering that the use of this medication can cause changes in the menstrual cycle. To use it, medical supervision is required.

Now you have the main information about Spirinolactone, but remember that any questions about this or any other medication should be resolved with a doctor!

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.