Adult Dosing
Diagnosis of primary hyperaldosteronism
Long test
- 400 mg PO qd x 3-4 wks
- Presumptive diagnosis is made if hypokalemia or hypertension is corrected
Short test
- 400 mg PO qd x 4 wks
- Presumptive diagnosis is made if serum potassium increases during spironolactone administration but drops after discontinuation
Maintenance therapy
Edema
- 25-200 mg/day PO in single or divided doses
Essential hypertension
- 25-200 mg/day PO in single or divided doses
- Continue therapy for at least 2 wks as maximum response may not occur before 2 wks
CHF, NYHA class III/IV
- Start 25 mg PO qd if serum potassium = < 5 mEq/L and serum creatinine = < 2.5 mg/dL
- Increase to 50 mg PO qd if indicated in patients who tolerate 25 mg/day
- May reduce to 25 mg PO qod in patients who do not tolerate 25 mg/day
Hypokalemia, diuretic induced
Polycystic Ovary Syndrome (PCOS) [Non-FDA Approved]
- 50–200 mg PO qd or divided q12 hrs
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Restrict potassium supplementation during therapy with spironolactone. Do not administer with other potassium sparing diuretics
- Avoid using oral potassium supplements in patients with serum potassium > 3.5 mEq/L
- Monitor serum electrolytes periodically, particularly in the elderly and in patients with renal or hepatic impairment
- Monitor potassium and creatinine in patients with severe heart failure 1 wk after starting therapy, monthly for 3 mo, then quarterly for a year, and then every 6 mo. Discontinue or interrupt treatment if serum potassium > 5 mEq/L or serum creatine > 4 mg/dL
- Minor alterations of fluid and electrolyte balance may precipitate hepatic coma. Use with caution
- Reversible hyperchloremic metabolic acidosis, usually in association with hyperkalemia, has been reported in some patients with decompensated hepatic cirrhosis
- Somnolence and dizziness have been reported to occur in few patients, hence caution is advised while driving or operating machinery
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment
- Co-administration of ACE inhibitors
- Co-administration of indomethacin
- Hyponatremia
- Diabetes mellitus
- Elderly patients
Pregnancy Category:C
Breastfeeding: This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776) and based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 28 April 2010). Manufacturer advises discontinuation of breastfeeding or discontinuation of therapy taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Spironolactone 25 MG TABS [Bottle] (ACTAVIS ELIZABETH)
30 mg = $15.99
60 mg = $22.98 - Aldactone 50 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $65.99
90 mg = $175.97 - Aldactone 100 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $97.99
90 mg = $279.98 - Spironolactone 100 MG TABS [Bottle] (MYLAN)
30 mg = $51.99
90 mg = $123.97 - Aldactone 25 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $39.99
90 mg = $101.97 - Spironolactone 50 MG TABS [Bottle] (MUTUAL PHARMACEUTICAL)
30 mg = $21.99
90 mg = $46.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
