speer-oh-no-LAK-tone 
Unlabeled Use:
Absorption: >90% absorbed. Oral suspension results in 15–37% higher serum concentrations compared to tablets. Bioavailability ↑ with food.
Distribution: Crosses the placenta; enters breast milk.
Protein Binding: >90%.
Metabolism/Excretion: Converted by the liver to its active diuretic compound (canrenone).
Half-life: 78–84 min (spironolactone); 13–24 hr (canrenone).
Contraindicated in:
Use Cautiously in:
CV: arrhythmias.
Derm: DRUG RASH WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, alopecia, pruritus.
Endo: amenorrhea, gynecomastia (in males), breast tenderness, , deepening of voice, ↑ hair growth (in females), sexual dysfunction.
F and E: hyperkalemia, hyponatremia, hyperchloremic metabolic acidosis.
GI: GI irritation.
GU: erectile dysfunction, dysuria.
Hemat: agranulocytosis, thrombocytopenia.
MS: muscle cramps.
Neuro: dizziness, clumsiness, headache, sedation.
Misc: hypersensitivity reactions(including anaphylaxis).
Drug-Drug:
Oral suspension is not therapeutically equivalents to tablets. If patient requires a dose >100 mg, use tablets, NOT suspension. Suspension doses >100 mg may result in higher than expected spironolactone concentrations.
HF
5 mEq/L and eGFR>50 mL/min/1.73 m2 — Tablet: 25 mg once daily; may then ↑ to 50 mg once daily; if develop hyperkalemia with 25 mg once daily, ↓ dose to 25 mg every other day. Suspension: 20 mg once daily; may then ↑ to 37.5 mg once daily; if develop hyperkalemia with 20 mg once daily, ↓ dose to 20 mg every other day. Serum potassium 5 mEq/L and eGFR 30–50 mL/min/1.73 m2 — Tablets: 25 mg every other day. Suspension: 10 mg once daily.Hypertension
Edema
Primary Hyperaldosteronism
Acne (off-label use)
Hormone Therapy for Transgender Females (off-label use)
(Generic available)
NDC Code*