section name header

Pronunciation ⬇

speer-oh-no-LAK-tone

Classifications ⬆ ⬇

Therapeutic Classification: diuretics, potassium sparing diuretics

Indications ⬆ ⬇

BEERS REMS

Unlabeled Use:
  • Acne.
  • Hormone therapy for transgender females (male-to-female).

Action ⬆ ⬇

  • Causes loss of sodium bicarbonate and calcium while saving potassium and hydrogen ions by antagonizing aldosterone.
  • Directly inhibits testosterone secretion and androgen binding to the androgen receptor.
Therapeutic effects:
  • Improved survival in patients with NYHA class II-IV HF.
  • Weak diuretic and antihypertensive response when compared with other diuretics.

Pharmacokinetics ⬆ ⬇

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).

Time/Action Profile ⬆ ⬇

(diuretic effect)

ROUTEONSETPEAKDURATION
POunknown1–3 hr2–3 days‡



‡Multiple doses.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

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)

Interactions ⬆ ⬇

Drug-drug:

Route/Dosage ⬆ ⬇

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

Hypertension

Edema

Primary Hyperaldosteronism

Acne (off-label use)

Hormone Therapy for Transgender Females (off-label use)

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Aldactone, Carospir

Pot. Nursing Diagnoses ⬆ ⬇

Code ⬆

NDC Code