Last Updated on May 30, 2023
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The active ingredient Spironolactone is a medication used to treat high blood pressure (antihypertensive) and a dehydrator (diuretic). As a so-called potassium-sparing diuretic Spironolactone is called is because, unlike other diuretics (such as Furosemide or Hydrochlorothiazide) hardly potassium is excreted with. Here you can read everything worth knowing about Spironolactone, adverse reactions and applications.
How Spironolactone works
The body is filtered by means of the kidneys, the blood and purifies it as waste products, pollutants and some drugs. The kidney is comprised of many nephrons – the smallest functional units, which in turn each consist of a renal corpuscle and a renal tubule. About the glomeruli, the blood is filtered, where larger components, such as proteins or whole blood cells are retained and smaller materials such as waste products, as well as salts and sugars are removed by filtration. The filtrate thus obtained is called primary urine; there are formed about 180 to 200 liters of it daily. This is still unfocused and is concentrated on the passage through the renal tubules. Here, salts and sugars that can still use the body, re-absorbed into the blood (dragging the possibility of water with it). Facilitate elimination substances, however, can pass freely; This second filtrate leaves as secondary or final urine the body.
The active ingredient Spironolactone prevents the hormone aldosterone can bind to docking in kidney tubule cells. As a result, less sodium and water from the primary urine are again absorbed into the blood, causing more final urine produced and excreted. The increased fluid excretion lowers the blood pressure.
Pharmacokinetics and metabolism of Spironolactone
After taking Spironolactone is rapidly absorbed to about three-quarters from the intestine into the blood. It is then largely converted in the liver to another active form, the canrenone is. The maximum blood levels of Spironolactone are reached about an hour after taking that. The metabolites after about two to three hours The diuretic effect occurs not immediately but only after a few days. The maximum effect is achieved after about five days. The elimination of the active substance is mainly via the kidneys in the urine.
When should you use Spironolactone?
The active ingredient Spironolactone is approved for the treatment of water retention (edema) and high blood levels of aldosterone, which clinically and by low levels of potassium in the blood can express itself. The drug is used long term in general.
How Spironolactone is taken?
Spironolactone is usually taken in the form of tablets or capsules. The dosage must be determined individually by the physician always depending on the severity of the disease. In general, the treatment with 100 to 200 milligrams per day Spironolactone is started; insufficient efficacy, this dosage can be increased to up to 400 milligrams of active ingredient per day. It must always be borne in mind that the full effect of Spironolactone occurs only after a few days.
At the market also combination preparations with other diuretics are available.
What are the side effects of Spironolactone?
With every tenth to hundredth treated themselves Spironolactone side effects like high potassium blood levels, muscle paralysis, excessive uric acid blood levels with an increased risk of gout attacks, cardiac arrhythmias, tenderness at the breast and the nipple and breast growth in men show (forms after discontinuation of the drug back).
Each hundredth to one thousandth patient Spironolactone leads to a reduction of platelet count, increased urea and creatinine levels in the blood, states of confusion, muscle cramps and potency disorders.
What should I watch for while taking Spironolactone?
The increase in potassium blood levels by Spironolactone may increase when at the same time more active ingredients are taken with kaliumsteigerndem effect. This applies, for instance potassium supplements, certain high blood pressure medicines from the group of ACE inhibitors (Captopril, Enalapril) and the sartans (Candesartan, Valsartan) and other potassium-sparing diuretics (triamterene, amiloride). Also NSAIDs (aspirin, Indomethacin), which are often taken as a painkiller, can lead to increased potassium levels. They can also – just like epilepsy agents (antiepileptic) Phenytoin – reduce the effect of Spironolactone
The intake of Spironolactone in combination with Furosemide and ACE inhibitors may lead to acute renal failure and massive drop in blood pressure. Before initiation of therapy with ACE inhibitors diuretics should be discontinued for a few days, so that the blood pressure at the start is not too strong.
The taking Spironolactone along with the cardiac glycosides Digoxin and digitoxin must be monitored strictly medical: It can lead to increased blood levels of cardiac glycosides. Even a slight increase can have serious side effects result (cardiac glycosides have a so-called narrow therapeutic index).
During pregnancy and lactation Spironolactone must not be used because there is no adequate data for this purpose. It overcomes the placental barrier and passes into breast milk.
The active ingredient Spironolactone may be used in children and adolescents in accordance with the body weight reduced dose.
Patients with severe renal impairment should not take Spironolactone, since it may impair renal function even further.
How to obtain medication with Spironolactone
medicines containing the active substance Spironolactone are available only with a doctor’s prescription in the pharmacy.
Since when Spironolactone is known?
Before the introduction of Spironolactone all diuretics led to an increased excretion of potassium. Although you can counteract a potassium deficiency by an additional potassium administration, alternatives were sought. In 1959 the drug Spironolactone by the pharmaceutical company GD Searle was first tested in 1961 and finally approved.