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How Much Spironolactone Should I Take?

Spironolactone Dosing for Heart Failure

The recommended starting spironolactone dose for treating severe heart failure is spironolactone 25 mg once daily. If necessary, your healthcare provider may increase your dose to 50 mg once daily or decrease it to 25 mg every other day.
 
Before starting spironolactone, people with severe heart failure should have their potassium level and kidney function checked. If your potassium is too high or your kidney function is too poor, spironolactone may not be recommended for your particular situation.
 

Spironolactone Dosing for High Blood Pressure

The recommended starting spironolactone dose for high blood pressure (hypertension) is 50 mg to 100 mg daily. This can be taken all at once or split up into two smaller doses per day. Your healthcare provider may need to adjust your dose if side effects occur or if your blood pressure is not under control.
 

Spironolactone Dosing for Water Retention

The recommended starting spironolactone dose for water retention (edema) is 100 mg daily. This can be taken all at once or split up into two smaller doses per day. Your healthcare provider may need to adjust your dose if side effects occur or if your water retention is not under control. Typical doses range from spironolactone 25 mg to 200 mg daily.
 

Spironolactone Dosing for Hypokalemia

The recommended spironolactone dose for treating low potassium levels in the blood (hypokalemia) is 25 mg to 100 mg daily (either taken all at once or split up into smaller doses).
 

General Information on Dosing With Spironolactone

Some considerations for people taking spironolactone include:
 
  • Spironolactone comes in tablet form. It is usually taken by mouth once or twice a day.
     
  • It does not matter if you take spironolactone with or without food.
     
  • Spironolactone should be taken at the same time(s) each day to maintain an even level of the medicine in your blood.
     
  • Because spironolactone increases urination, it is best to take it in the morning (to avoid needing to get up to use the bathroom throughout the night). If you take spironolactone twice daily, try to take your last dose of the day before 6 p.m., unless your healthcare provider instructs you otherwise.
     
  • For spironolactone to work properly, it must be taken as prescribed. The medication will not work if you stop taking it.
     
  • If you are unsure about anything related to spironolactone or your spironolactone dosage, please talk to your doctor, nurse, or pharmacist.
     
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