For those who are being treated for hypokalemia with spironolactone, dosing typically ranges from 25 mg to 100 mg daily. The recommended dose for treating water retention is 100 mg daily. For high blood pressure control, the usual starting spironolactone dosage is 50 mg to 100 mg daily. You can also take 100 mg to 400 mg of spironolactone for long-term treatment of hyperaldosteronism.
The dose of spironolactone (Aldactone®) that your healthcare provider recommends will vary depending on a number of factors, including:
- Other medical conditions you may have
- Other medications you may be currently taking
- How you respond to spironolactone.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
Spironolactone can be used to diagnose hyperaldosteronism. For this purpose, the usual dose is 400 mg once daily for three to four weeks (the "long test") or for four days (the "short test"). Your healthcare provider will monitor your blood pressure and potassium levels to test whether you have hyperaldosteronism (if you do, your blood pressure and potassium levels should improve).
After the diagnosis, spironolactone can be used short-term to control hyperaldosteronism until surgery can be performed to correct the problem. It can also be used long-term for people who cannot or will not have surgery. For these uses, the dose is usually spironolactone 100 mg to 400 mg once daily. Alternatively, the daily dose can be split up into smaller, more frequent doses throughout the day.