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Warnings and Precautions With Spironolactone

To help ensure a safe and effective treatment process, make sure to talk to your healthcare provider beforehand about the warnings and precautions with spironolactone. The medication should be used cautiously in people with liver or kidney disease. You should not take spironolactone if you are allergic to any components of the medicine, have high potassium levels, or are not producing any urine.

Spironolactone: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking spironolactone (Aldactone®) if you have:
 
  • Liver disease, including cirrhosis
  • Kidney disease or kidney failure
  • Fluid or electrolyte problems
  • Addison's disease
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or trying to become pregnant
  • Breastfeeding.
     
Tell your healthcare provider about all other medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Some Precautions and Warnings for Spironolactone

Some spironolactone warnings and precautions to be aware of include:
 
  • Spironolactone can cause high potassium levels (hyperkalemia) or other electrolyte imbalances. If you notice any symptoms of a possible electrolyte imbalance or dehydration, contact your healthcare provider. These symptoms may include:
    • Dry mouth
    • Thirst
    • Weakness
    • Lethargy
    • Drowsiness
    • Restlessness
    • Muscle pain or muscle cramps
    • Low blood pressure (hypotension)
    • Decreased urination
    • Rapid heart rate (tachycardia), slow heart rate (bradycardia), or irregular heart rhythm (arrhythmia)
    • Nausea or vomiting.
 
High potassium levels can be very dangerous. Because there are sometimes no symptoms of potassium problems, your healthcare provider should measure your potassium levels regularly (using a blood test).
  • Do not use salt substitutes while taking spironolactone. Salt substitutes usually contain potassium, and combining them with spironolactone can increase your risk of high potassium levels in your blood (hyperkalemia). Herb-type salt substitutes (that do not contain potassium) are okay to use.
     
  • Spironolactone should be started cautiously in people with liver disease, as fluid or electrolyte imbalance can be especially dangerous in people with liver disease.
     
  • If kidney problems seem to be getting worse (especially for those with very severe kidney disease), spironolactone should be stopped, since the drug can sometimes make kidney problems worse.
     
  • Breast enlargement in males (known medically as gynecomastia) has occurred in men taking spironolactone, due to its effect on male hormones. Usually, the breast enlargement goes away once spironolactone is stopped.
     
  • There are a number of medicines that can interact negatively with spironolactone (see Drug Interactions With Spironolactone).
     
  • Spironolactone is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using spironolactone during pregnancy (see Aldactone and Pregnancy for more information).
     
  • Spironolactone passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using spironolactone (see Aldactone and Breastfeeding for more information).
     
 
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