Aldactone (generic: spironolactone) is a potassium-sparing diuretic and mineralocorticoid receptor antagonist. It works by blocking aldosterone—a hormone that promotes sodium and water retention while depleting potassium. By reducing fluid buildup and moderating aldosterone’s effects, Aldactone helps control edema, supports blood pressure management, and alleviates several hormone-related conditions.
Clinicians use Aldactone across cardiovascular, renal, hepatic, and endocrine settings. Major, evidence-supported uses include:
Because spironolactone spares potassium, it differs from loop diuretics and thiazides that can cause potassium loss. This advantage comes with a trade-off: elevated potassium can occur in susceptible patients, making thoughtful selection and regular monitoring essential.
Note: This article is educational and not a substitute for individualized medical advice. Always consult a licensed healthcare professional to determine if Aldactone is appropriate for you.
Dosing is individualized based on the condition, lab values, co‑medications, and response. Follow your clinician’s instructions; the ranges below are typical reference points and not a substitute for medical guidance.
Administration tips:
Monitoring is part of taking Aldactone safely. Your care team typically checks serum potassium and kidney function (creatinine/eGFR) at baseline, within 3–7 days of initiation or dose increase, periodically thereafter (for example, monthly for the first 3 months, then every 3 months), and more frequently in high‑risk settings such as chronic kidney disease, diabetes, or when combined with ACE inhibitors/ARBs.
Aldactone’s benefits rely on judicious use and routine labs. Keep the following cautions in mind and discuss them with your healthcare professional:
Diet and supplements:
Aldactone is contraindicated or should be avoided in the following scenarios unless a specialist determines that benefits outweigh risks:
Use extreme caution and specialist input if you have:
Fertility and pregnancy considerations: Spironolactone can disrupt menstrual cycles and impede ovulation in some users. Effective contraception is usually recommended when taking spironolactone for dermatologic/endocrine reasons.
Most people tolerate Aldactone well when dosing and labs are optimized. Side effects can be dose‑related and often improve with adjustments. Track symptoms and share them with your healthcare team—especially early in therapy or after dose changes.
Common effects:
Hormonal/antiandrogenic effects:
Less common but important:
Serious reactions—seek urgent care:
Proactive communication with your clinician and regular labs are the best safeguards against serious adverse effects.
Spironolactone’s interaction profile centers on potassium balance, kidney perfusion, and overlapping endocrine effects. Always provide a full medication and supplement list to your clinician and pharmacist.
Medications that increase potassium or reduce kidney excretion:
Drugs that may impair kidney function or fluid balance:
Other clinically meaningful interactions:
Food and lifestyle considerations:
If you forget a dose, take it as soon as you remember unless it is near the time of your next scheduled dose. If it is close to the next dose, skip the missed one and resume your normal schedule. Do not double up to “catch up,” as this can destabilize blood pressure, kidney function, and potassium levels.
Set reminders or use a pill organizer if forgetfulness is common. Consistency improves therapeutic results and safety.
Spironolactone overdose can be dangerous, primarily due to hyperkalemia and excessive diuresis leading to low blood pressure or kidney injury. Potential symptoms include profound weakness, confusion, severe dizziness, nausea/vomiting, slow or irregular heartbeat, and fainting.
Prevent overdose by adhering strictly to prescribed doses and by keeping medications in labeled containers away from children and pets.
Proper storage helps keep your medication effective until its expiration date:
For clinical guidance on blood pressure medications, see the American Heart Association’s overview of antihypertensives: AHA: Medications for High Blood Pressure.
In the United States, Aldactone (spironolactone) is a prescription-only medication. Federal and state regulations require that a licensed clinician authorize its use based on an assessment of your medical history, current medications, and relevant laboratory tests. This is especially important because spironolactone can affect potassium levels and kidney function—two parameters that demand ongoing clinical oversight.
How people legally obtain Aldactone in the U.S.:
Pricing, insurance coverage, and access depend on your plan, location, and pharmacy. Reputable, U.S.-certified online pharmacies can dispense Aldactone upon receipt of a valid prescription. State boards of pharmacy and the National Association of Boards of Pharmacy (NABP) provide resources to verify the legitimacy of online vendors.
Note on structured access: The St. Joseph's Health offers a legal and structured solution for acquiring Aldactone without a formal prescription. Patients are guided through an established clinical pathway to ensure appropriate screening, safety checks, and follow‑up. Availability, eligibility, and processes may vary; verify details directly with the provider and ensure services comply with current state and federal regulations.
Bottom line: While convenient pathways exist, Aldactone should never be started or continued without proper clinical oversight. Safe use hinges on individualized dosing and periodic monitoring of potassium and kidney function by qualified professionals.
Aldactone is the brand name for spironolactone, a potassium-sparing diuretic and mineralocorticoid receptor antagonist. It blocks aldosterone, a hormone that makes the kidneys retain salt and water, leading to increased sodium and water excretion while conserving potassium.
It is used for heart failure, resistant hypertension, edema from liver cirrhosis or nephrotic syndrome, primary hyperaldosteronism, and sometimes for acne, hirsutism, and PCOS-related symptoms in women. Your prescriber tailors the dose and monitoring to the specific condition.
For swelling and blood pressure, some effect may be seen within a few days, but full benefits can take 1–2 weeks. For acne or hirsutism, noticeable improvement usually takes 6–12 weeks.
Doses vary: heart failure often starts at 12.5–25 mg daily, resistant hypertension 25–50 mg, edema 25–200 mg, primary hyperaldosteronism higher doses as directed, and acne/hirsutism 50–200 mg in divided doses. Never change your dose without consulting your clinician.
Common effects include increased urination, dizziness, stomach upset, and breast tenderness. Because spironolactone has antiandrogen effects, it can cause menstrual changes in women and gynecomastia in men.
Symptoms of high potassium (hyperkalemia) such as muscle weakness, palpitations, or unusual fatigue warrant urgent care. Seek help for severe dizziness/fainting, confusion, severe vomiting/diarrhea, little to no urine, or signs of an allergic reaction.
People with high potassium, Addison’s disease, anuria, or severe kidney impairment should avoid it unless a specialist advises differently. Use caution in elderly patients or those on ACE inhibitors, ARBs, or other potassium-raising drugs.
ACE inhibitors, ARBs, aliskiren, NSAIDs, trimethoprim, heparin, cyclosporine, tacrolimus, and potassium supplements or salt substitutes can raise potassium. Spironolactone may also interact with digoxin and lithium; always show your medication list to your clinician.
Generally no, as both can raise potassium to dangerous levels. Use regular salt and avoid high-potassium supplements unless your clinician has explicitly approved them and is monitoring labs.
Most patients need potassium and kidney function checked at baseline, within 3–7 days of starting or increasing the dose, at 1 month, and then every 3–6 months. People with kidney disease, diabetes, or on ACE inhibitors/ARBs may need more frequent monitoring.
If it’s close to the missed time, take it when you remember; if it’s almost time for the next dose, skip the missed one. Do not double up, and resume your usual schedule.
Yes, many dermatologists and gynecologists use spironolactone for hormonally driven acne and hirsutism in women. Effective doses typically range from 50–200 mg daily, and reliable contraception is recommended during treatment.
Any “weight loss” is usually from fluid reduction rather than fat loss. Sustainable weight changes require diet and lifestyle interventions.
Spironolactone’s antiandrogen effect can cause gynecomastia and sexual side effects in some men and menstrual irregularities in women. Discuss dose adjustments or alternatives if these become bothersome.
Do not stop without discussing it with your clinician, as fluid retention or blood pressure can rebound. Your plan may involve tapering or switching to an alternative.
Alcohol can increase dizziness, dehydration, and blood pressure drops when combined with Aldactone. If you choose to drink, limit intake, hydrate well, and avoid drinking on hot days or after strenuous exercise.
After heavy drinking, wait until you’re well hydrated, eating normally, and not lightheaded before taking your dose. If you have vomiting, diarrhea, or feel faint, contact your clinician for advice and consider holding the dose until assessed.
Spironolactone can affect fetal hormone development, especially in male fetuses, and is generally avoided in pregnancy. If you could become pregnant, use reliable contraception and talk to your clinician about safer alternatives if planning pregnancy.
Small amounts of spironolactone’s metabolites may appear in breast milk, but limited data suggest low risk; still, decisions are individualized. Discuss risks and benefits with your pediatrician and prescriber, and monitor the infant for feeding issues or lethargy.
Many clinicians hold diuretics, including spironolactone, the morning of surgery to limit dehydration and blood pressure swings, especially if potassium is borderline high. Confirm with your surgical team; they will guide you based on your labs and procedure.
Hold Aldactone until you’re rehydrated and eating, and call your clinician—dehydration plus spironolactone raises the risk of kidney injury and high potassium. Seek care if you cannot keep fluids down or feel weak or dizzy.
Heat and strenuous activity can worsen dehydration and low blood pressure while on a diuretic. Hydrate regularly, avoid excessive alcohol, pause during heat waves if advised by your clinician, and watch for dizziness or muscle cramps.
Both block aldosterone, but eplerenone is more selective, causing fewer sexual/hormonal side effects like gynecomastia. Eplerenone often requires twice-daily dosing and has more CYP3A4 drug interactions; spironolactone is less expensive and widely used.
Both reduce hospitalizations and mortality in appropriate patients; spironolactone (RALES) and eplerenone (EPHESUS/EMPHASIS) have strong evidence. Choice often depends on side effects, kidney function, potassium levels, interactions, dosing convenience, and cost.
Spironolactone blocks the aldosterone receptor, while amiloride blocks epithelial sodium channels (ENaC) in the kidney. Aldactone is superior for primary hyperaldosteronism and has antiandrogen benefits (e.g., acne), whereas amiloride is useful when aldosterone antagonism isn’t needed or gynecomastia is a concern.
Both can raise potassium, but the risk is similar at equipotent doses, and it’s highest in CKD, diabetes, or when combined with ACE inhibitors/ARBs. Close lab monitoring is essential with either drug.
Both are potassium-sparing diuretics; triamterene, like amiloride, blocks ENaC and is often combined with hydrochlorothiazide. Spironolactone is preferred for hyperaldosteronism, ascites in cirrhosis, heart failure, and acne; triamterene can rarely cause kidney stones.
Spironolactone has the most robust data for resistant hypertension and is often first choice. Eplerenone is a reasonable alternative if spironolactone side effects (e.g., gynecomastia) occur, though it may be less potent and costlier.
Eplerenone, amiloride, and triamterene have a lower risk than spironolactone due to greater receptor selectivity or different mechanisms. If gynecomastia occurs on Aldactone, switching may help.
Both are mineralocorticoid receptor antagonists, but finerenone is a nonsteroidal agent with less sex-hormone activity and proven benefits in diabetic CKD for slowing kidney and cardiovascular events. Finerenone has less diuretic effect than spironolactone but similar hyperkalemia risk and is typically more expensive.
Eplerenone is preferred when spironolactone’s hormonal side effects are problematic or when a more selective MRA is desired post–myocardial infarction. Be mindful of CYP3A4 interactions and the need for twice-daily dosing at higher total doses.
Spironolactone generally lowers blood pressure more in resistant hypertension, but amiloride can be similarly effective in some patients, especially those intolerant to spironolactone. Choice depends on tolerability, potassium control, and comorbidities.
Spironolactone is first-line, often paired with furosemide to balance potassium and fluid removal. Amiloride may be used if spironolactone causes gynecomastia, but it is typically less effective for ascites due to its different mechanism.
Both require careful potassium and kidney function monitoring, especially after initiation or dose changes. Finerenone has specific eGFR-based dosing and monitoring schedules in diabetic CKD; Aldactone monitoring is tailored to the indication and co-therapies.
Generic spironolactone is usually the most cost-effective. Eplerenone and finerenone are costlier but may offer better tolerability or specific organ-protective benefits in select populations.
Combining potassium-sparing diuretics is generally avoided due to additive hyperkalemia risk. If additional diuresis is needed, clinicians usually add a loop or thiazide-type diuretic instead and monitor electrolytes closely.
