Spiros Special Precautions

Patients receiving spironolactone therapy should be carefully evaluated for possible disturbances of fluid and electrolyte balance particularly in the elderly and in those with significant renal and hepatic impairment.
Hyperkalemia may occur in patients with impaired renal function or excessive potassium intake and can cause irregularities, which can be fatal. If hypernatremia occur, spironolactone should be discontinued, and if necessary, active measures taken to reduce the serum potassium levels to normal.
Reversibly increases in blood urea have been reported in association with spironolactone therapy, particularly in the presence of impaired renal function.
Reversible hyperchloremic metabolic acidosis, usually in association with hyperkalemia, has been reported to occur in some patients with decompensated cirrhosis even in the presence of normal renal function.
Caution should be taken in patients diagnosed with porphyria as Spironolactone is considered unsafe in these patients.
Care should be taken in patients suffering from menstrual abnormalities or breast enlargement.