Spironolactone is used to treat water retention caused by heart failure and kidney or liver disease. Water retention may be noticed as swelling of the feet, ankles, lower leg and hands, or shortness of breath. For this reason, it is commonly known as a "water pill."
This medicine is also used together with other medicines to help keep your blood pressure under control.
Spironolactone may be used to treat other conditions as decided by your doctor.
Take Spironolactone exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take this medicine together with food or immediately after a meal. Try to take it at the same time each day.
You may need to pass urine more often while being treated with Spironolactone. Take this medicine early in the day, preferably in the morning. If your doctor has told you to take it twice a day, take the last dose in the late afternoon. This is to prevent you from waking up frequently at night to go to the toilet.
Spironolactone is available as a tablet or an oral suspension.
If you are taking an oral suspension, shake the bottle well before you take the medicine to ensure that the liquid is evenly mixed. Use the measuring spoon or cup provided to measure your dose.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type and severity of your condition and your response to the medication.
Spironolactone must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by your doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- high potassium levels in the blood
- Addison's disease (a rare disorder where the adrenal glands produce insufficient amounts of certain hormones)
- severe kidney disease or kidney problem e.g. unable to pass urine
as Spironolactone may not be suitable for you.
Do not take Spironolactone with other similar water pills or medicines for water retention or any potassium supplements. Please see the section "Can I take this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- weakness and inability of the heart to pump blood
- mild to moderate kidney disease
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
Do not switch between different dosage forms unless instructed by your doctor. This is because different dosage forms of Spironolactone may have different ways of working in your body.
If you are going to have certain laboratory tests (e.g. digoxin assays), inform your doctor that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. kidney function, electrolyte, sugar and uric acid levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
What lifestyle changes can I make to improve my blood pressure?
Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.
If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.
Spironolactone may cause any of the following side effects: dizziness, headache, drowsiness, fever, tiredness, weakness, nausea, vomiting, diarrhoea, stomach cramps, breast pain, irregular menstruation, and changes in sex drive.
You may need to pass urine more often while you are being treated with this medicine. As your body adjusts to the medicine, this urination effect should also decrease.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- muscle weakness, cramping or numbness; fast or irregular heartbeat
- mood changes, confusion, muscle pain or weakness, severe dizziness or passing out, seizures, increased thirst, unable to pass urine or change in the amount of urine passed
- enlarged breasts in men
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Spironolactone with the following medicines:
- eplerenone (medicine for high blood pressure)
- other water pills or medicines for water retention e.g. triamterene, amiloride
- potassium supplements
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- other medicines for high blood pressure e.g. enalapril, losartan
- NSAIDs (medicines for pain and inflammation) e.g. ibuprofen, mefenamic acid, indometacin, aspirin
- digoxin (medicine for heart disease)
- lithium (medicine for mood disorders)
- blood-thinning medicines e.g. heparin, dalteparin
- colestyramine (cholesterol-lowering medicine)
- carbenoxolone (medicine used to treat mouth or stomach ulcers)
- norepinephrine (medicine used for low blood pressure or heart problems)
This list does not include all medicines that may interact with Spironolactone.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Do not take salt substitutes that contain potassium.
Avoid taking too much food that is high in potassium, such as orange juice, bananas, or prunes.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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