Spironolactone

What spironolactone is for

Spironolactone is a diuretic medicine, sometimes called "water tablets", that make you pee more. If your body has too much fluid, spironolactone can help you get rid of it.

It's used to treat:

• swelling, in the ankles, feet and other parts of the body, caused by fluid build-up (oedema)
• heart failure
• high blood pressure (hypertension) if other medicines have not worked

How to take spironolactone

Spironolactone usually comes as tablets or a liquid you swallow.

Your dose and how long you take it for depends on why you're taking it.

When taking spironolactone:

• take it with food or just after food
• use the syringe or spoon that comes with your liquid medicine to measure out the right dose

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it, or you have any other problems taking it.

If you miss a dose of spironolactone

If you forget to take a dose of spironolactone, take it as soon as you remember, unless it's nearly time for your next dose.

If it's nearly time for your next dose, skip the dose you missed and take your next dose at the usual time.

Do not take 2 doses at the same time to make up for a missed one.

If you take too much spironolactone

Taking an extra dose of spironolactone is unlikely to cause problems, but it's important to get medical advice if you take too much because it can sometimes be dangerous.

Side effects of spironolactone

Like all medicines spironolactone can cause side effects, but not everyone gets them.

Common side effects

Common side effects of spironolactone include:

• feeling dizzy
• feeling sick (nausea)
• muscle or leg cramps
• feeling tired or low in energy
• breast pain and increase in breast size, including in men

Spironolactone will not usually affect your ability to drive, ride a bike or use machinery, but if you feel dizzy or have problems with your vision after taking it, wait until the side effects stop.

Serious side effects

Spironolactone can sometimes cause serious side effects, but most of them are rare.

Possible serious side effects of spironolactone include:

• an allergic reaction (anaphylaxis) – causing symptoms such as swollen throat or tongue, a raised and itchy rash, and difficulty breathing
• Stevens-Johnson syndrome – causing itchy and blistering skin around the lips and the rest of the body
• liver problems – causing eyes and skin to turn yellow (jaundice), although this may be more difficult to see on black or brown skin
• kidney problems – causing symptoms such as tiredness, breathlessness, feeling sick (nausea) or being sick (vomiting)
• high potassium levels (hyperkalaemia) – causing symptoms such as muscle weakness, tiredness, numbness and irregular heartbeat (arrhythmia)

Who can and cannot take spironolactone

Most adults and children can take spironolactone, but it's not suitable for everyone.

You may not be able to take spironolactone if you:

• have ever had an allergic reaction to spironolactone or any of its ingredients
• have severe kidney problems
• are unable to pee properly because of an underlying condition, such as a urinary tract infection
• have Addison's disease – a hormone imbalance that causes weakness, weight loss and low blood pressure
• have ever had high levels of potassium in your blood (hyperkalaemia)

Breastfeeding and spironolactone

You may be able to take spironolactone while breastfeeding, but check with a doctor or healthcare professional first.

It's rare for breastfed babies to get any side effects from medicine you're taking, but speak to a healthcare professional if you have any concerns about your baby.

Pregnancy and spironolactone

Spironolactone is not usually recommended during pregnancy. This is because it can potentially affect a baby's development.

Find out more about taking a diuretic medicine, including spironolactone, during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking spironolactone with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with spironolactone.

These include:

• digoxin, a medicine used to treat an irregular heartbeat
• some medicines to treat high blood pressure and heart failure, such as eplerenone
• supplements containing potassium
• non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin and diclofenac

Before you take spironolactone, tell your doctor or a pharmacist if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with spironolactone

Spironolactone can sometimes raise your potassium levels and cause a condition called hyperkalaemia.

Eating foods like bananas and avocados, or salt substitutes such as Lo-Salt, while taking spironolactone can raise potassium levels further. Ask a doctor or dietitian for advice.