- Primary hyperaldosteronism;
- PO 100-400 mg per day in preparation for surgery initially
- Essential hypertension:
- PO 25-100mg OD or BD initially; may adjust dosage to patient response every 2weeks
- CHF:
- PO 5-25 mg OD. May increase dose every 2 weeks. Max: 50 mg/day
- Edema associated with cirrhosis or nephrotic syndrome:
- PO 100mg OD/BD. May increase dose after 5 days.
- Hypokalemia:
- PO 25-100 mg per day
- PO 25-100 mg per day
- Idiopathic hirsuitism (Off-label):
- PO 50-200 mg OD/BD
- PO 50-200 mg OD/BD
- Acne (Off-label):
- Initially 25mg OD; increase to 50-200 mg OD/BD
- Initially 25mg OD; increase to 50-200 mg OD/BD
Children: 3mg/kg daily in divided doses
Renal dosing
- eGFR 30-49: start 12.5 mg OD then may incr. to 12.5-25 mg OD after week 4
- eGFR <30: avoid use
- Tablet:
- 25mg
- 50mg
- 100mg
- Best taken in the morning due to its diuretic effect.
- For children, tablet may be crushed and given in suspension if necessary. Insoluble in water.
Potassium-sparing diuretic.
It competitively binds to receptors at the aldosterone-dependent Na-K exchange site in the distal convoluted tubule resulting in increased excretion of Na+, Cl-, and water and retention of K+ and H+.
It also increases testosterone clearance and promotes estradiol production.
- Gynecomastia
- Hyperkalemia
- Nausea
- Vomiting
- Drowsiness
- Mental confusion
- Mild androgenicity
- Menstrual irregularity
- Hyponatremia
- Abdominal cramps
- Fever
- Rash
- Impotence
- Post-menopausal bleeding
- Hypersensitivity to components
- Acute renal insufficiency
- Anuria
- Hyperkalemia
- Lactation
- Pregnancy
- Addison’s disease
- Patients >65 years
- Eplerenone
- Amiloride
- Triamterene
- Isocarboxazid
- Cyclosporine
Drug Status
| Availability | Prescription only |
| Pregnancy | Category B3; Contraindicated |
| Breastfeeding | Contraindicated |
| Schedule | Not controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Aldactone | 100mg | Tablet | 10’s | Pfizer Labs | Pfizer Labs |
| Aldactone | 25mg | Tablet | 100’s | Pfizer Labs | Pfizer Labs |
| Lactone | 25mg | Tablet | 100’s | Dawa Ltd | Dawa Ltd |
| Spillar | 25mg | Tablet | 100’s | Centaur Pharma | Sai Pharma |
| Spirolac-100 | 100mg | Tablet | 100’s | Pharma Life Science | Pharma Life Science |
| Spirolac-25 | 25mg | Tablet | 100’s | Pharma Life Science | Pharma Life Science |
| Spirolon | 25mg | Tablet | 100’s | Remedica Ltd | Twokay Chemicals |
| Spirolon | 100mg | Tablet | 100’s | Remedica Ltd | Twokay Chemicals |