How does spironolactone work in hypertension?
Spironolactone is an aldosterone receptor antagonist. It causes the kidneys to excrete more sodium and water which reduces the blood pressure.
Is spironolactone used to treat hypertension?
Spironolactone is used in combination with other medicines to treat high blood pressure (hypertension) and heart failure. Lowering blood pressure can reduce the risk of strokes and heart attacks. Spironolactone is also used to lessen the need for hospitalization for heart failure.
What is spironolactone mechanism of action?
Mechanism of action: Aldactone (spironolactone) is a specific pharmacologic antagonist of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule.
When do you add spironolactone for hypertension?
Spironolactone is recommended in patients with resistant hypertension which is defined as uncontrolled blood pressure despite three antihyperternsive drug combination including a diuretic. Spironolactone is a mineralocorticoid receptor antagonist and causes anti-androgenic side effects.
Is spironolactone better than amlodipine?
Medicine: spironolactone (20mg/tablet), indapamide (1.5mg/tablet) and amlodipine (5mg/tablet). Rationale: Our hypothesis of the present trial is that spironolactone is superior to indapamide in cardiovascular prevention in hypertensive patients, with the possible addition of amlodipine.
How does spironolactone help the heart?
Based on the pathophysiology of resistant hypertension, spironolactone use in patients with heart failure with preserved ejection fraction (HFpEF) with resistant hypertension, in addition to lowering blood pressure, may reduce the risk of volume overload, resulting in a reduced risk of heart failure and cardiovascular ...
What does spironolactone do to potassium?
Spironolactone is a potassium-sparing diuretic (water pill). It prevents your body from absorbing too much salt and keeps your potassium levels from getting too low. This medicine is also used to treat or prevent hypokalemia (low potassium levels in the blood).
Does spironolactone increase potassium?
Our retrospective chart review shows that in our practice, spironolactone is effective in raising serum potassium in PD patients regardless of the indication for use. Among patients treated for low serum potassium, it was effective in raising potassium to a normal range.
Before Taking This Medicine
You should not use spironolactone if you are allergic to it, or if you have: 1. Addison's disease (an adrenal gland disorder); 2. high levels of po...
How Should I Take Spironolactone?
Take spironolactone exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change you...
What Happens If I Miss A Dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to...
What Should I Avoid While Taking Spironolactone?
Drinking alcohol can increase certain side effects of spironolactone.See also: Spironolactone and alcohol (in more detail)Do not use salt substitut...
Spironolactone Side Effects
Get emergency medical help if you have signs of an allergic reaction to spironolactone: hives; difficulty breathing; swelling of your face, lips, t...
Spironolactone Dosing Information
Usual Adult Dose for Edema:25 to 200 mg orally per day in single or divided dosesDuration of therapy: When given as the sole diuretic, continue the...
What Other Drugs Will Affect Spironolactone?
Taking this medicine with other drugs that make you dizzy or lower your blood pressure can worsen these effects. Ask your doctor before taking a sl...
What is a spironolactone?
Spironolactone is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low . Spironolactone is used to treat heart failure, high blood pressure (hypertension), or hypokalemia ( low potassium levels in the blood). Spironolactone also treats fluid retention ...
What are the side effects of spironolactone?
Spironolactone side effects. Get emergency medical help if you have signs of an allergic reaction to spironolactone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: a light-headed feeling, like you might pass out; little or no urination;
How long does a diuretic last?
Duration of therapy: When given as the sole diuretic, continue the initial dose for at least 5 days, after which the initial dose may be adjusted to an optimal maintenance dose.Comments:-A second diuretic that acts more proximally at the renal tubule may be added if adequate diuresis has not been achieved after 5 days.
Is spironolactone safe for pregnant women?
To make sure spironolactone is safe for you, tell your doctor if you have: an electrolyte imbalance (such as low levels of calcium, magnesium, or sodium in your blood); kidney disease; liver disease; or. heart disease. Tell your doctor if you are pregnant or plan to become pregnant.
Can you take spironolactone if you are allergic to it?
You should not use spironolactone if you are allergic to it, or if you have: if you are also taking eplerenone. To make sure spironolactone is safe for you, tell your doctor if you have: an electrolyte imbalance (such as low levels of calcium, magnesium, or sodium in your blood);
Can you take eplerenone with spironolactone?
You should use spironolactone with caution if you have kidney problems, high levels of potassium in your blood, Addison's disease, if you are unable to urinate, or if you are also taking eplerenone . Spironolactone has caused tumors in animals but it is not known whether this could occur in people.
Can you breastfeed while taking spironolactone?
Your doctor should decide whether you take spironolactone if you are pregnant. It may not be safe to breastfeed while using spironolactone.
What is resistant hypertension?
Resistant hypertension is defined as uncontrolled blood pressure (BP) despite treatment with at least 3 BP-lowering medications.
What is hot line IV?
SESSION NAME: Hot Line IV - Hypertension. In patients with poor blood pressure control despite treatment with a combination of three drugs (‘resistant hypertension’), addition of the diuretic spironolactone was significantly more effective than adding other blood pressure lowering drugs, according to results of the PATHWAY-2 trial.
How many people took spironolactone?
Among the 1790 participants who took spironolactone for any cause, investigators ascribed 297 adverse events in 238 participants (13%) to spironolactone, which was discontinued temporarily or permanently as a result in 110 participants (6%).
How long does spironolactone last?
The median duration of spironolactone treatment was 1.3 years (interquartile range: 0.6 to 2.6 years). The median dose of spironolactone was 25 mg (interquartile range: 25 to 50 mg) at both the start and end of the observation period.
What information was routinely recorded about adverse events at each ASCOT study visit?
Information was routinely recorded about adverse events at each ASCOT study visit; investigators were asked to give an opinion on causality (study drug, another drug, or concurrent condition or illness). The current analyses include all of the participants prescribed spironolactone, whatever the indication, but only those events attributed to spironolactone.
Does spironolactone lower blood pressure?
In conclusion, spironolactone effectively lowers blood pressure in patients with hypertension uncontrolled by a mean of ≈3 other drugs. Although nonrandomized and not placebo controlled, these data support the use of spironolactone in uncontrolled hypertension.
Is spironolactone a fourth line medication?
Spironolactone is recommended as fourth-line therapy for essential hypertension despite few supporting data for this indication. We evaluated the effect among 1411 participants in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm who received spironolactone mainly as a fourth-line antihypertensive agent for uncontrolled blood pressure and who had valid BP measurements before and during spironolactone treatment. Among those who received spironolactone, the mean age was 63 years (SD: ±8 years), 77% were men, and 40% had diabetes. Spironolactone was initiated a median of 3.2 years (interquartile range: 2.0 to 4.4 years) after randomization and added to a mean of 2.9 (SD: ±0.9) other antihypertensive drugs. The median duration of spironolactone treatment was 1.3 years (interquartile range: 0.6 to 2.6 years). The median dose of spironolactone was 25 mg (interquartile range: 25 to 50 mg) at both the start and end of the observation period. During spironolactone therapy, mean blood pressure fell from 156.9/85.3 mm Hg (SD: ±18.0/11.5 mm Hg) by 21.9/9.5 mm Hg (95% CI: 20.8 to 23.0/9.0 to 10.1 mm Hg; P <0.001); the BP reduction was largely unaffected by age, sex, smoking, and diabetic status. Spironolactone was generally well tolerated; 6% of participants discontinued the drug because of adverse effects. The most frequent adverse events were gynecomastia or breast discomfort and biochemical abnormalities (principally hyperkaliemia), which were recorded as adverse events in 6% and 2% of participants, respectively. In conclusion, spironolactone effectively lowers blood pressure in patients with hypertension uncontrolled by a mean of ≈3 other drugs. Although nonrandomized and not placebo controlled, these data support the use of spironolactone in uncontrolled hypertension.
