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Aldactone (spironolactone) is a diuretic most frequently used to treat high blood pressure, low potassium levels, and edema caused by congestive heart failure, certain kidney disorders, or cirrhosis of the liver.

This medication is a potassium-sparing diuretic, meaning it does not promote excretion of potassium, unlike many other diuretics. It should not be used by patients with chronic high levels of potassium.

Treatment with Aldactone

The effects of Aldactone on both high blood pressure and edema are quite similar; the medication promotes excretion of sodium and water through the kidneys (urination) while promoting retention of potassium which may otherwise be excreted.

Increasing secretion of salt and water, particularly when also adopting lifestyle changes such as lower salt intake, will reduce stress on the heart and help eliminate the swelling or bloating associated with edema.

For both edema and high blood pressure, it is quite common for multiple medications to be prescribed; patients may be given several diuretics, several types of blood pressure medications, and so forth. However, taking multiple similar medications should not be done without explicit doctor approval; severe adverse reactions could result.

Aldactone may also be prescribed for patients with chronic low levels of potassium, a condition known as hypokalemia. In this instance the important effect is promoting retention of potassium; it reduces the amount of potassium excreted in urine.

Most patients are prescribed 25 to 200 mg of Aldactone daily for all conditions, with the exception of Primary Hyperaldosteronism (see below).

Doses may be taken all at once, or split into two doses.

In all cases treatment may be discontinued if the underlying cause is resolved; otherwise treatment may continue indefinitely.

Treating Primary Hyperaldosteronism

Primary Hyperaldosteronism is a condition in which the body overproduces the hormone aldosterone, which is produced by the adrenal glands. While there are a number of ailments which may cause overproduction of aldosterone, the most common by far is Adrenal Adenoma, also known as Conn's Syndrome.

High levels of aldosterone promotes retention of water and sodium, while also promoting the excretion of potassium, which causes blood pressure to rise and puts stress on the heart. Aldactone interferes with the action of aldosterone, restoring more optimal balances of water and sodium and decreasing the excretion of potassium.

Patients treating Primary Hyperaldosteronism are usually started on 100 mg per day, which may be increased to 400 mg daily.

It is common for regular blood tests to be administered while taking large doses of Aldactone to ensure that electrolytes are not becoming imbalanced and that no adverse reactions are developing.

Warnings Before Use

Some patients are not good candidates for this treatment and should avoid use if certain preexisting conditions are present:

• Chronic high levels of potassium (hyperkalemia)
• Difficulty or inability to urinate
• Addison's disease (an adrenal gland disorder)
• Taking the medication eplerenone
• Pregnancy or breast-feeding

Other conditions put patients at higher risk of adverse effects; in these cases patients should not use Aldactone without doctor approval:

• Kidney, heart or liver disease
• Chronic electrolyte imbalances
• Taking potassium supplements

Aldactone can cause complications during surgery, including dental work; it may be necessary to stop treatment or reduce dosage prior to any procedures. Be sure to inform all involved with any procedure that the medication is being taken.

Side effects are typically mild, including:

• Headache
• Nausea
• Diarrhea
• Enlarged breasts
• Changes in menstruation
• Muscle cramps

Side effects may cease as the body becomes used to treatment, and usually reverse completely when treatment stops.

If side effects are severe, speak with a doctor about other options; there are many similar treatments available which may be more suitable for any particular individual.