Spironolactone is a potassium-sparing diuretic and selective aldosterone blocker used to treat edema, hypertension, hypokalemia, and other conditions. It is rapidly absorbed from the gastrointestinal tract and highly protein bound. It is metabolized in the liver and excreted primarily in urine. Common side effects include hyperkalemia, gastrointestinal issues, and menstrual irregularities. It can interact with other drugs to increase risks or decrease efficacy.

1. Spironolactone
Presented By
Qasim Jan

2. Introduction
• Class: Diuretic
Potassium Sparing
Selective Aldosterone Blocker
• Strength:
25MG TAB
50MG TAB
100MG TAB
• Pregnancy Category: C

3. Pharmacokinetics
• Absorption: Rapidly absorbed from GIT after oral administration
• Protein Binding: 90% Plasma protein binding
• Metabolism: Hepatic & Testicular CYP450
• Excretion: Primarily in Urine, secondarily in Bile
• Half Life: 10 minutes

4. Indications
• Edema associated with:
• Congestive Heart Failure
• Excessive Aldosterone Excretion
• Hypertension
• Primary Hyperaldosteronism
• Hypokalemia
• Acne in Woman
• Hirsutism

5. Dosage
• Edema:
Oral: 25-200 mg daily in 1-2 divided doses
• Hypokalemia:
Oral: 25-100 mg once daily
• Hypertension :
Oral: 25-50 mg daily in 1-2 divided doses

6. • Diagnosis of primary aldosteronism:
Oral: Long test: 400 mg once daily for 3-4 weeks;
short test: 400 mg once daily for 4 days
•Heart Failure:
12.5-25 mg once daily; maximum daily dose:
50 mg. If 25 mg once daily not tolerated, may reduce to 25
mg every other day

7. • Acne in women (unlabeled use):
• Oral: 50-200 mg once daily
• Hirsutism in women (unlabeled use):
• Oral: 50-200 mg daily in 1-2 divided doses.

8. Common side effect:
• Cardiovascular: Vasculitis
• Central nervous system: Ataxia, confusion, drowsiness, headache,
lethargy
• Dermatologic: Erythematous maculopapular rash, Stevens-Johnson
syndrome, toxic epidermal necrolysis, urticaria
• Endocrine & metabolic: Amenorrhea, gynecomastia, hyperkalemia

9. • Gastrointestinal: Abdominal cramps, diarrhea, gastritis,
gastrointestinal hemorrhage, gastrointestinal ulcer, nausea, vomiting
• Genitourinary: Impotence, irregular menses, postmenopausal
bleeding
• Hematologic & oncologic: Agranulocytosis, malignant neoplasm of
breast
• Hepatic: Hepatotoxicity

10. Interactions
• The risk or severity of adverse effects can be increased when
Spironolactone is combined with Acebutolol.
• Aceclofenac may decrease the antihypertensive activities of
Spironolactone.
• The therapeutic efficacy of Spironolactone can be decreased when
used in combination with Acemetacin.
• The therapeutic efficacy of Acetyldigitoxin can be decreased when
used in combination with Spironolactone.