Aldactone

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How does it work?

Spironolactone belongs to a group of medications known as the potassium-sparing diuretics. It acts in the kidney to remove excess water from the blood into the urine. Spironolactone blocks the actions of a hormone called aldosterone, which causes an increase in the removal of salts such as sodium from the blood. This removal of salts causes water to be drawn out of the blood and into the kidneys, where it is then excreted in the urine. Removing water from the blood causes a decrease in the volume of fluid circulating through the blood vessels. This drop in fluid volume decreases the effort required by the heart to pump blood around the body. There are many conditions which may lead to an accumulation of fluid in the body (oedema). Spironolactone is commonly used in conditions such as heart failure, where the pumping mechanism of the heart is less effective. It is used to relieve the symptoms of heart failure, such as the shortness of breath seen with fluid on the lungs. It is also used to remove excess fluid associated with liver failure, as well as in the treatment of excessive levels of aldosterone (hyperaldosteronism). Spironolactone does not increase the loss of potassium from the body in the urine, therefore there is less risk of developing low potassium levels in the blood (hypokalaemia). When it is used alone it has a weak effect, therefore it is often used in combination with other diuretics.

What is it used for?

- A syndrome caused by kidney inflammation, characterised by a large amount of protein in the urine, swelling, weight gain and high blood pressure (nephrotic syndrome)
- Congestive heart failure
- Fluid collection in abdomen (ascites)
- Liver cirrhosis, with collection of fluid in the abdominal cavity
- Overproduction of aldosterone, a steroid hormone which regulates salt and water balance (hyperaldosteronism)

Warning!

- It is recommended that individuals taking this medicine have their fluid and salt (electrolyte) balance monitored regularly.
- If you experience any of the following symptoms while taking this medicine you should inform your doctor promptly, so that the amount of fluids and salts in your body can be checked: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting.
- As diuretics cause your kidneys to produce more urine, you may prefer to take this medicine in the morning rather than before going to bed, as this will reduce the likelihood of you needing to get up in the night to visit the toilet. Seek further advice from your doctor or pharmacist.

Use with caution in

- Elderly people
- Kidney disease
- Liver disease

Not to be used in

- Failure of the kidneys to produce urine (anuria)
- High levels of potassium in the blood (hyperkalaemia)
- Inadequate production of natural steroid hormones by the adrenal glands
- Severe and worsening kidney disease
- Sudden decrease in kidney function (acute renal insufficiency)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.
- This medicine passes into breast milk. It is recommended that mothers should avoid using this medicine while breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Headache
- Impotence
- Confusion
- Fatigue
- Skin rashes
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Abnormal enlargement of breasts in men (gynaecomastia)
- Irregular menstrual cycle
- Disturbances in the levels of chemical components (electrolytes) in the blood

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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