Spironolactone

Question 1

What sort of drug is Spironolactone and how does it work?

Answer 1

It is an aldosterone antagonist and acts on the collecting duct.

Question 2

What are the adverse effects of Spironolactone?

Answer 2

Hyperkalaemia

Gynaecomastia

Question 3

What are the indications of spironolactone?

Answer 3

• Ascites: patients with cirrhosis develop a secondary hyperaldosteronism.
  
  • Relatively large doses such as 100 or 200mg are often used
• Hypertension: used in some patients as a NICE ‘step 4’ treatment
• Heart failure
  
  • ​(RALES study - Spironolactone reduces all cause mortality in NYHA 3 & 4 and already on ACE-I.)
• Nephrotic syndrome
• Conn’s syndrome