Spironolactone, sold under the brand name Aldactone among others, is classed as a diuretic medication. It can be used to treat fluid build-up due to liver disease or kidney disease. It is also used to reduce risk of disease progression, hospitalization an + some more technical info; mechanistically spironolactone is a potassium sparing, competitive antagonist of the mineralocorticoid receptor that reduces aldosterone mediated sodium reabsorption and potassium excretion in the renal collecting duct. It is metabolized in the liver to active metabolites including canrenone and 7 alpha thio-spironolactone which contribute to clinical effect. Indications include management of heart failure with reduced ejection fraction to lower morbidity and mortality, resistant hypertension, primary hyperaldosteronism, edema associated with hepatic cirrhosis and nephrotic syndrome, and certain endocrine and dermatologic uses such as androgen related hirsutism and acne in women. Important clinical considerations include monitoring of serum potassium and renal function due to risk of hyperkalemia, dose adjustment or avoidance in severe renal impairment, potential interactions with ACE inhibitors ARBs potassium supplements and NSAIDs, and antiandrogenic effects that can alter sex hormone related physiology.
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Parent: Spironolactone
Active pharmaceutical ingredient quality control typically targets high purity and well defined related substance limits; commonly accepted specifications for spironolactone API set assay values above 98 percent and control related substances using HPLC or LC MS methods. Known related compounds and degradation products include canrenone, 7 alpha thio-spironolactone, 7 alpha thio-canrenone and other steroidal transformation products. Typical manufacturing specifications control total impurities to low single digit percentages and individual identified related compounds are commonly limited to low tenths of a percent, for example individual known impurities often reported under 0.5 percent and unspecified impurities limited to 0.1 to 0.2 percent as part of stability and release criteria; exact limits vary by manufacturer and regulatory monograph. Routine characterization includes identity, assay, related substances, residual solvents and heavy metals with follow up by forced degradation studies to define degradation pathways.
Spironolactone is used to treat fluid retention from conditions such as heart failure, liver cirrhosis and nephrotic syndrome, to manage resistant hypertension and primary hyperaldosteronism, and for certain hormonal indications such as hirsutism and acne in women. It is also prescribed to reduce risk of disease progression and hospitalization in selected heart failure patients.
Spironolactone has antiandrogenic activity; it blocks androgen receptors and can inhibit androgen synthesis, which often reduces symptoms of excess androgens such as hirsutism and acne. It may also cause menstrual irregularities and changes in libido due to its effects on sex steroid pathways.
A major side effect is hyperkalemia. Other important adverse effects include renal function deterioration in susceptible patients, gynecomastia in men, menstrual irregularities in women and gastrointestinal symptoms. Monitoring electrolytes and renal function is essential.
No, Lasix is the brand name for furosemide, a loop diuretic. Spironolactone is a potassium sparing, mineralocorticoid receptor antagonist and has a different mechanism of action and risk profile.
