Global InformationSpironolactone information
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| Pronunciation | /ˌspaɪroʊnoʊˈlæktoʊn/ SPY-roh-noh-LAK-tone,[1] /ˌspɪəroʊnoʊˈlæktoʊn/ SPEER-oh-noh-LAK-tone[2] |
| Trade names | Aldactone, others |
| Other names | SC-9420; NSC-150339; 7α-Acetylthiospirolactone; 7α-Acetylthio-17α-hydroxy-3-oxopregn-4-ene-21-carboxylic acid γ-lactone |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a682627 |
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| Routes of administration | By mouth,[4] topical[5] |
| Drug class | Antimineralocorticoid; Steroidal antiandrogen |
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| Pharmacokinetic data | |
| Bioavailability | 60–90%[11][12][13] |
| Protein binding | Spironolactone: 88% (to albumin and AGP)[14] Canrenone: 99.2% (to albumin)[14] |
| Metabolism | Liver, others: • Deacetylation via CES • S-Oxygenation via FOM • S-Methylation via TMT • Dethioacetylation • Hydroxylation via CYP3A4 • Lactone hydrolysis via PON3[11][12][17][18][19][20][21] |
| Metabolites | 7α-TS, 7α-TMS, 6β-OH-7α-TMS, canrenone, others[11][12][15] (All three active)[16] |
| Elimination half-life | Spironolactone: 1.4 hrs[11] 7α-TMS: 13.8 hours[11] 6β-OH-7α-TMS: 15.0 hrs[11] Canrenone: 16.5 hours[11] |
| Excretion | Urine, bile[12] |
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| ECHA InfoCard | 100.000.122 |
| Chemical and physical data | |
| Formula | C24H32O4S |
| Molar mass | 416.58 g·mol−1 |
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| Melting point | 134 to 135 °C (273 to 275 °F) |
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Spironolactone, sold under the brand name Aldactone among others, is a diuretic medication primarily used to treat fluid build-up due to heart failure, liver scarring, or kidney disease.[4] It is also used in the treatment of high blood pressure, and low blood potassium that does not improve with supplementation. In high doses it is an anti-androgenic, used to treat early puberty in boys, acne and excessive hair growth in women, and as a part of feminizing hormone therapy in trans women.[4][22][23] Spironolactone is taken by mouth.[4]
Common side effects include electrolyte abnormalities, particularly high blood potassium, nausea, vomiting, headache, rashes, and a decreased desire for sex.[4] In those with liver or kidney problems, extra care should be taken.[4] Spironolactone has not been well studied in pregnancy and should not be used to treat high blood pressure of pregnancy.[3] It is a steroid that blocks the effects of the hormones aldosterone and testosterone and has some estrogen-like effects.[4][24] Spironolactone belongs to a class of medications known as potassium-sparing diuretics.[4]
Spironolactone was discovered in 1957, and was introduced in 1959.[25][26][27] It is on the World Health Organization's List of Essential Medicines.[28][29] It is available as a generic medication.[4] In 2021, it was the 54th most commonly prescribed medication in the United States, with more than 12 million prescriptions.[30][31]
- ^ Loughlin KR, Generali JA (2006). The Guide to Off-label Prescription Drugs: New Uses for FDA-approved Prescription Drugs. Simon and Schuster. pp. 131–. ISBN 978-0-7432-8667-1. Archived from the original on 7 October 2022. Retrieved 6 November 2016.
- ^ Clark MA, Harvey RA, Finkel R, Rey JA, Whalen K (15 December 2011). Pharmacology. Lippincott Williams & Wilkins. pp. 286, 337. ISBN 978-1-4511-1314-3. Archived from the original on 7 October 2022. Retrieved 6 November 2016.
- ^ a b "Spironolactone Pregnancy and Breastfeeding Warnings". Archived from the original on 2 December 2015. Retrieved 29 November 2015.
- ^ a b c d e f g h i "Spironolactone". The American Society of Health-System Pharmacists. Archived from the original on 16 November 2015. Retrieved 24 October 2015.
- ^ Cite error: The named reference
FARIDDiamanti-Kandarakis2009was invoked but never defined (see the help page). - ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
- ^ "Aldactone 25 mg Film-Coated TabletsSummary of Product Characteristics (SmPC)". (emc). 3 February 2022. Archived from the original on 6 October 2022. Retrieved 2 August 2023.
- ^ Cite error: The named reference
Aldactone labelwas invoked but never defined (see the help page). - ^ "Qaialdo EPAR". European Medicines Agency (EMA). 25 July 2023. Archived from the original on 27 July 2023. Retrieved 2 August 2023.
- ^ "Qaialdo". Union Register of medicinal products. 31 May 2023. Archived from the original on 6 June 2023. Retrieved 6 June 2023.
- ^ a b c d e f g Cite error: The named reference
pmid15947888was invoked but never defined (see the help page). - ^ a b c d Maron BA, Leopold JA (September 2008). "Mineralocorticoid receptor antagonists and endothelial function". Current Opinion in Investigational Drugs. 9 (9): 963–9. PMC 2967484. PMID 18729003.
- ^ Carone L, Oxberry SG, Twycross R, Charlesworth S, Mihalyo M, Wilcock A (February 2017). "Spironolactone". Journal of Pain and Symptom Management. 53 (2): 288–292. doi:10.1016/j.jpainsymman.2016.12.320. PMID 28024992.
- ^ a b Cite error: The named reference
TakamuraMaruyama1997was invoked but never defined (see the help page). - ^ Cite error: The named reference
SzaszBudvari-Barany1990was invoked but never defined (see the help page). - ^ McDonagh TA, Gardner RS, Clark AL, Dargie H (14 July 2011). Oxford Textbook of Heart Failure. OUP Oxford. pp. 403–. ISBN 978-0-19-957772-9. Archived from the original on 27 March 2017.
- ^ Cite error: The named reference
Parkinson2001was invoked but never defined (see the help page). - ^ Cite error: The named reference
Klaassen2007was invoked but never defined (see the help page). - ^ Cite error: The named reference
pmid7895608was invoked but never defined (see the help page). - ^ Cite error: The named reference
BlackElliott2006was invoked but never defined (see the help page). - ^ Cite error: The named reference
pmid14579013was invoked but never defined (see the help page). - ^ Friedman AJ (October 2015). "Spironolactone for Adult Female Acne". Cutis. 96 (4): 216–7. PMID 27141564.
- ^ Maizes V (2015). Integrative Women's Health (2 ed.). Oxford University Press. p. 746. ISBN 978-0-19-021480-7.
- ^ Deedwania PC (30 January 2014). Drug & Device Selection in Heart Failure. JP Medical Ltd. pp. 47–. ISBN 978-93-5090-723-8. Archived from the original on 7 October 2022. Retrieved 5 July 2017.
- ^ Ottow E, Weinmann H (9 July 2008). Nuclear Receptors As Drug Targets. John Wiley & Sons. p. 410. ISBN 978-3-527-62330-3. Archived from the original on 21 June 2013. Retrieved 28 May 2012.
- ^ Wermuth CG (24 July 2008). The Practice of Medicinal Chemistry. Academic Press. p. 34. ISBN 978-0-12-374194-3. Archived from the original on 21 June 2013. Retrieved 27 May 2012.
- ^ Sittig M (1988). Pharmaceutical Manufacturing Encyclopedia. William Andrew. p. 1385. ISBN 978-0-8155-1144-1. Archived from the original on 20 June 2013. Retrieved 27 May 2012.
- ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
- ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
- ^ "Spironolactone - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.