Aldactone

Aldactone is the brand name for spironolactone, a potassium-sparing diuretic and aldosterone receptor antagonist (mineralocorticoid receptor antagonist). It acts in the distal nephron to promote the excretion of sodium and water while conserving potassium, helping to reduce fluid buildup without causing large losses of potassium.

It is used to treat edema associated with heart failure, liver cirrhosis, and nephrotic syndrome; it also helps manage hypertension, especially when blood pressure remains high despite other treatments, and can be used in primary hyperaldosteronism. In women, spironolactone’s antiandrogen effects can be helpful for hirsutism or acne as part of a broader treatment plan.

Mechanistically, spironolactone blocks the mineralocorticoid receptor, reducing sodium reabsorption in the collecting ducts. Its antiandrogen activity results from receptor antagonism and interference with androgen synthesis, which can contribute to its therapeutic effects in women but may cause antiandrogen–related side effects in men.

Common adverse effects include hyperkalemia, dizziness, gastrointestinal upset, breast tenderness, and, with long-term use, gynecomastia. It is contraindicated in hyperkalemia, anuria, or significant renal impairment, and it should be used with caution with other potassium-sparing medications. It is generally avoided during pregnancy due to potential fetal harm and is excreted in breast milk.

Aldactone is available as oral tablets, typically in strengths such as 25 mg, 50 mg, and 100 mg. Interactions include potassium supplements, ACE inhibitors, ARBs, and NSAIDs, which can affect kidney function or potassium levels.