Spironolactone

What is spironolactone?

Spironolactone is a medicine called a diuretic (or “water pill”). This medicine is used to reduce extra fluid that builds up in the abdomen, called ascites, in patients with liver disease. It can also help control high blood pressure from extra water in the body (edema) associated with certain diseases in the liver.

Spironolactone is taken by mouth and is available as a tablet. It may also be made into a liquid form (suspension) by a pharmacy. You may hear spironolactone called by its brand name Aldactone.

Before giving spironolactone to your child

Tell your doctor if your child is allergic to spironolactone or any ingredients in the formulation.

Talk with your doctor or pharmacist if your child has any of the following conditions. This medicine may not be right for your child if they have:

• Kidney disease
• Diabetes
• High potassium levels
• Addison’s disease
• Trouble producing urine or difficulty urinating

How should you give your child spironolactone?

Follow these instructions when giving your child spironolactone:

• Talk to your child’s doctor before you change the dose or stop giving this medicine for any reason. Your child may become ill if they stop taking this medicine suddenly.
• To gain the most benefit, give your child this medicine at the same time every day. Pick times that are easy for you to remember.
• Give your child this medicine with or without food.
• Give with food to reduce the chance of an upset stomach.
• If you are giving one dose per day, give this medicine in the morning to minimize the chance that your child will wake up with the urge to urinate at night.
• If you are giving two doses per day, give this medicine in the morning and at dinner. Considering giving the night-time dose no later than 6 p.m. because this medicine may make your child want to urinate at night.
• If your child is taking the liquid form, shake the bottle well. Measure the dose with a measuring cup or an oral syringe the pharmacist gave you.

What should you do if your child misses a dose of spironolactone?

If your child misses a dose of the medicine:

• Give your child the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose, and give your child the next dose at the regular time.
• Give your child only one dose at a time.

What are the possible side effects of spironolactone?

Your child may have some of these side effects while they take spironolactone. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:

• Feeling sleepy
• Dizziness when getting up from a lying or sitting position
• Increased thirst
• Dry mouth
• Headache
• Upset stomach, stomach cramps or throwing up
• Loose stools or more frequent stools (diarrhea)
• Unusual tiredness or weakness
• Changes to how often your child urinates
• Swelling of the breasts or breast soreness (males and females)

If your child has menstrual periods:

• Period (menstrual) changes

If your child is or may be sexually active:

• Change in sex ability

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to an Emergency Department at the hospital if your child has any of these side effects:

• Irregular heart beat
• Shortness of breath or difficulty breathing (signs of allergic reaction)
• Blood in throw-up, urine or bowel movements
• Muscle cramps or pain
• A burning, numbing, or tingling feeling
• Reduced urination
• Severe rash

What safety measures should you take when your child is using spironolactone?

There are some medicines that should not be taken together with spironolactone or in some cases the dose of spironolactone or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medicines (prescription, over the counter or herbal). Some medicines include:

• An angiotensin converting enzyme (ACE) inhibitor used to lower blood pressure (e.g., enalapril).
• An angiotensin receptor blocker (ARB) used to lower blood pressure (e.g., losartan).
• Heparin or low molecular weight heparin, also known as blood thinners, used to prevent blood clotting (e.g., enoxaparin, tinzaparin).
• Avoid potassium supplements, salt substitutes and foods containing high levels of potassium (e.g., bananas, prunes, raisins and orange juice) as instructed by your child’s doctor or dietician.
• Alcohol may interact with this drug. Be sure your child does not drink alcohol while on this medicine.

Other safety measures to consider are:

• Attend all appointments at the clinic or doctor’s office so that the doctor can check your child’s response to this medicine. The doctor may need to change the dose so that your child is getting the right amount.
• Have your child avoid tasks or actions that call for alertness until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or operating motorized vehicles.
• If your child is on a low-salt or salt-free diet, talk with your child's doctor.

What other important information should I know about spironolactone?

The liquid form of the medicine (spironolactone suspension) must be made by a pharmacy. Make sure your pharmacy is able to make it for your child.

Keep all medicines out of your child’s sight and reach.

Make sure you have enough medicine on hand to last through weekends, holidays, or vacations.

Keep a list of all medicines your child is taking and show the list to the doctor or pharmacist when needed.

Do not share your child’s medicine with others. Do not give anyone else’s medicine to your child.

Store the tablet or liquid form of the medicine in a safe, dry place at room temperature. Do not store in a bathroom.

Do not keep any medicines that are past the expiry date labeled on the bottle. Check with your pharmacist about the best way to throw away outdated or leftover medicines.

Keep spironolactone out of your child's sight and reach and locked up in a safe place. If your child takes too much spironolactone, call the Ontario Poison Centre at one of these numbers. These calls are free.

• Call 416-813-5900 if you live in Toronto.
• Call 1-800-268-9017 if you live somewhere else in Ontario.
• If you live outside of Ontario, call your local Poison Information Centre.