Spironolactone | Health Notes at WWSM | Health Information at WWSM

Spironolactone

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Also indexed as: Aldactone, Laractone, Novo-Spiroton, Spiroctan, Spirolone

Combination drug: Aldactazide

Spironolactone is a potassium-sparing diuretic. Diuretics cause water loss and are used to treat a variety of conditions, including high blood pressure, heart failure, and diseases of the kidneys and liver. Spironolactone is available as a single agent and in a combination drug product.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.	Buchu Cleavers Dandelion Gravel root Horsetail Juniper Magnesium* Uva ursi
Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.	Potassium Sodium
Depletion or interference	None known
Side effect reduction/prevention	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Folic acid
One study showed that people taking diuretics for more than six months had dramatically lower blood levels of folic acid and higher levels of homocysteine compared with individuals not taking diuretics.¹ Homocysteine, a toxic amino acid by-product, has been associated with atherosclerosis. Folic acid is also an important cause of elevated homocysteine levels. Until further information is available, people taking diuretics for longer than six months should probably supplement with folic acid.

Magnesium
Preliminary research in animals suggests that amiloride, a drug similar to spironolactone, may inhibit the urinary excretion of magnesium.² It is unknown if this same effect would occur in humans or with spironolactone. Persons taking more than 300 mg of magnesium per day and spironolactone should consult with a doctor as this combination may lead to potentially dangerous increases in the level of magnesium in the body. The combination of spironolactone and hydrochlorothiazide would likely eliminate this problem, as hydrochlorothiazide may deplete magnesium.

Potassium
As a potassium-sparing diuretic, spironolactone reduces urinary loss of potassium, which can lead to elevated potassium levels.³ People taking spironolactone should avoid potassium supplements, potassium-containing salt substitutes (Morton Salt Substitute, No Salt, Lite Salt, and others), and even high-potassium foods (primarily fruit). Doctors should monitor potassium blood levels in patients taking spironolactone to prevent problems associated with elevated potassium levels.

However, one medication (Aldactazide) contains the combination of the potassium-sparing drug spironolactone and the potassium-depleting drug hydrochlorothiazide. With the use of Aldactazide, potassium excess and potassium depletion are both possible. People taking this combination drug should have their potassium levels monitored by a doctor to determine whether their potassium intake should be increased, reduced, or kept the same.

Sodium
Diuretics, including spironolactone, cause increased loss of sodium in the urine. By removing sodium from the body, diuretics also cause water to leave the body. This reduction of body water is the purpose of taking diuretics. Therefore, there is usually no reason to replace lost sodium, although strict limitation of salt intake in combination with the actions of diuretics can sometimes cause excessive sodium depletion. On the other hand, people who restrict sodium intake and in the process reduce blood pressure may need to have their dose of diuretics lowered. People taking spironolactone should talk with their prescribing doctor before severely restricting salt.

Interactions with Herbs

Diuretic herbs
Herbs that have a diuretic effect should be avoided when taking diuretic medications, as they may increase the effect of these drugs and lead to possible cardiovascular side effects. These herbs include dandelion, uva ursi, juniper, buchu, cleavers, horsetail, and gravel root.⁴

Interactions with Foods and Other Compounds

Food
Food can increase absorption of spironolactone.⁵ Spironolactone should be taken at the same time and always with food or always without food, every day for best results. People with questions about spironolactone and food should ask their prescribing doctor or chemist.

References
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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires September 2008.

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Interactions with Dietary Supplements

Interactions with Herbs

Interactions with Foods and Other Compounds