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    Spironolactone

    Topic Contents

    Spironolactone

    Drug Information

    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.

    Common brand names:

    Aldactone

    Summary of Interactions with Vitamins, Herbs, & Foods

    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • 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 byproduct, 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.

    Reduce Side Effects

    • none

    Support Medicine

    • none

    Reduces Effectiveness

    • none

    Potential Negative Interaction

    • Buchu
      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.2
    • Cleavers
      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.3
    • Dandelion
      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
    • Gravel Root
      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.5
    • Horsetail
      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.6
    • Juniper
      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.7
    • Uva Ursi
      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.8
    • Magnesium

      Preliminary research in animals suggests that amiloride , a drug similar to spironolactone, may inhibit the urinary excretion of magnesium.9 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.

      The interaction is supported by preliminary,weak, fragmentary, and/or contradictory scientific evidence.

    Explanation Required

    • Potassium

      As a potassium-sparing diuretic, spironolactone reduces urinary loss of potassium, which can lead to elevated potassium levels.10 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.

    The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers? package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

    References

    1. Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866?70.

    2. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102?3.

    3. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102?3.

    4. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102?3.

    5. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102?3.

    6. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102?3.

    7. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102?3.

    8. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102?3.

    9. Devane J, Ryan MP. The effects of amiloride and triamterene on urinary magnesium excretion in conscious saline-loaded rats. Br J Pharmacol 1981;72:285?9.

    10. Ramsay LE, Hettiarachchi J, Fraser R, Morton JJ. Amiloride, spironolactone, and potassium chloride in thiazide-treated hypertensive patients. Clin Pharmacol Ther 1980;27:533?43.

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