Drug Class: Potassium-Sparing Diuretic / Aldosterone Receptor Antagonist | Form: Oral Tablet | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Aldactone 100mg Tablet? Aldactone 100mg contains Spironolactone — a potassium-sparing diuretic and aldosterone receptor antagonist with a uniquely broad clinical application spanning heart failure, liver cirrhosis, kidney disease, hypertension, and hormonal conditions. Unlike loop diuretics such as Furosemide that cause dangerous potassium loss, Spironolactone blocks aldosterone receptors in the kidney — increasing sodium and water excretion while conserving potassium. This potassium-retaining diuresis makes it particularly valuable when combined with potassium-losing diuretics and in heart failure where landmark clinical trials demonstrated that Spironolactone significantly reduces mortality and hospitalisation beyond blood pressure and fluid control alone. At 100mg it delivers strong aldosterone blockade for conditions requiring intensive antialdosterone therapy — primary hyperaldosteronism, refractory oedema, and advanced heart failure.
What is Aldactone 100mg Used For?
- Oedema in heart failure — fluid retention management with potassium conservation (دل کی کمزوری میں سوجن کا علاج)
- Oedema in liver cirrhosis — ascites and fluid retention in chronic liver disease (جگر کی بیماری میں پانی بھرنا)
- Oedema in nephrotic syndrome — kidney disease-related fluid retention (گردے کی بیماری میں سوجن)
- Primary hyperaldosteronism — excess aldosterone production from adrenal gland (ادرینل گلینڈ کی زیادہ الڈوسٹیرون پیداوار)
- Hypertension — particularly resistant hypertension and hypertension with hypokalaemia (ہائی بلڈ پریشر)
- Heart failure mortality reduction — improving survival in moderate to severe heart failure under cardiologist supervision
- Secondary hyperaldosteronism — conditions causing excessive aldosterone from other diseases
How Does it Work? Spironolactone competitively and selectively blocks aldosterone receptors in the distal renal tubule and collecting duct — preventing aldosterone from stimulating sodium reabsorption and potassium excretion. By blocking this hormonal signal, Spironolactone reverses aldosterone's effects — increasing urinary sodium and water excretion to reduce fluid retention while conserving potassium that would otherwise be lost. In heart failure, aldosterone causes harmful cardiac fibrosis and remodelling beyond its renal effects — Spironolactone's anti-fibrotic cardiac action contributes to its proven mortality benefit in heart failure patients. In primary hyperaldosteronism, blocking the excess aldosterone directly corrects the hormonal imbalance driving hypertension and hypokalaemia.
Dosage and Administration
⚠️ Monitor blood potassium levels regularly — dangerous hyperkalaemia risk especially when combined with ACE inhibitors, ARBs, or potassium supplements. Monitor kidney function throughout treatment. Take with food to improve absorption and reduce stomach irritation. Never combine with other potassium-sparing diuretics without specialist supervision.
| Indication | Usual Adult Dose | Frequency | Notes |
|---|---|---|---|
| Oedema — heart / liver / kidney | 100mg | Once daily or in divided doses | Adjusted by doctor based on response |
| Primary hyperaldosteronism | 100 – 400mg | Once daily | Pre-operative or long-term management |
| Hypertension | 25 – 100mg | Once daily | Adjusted to blood pressure response |
| Heart failure mortality reduction | 25 – 50mg | Once daily | Under strict cardiologist supervision |
| Secondary hyperaldosteronism | 100 – 200mg | Once daily | As directed by specialist |
Active Ingredients
| Ingredient | Strength |
|---|---|
| Spironolactone | 100mg |
Who Should NOT Take Aldactone 100mg?
- Allergy to Spironolactone or any component of the tablet
- Hyperkalaemia — already elevated blood potassium above normal range
- Severe kidney impairment or acute kidney failure — dangerous potassium accumulation
- Addison's disease — adrenal insufficiency
- Anuria — complete absence of urine production
- Currently taking other potassium-sparing diuretics without specialist supervision
- Pregnancy — Spironolactone has antiandrogenic effects that can cause foetal feminisation
- Breastfeeding — active metabolite passes into breast milk
- Children — dose adjustment required under specialist supervision
Side Effects
Common: Increased urination (پیشاب زیادہ آنا), mild dizziness especially on standing, mild nausea and stomach discomfort — reduced by taking with food, gynaecomastia — breast tissue enlargement in men at higher doses (مردوں میں چھاتی کا بڑھنا — خوراک کم کرنے سے عام طور پر ٹھیک ہوتا ہے), menstrual irregularities in women from antiandrogenic effects (ماہواری کی بے قاعدگی), mild headache.
Serious — Stop and seek emergency help immediately: Dangerous hyperkalaemia — severe muscle weakness, paralysis, irregular heartbeat, and cardiac arrest from elevated potassium (پوٹاشیم کی خطرناک زیادتی — فوری ہسپتال جائیں), significant worsening of kidney function — reduced urination with ankle swelling (فوری ڈاکٹر کو بتائیں), severe allergic reaction — sudden widespread rash, swelling of face or throat, difficulty breathing (فوری ہسپتال جائیں), severe electrolyte imbalance — profound weakness with confusion and irregular heartbeat (فوری مدد لیں), severe liver reactions in cirrhotic patients — worsening jaundice or hepatic encephalopathy.
Drug Interactions
| Medicine | Interaction |
|---|---|
| ACE inhibitors (Enalapril, Lisinopril) | Severely increased hyperkalaemia risk — life-threatening potassium elevation; close monitoring essential |
| ARBs (Valsartan, Telmisartan) | Severely increased hyperkalaemia risk — avoid combination or monitor potassium very closely |
| Potassium supplements | Greatly increased hyperkalaemia risk — avoid combination unless specifically directed by specialist |
| Other potassium-sparing diuretics (Amiloride, Triamterene) | Severely additive hyperkalaemia risk — never combine without strict specialist supervision |
| NSAIDs (Ibuprofen, Diclofenac) | Reduce diuretic effectiveness and increase kidney toxicity risk — monitor closely |
| Digoxin | Spironolactone increases Digoxin blood levels — serious toxicity risk; reduce Digoxin dose and monitor levels |
| Lithium | Spironolactone alters Lithium excretion — toxicity risk; monitor Lithium levels closely |
| Antihypertensives | Additive blood pressure lowering — increased hypotension risk |
| Heparin / Low molecular weight heparin | Additive hyperkalaemia risk — monitor potassium closely |
| Alcohol (شراب) | Increases blood pressure lowering and dizziness — avoid excessive consumption |
Storage: Store below 25°C in a cool, dry place. Protect from moisture and direct sunlight. Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں). Do not use after expiry date.
FAQs
Q: Why does Aldactone 100mg cause breast enlargement in men and is it reversible? Spironolactone has antiandrogenic properties — blocking testosterone and androgen receptors in breast tissue at higher doses. This causes gynaecomastia in a proportion of men taking 100mg or above. It is dose-dependent — reducing to the lowest effective dose or switching to the more selective aldosterone antagonist Eplerenone can reduce this side effect. Gynaecomastia is usually reversible after stopping treatment.
Q: How frequently must blood potassium be checked while taking Aldactone 100mg? Potassium monitoring is essential — check within 1 week of starting or dose change, then monthly for 3 months, then every 3 to 6 months when stable. More frequent monitoring is required when combined with ACE inhibitors, ARBs, or in patients with any kidney impairment. Dangerous hyperkalaemia can be asymptomatic until levels are critically high — never skip blood tests.
Q: Can Aldactone 100mg be taken alongside Furosemide for heart failure fluid management? Yes — combining Spironolactone with Furosemide is a very common and clinically beneficial heart failure strategy. Furosemide causes potassium loss while Spironolactone conserves potassium — their opposing effects on potassium partially balance each other while both contribute to fluid removal. However potassium levels must still be monitored regularly as the balance can shift unpredictably with changes in dose, diet, or kidney function.
Medical Disclaimer: This information is for general awareness only and does not replace medical advice. Always consult a qualified doctor or pharmacist before taking any prescription medicine.