Presentation
To present a case of central serous chorioretinopathy (CSC) treatment with spironolactone in a challenge-rechallenge pattern. [ncbi.nlm.nih.gov]
Entire Body System
- Congestive Heart Failure
It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. [fpnotebook.com]
or hospitalization for the management of heart failure. [ncbi.nlm.nih.gov]
Spironolactone is an aldosterone antagonist (also reduces the activity of the enzyme Na+K+ATPase in renal tubular cells (1)) used in the treatment of: oedema and ascites in liver cirrhosis malignant ascites nephrotic syndrome congestive heart failure [gpnotebook.co.uk]
- Pain
Clinical trial of the p38 MAP kinase inhibitor dilmapimod in neuropathic pain following nerve injury. Eur J Pain 2011;15:1040–8. [doi.org]
Conclusion Fifteen of 31 women with otherwise treatment-resistant FMS experienced a number of prolonged beneficial effects from spironolactone on their complex pain-condition. [ncbi.nlm.nih.gov]
If you experience any of these symptoms, call your doctor immediately: muscle weakness, pain, or cramps pain, burning, numbness, or tingling in the hands or feet inability to move arms or legs changes in heartbeat confusion nausea extreme tiredness dry [nlm.nih.gov]
- Fever
From the start of treatment he had progressively developed erythroderma, fever, anorexia and prostration, oedema of both hands and face, hypereosinophilia (42%; 5810 eosinophils/mm3), hepatic failure (including cholestatic jaundice, cytolysis, coagulation [ncbi.nlm.nih.gov]
Acetylsalicylic acid Pain, fever, and inflammation Acetylsalicylic acid (ASA), in the regular tablet form (immediate-release), is indicated to relieve pain, fever, and inflammation associated with many conditions, including the flu, the common... [drugbank.ca]
Check with your doctor as soon as possible if any of the following side effects occur: confusion enlarged or painful breasts fast, slow, or irregular heartbeat fever increased infections irregular menstrual period muscle weakness or cramps rapid weight [medbroadcast.com]
Spironolactone has been known to cause headache, heartburn, sores, foul breath, ulcers, vomiting, changes to urine and bowel functions, chills, fever, weakness and fatigue, among others, according to Drugs.com Diet and Exercise This medicine may help [livestrong.com]
- Chills
Spironolactone has been known to cause headache, heartburn, sores, foul breath, ulcers, vomiting, changes to urine and bowel functions, chills, fever, weakness and fatigue, among others, according to Drugs.com Diet and Exercise This medicine may help [livestrong.com]
These side effects include blood in the stool, chills, cloudy or dark urine, difficulty urinating, changes in urine output, diarrhea, difficulty swallowing, dizziness, dimpling of the skin, heartburn, headaches, fatigue, fast heartbeat, loss of appetite [md-health.com]
[…] signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools) signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills [medbroadcast.com]
[…] check with your doctor immediately if any of these side effects occur when taking Spironolactona: Incidence not known: Abdominal or stomach cramping, burning, or tenderness bleeding gums bloody or black, tarry stools bloody urine breast pain chest pain chills [ndrugs.com]
- Rigor
We pride ourselves on our rigorous editorial processes and innovative approach to content delivery. [about.medicinescomplete.com]
They are under intense pressure to recruit patients rapidly and inexpensively and may have little motivation to rigorously review sites that enroll large numbers of patients. [cardiobrief.org]
[…] mechanistic studies involving patients with heart failure and preserved left ventricular function, mineralocorticoid-receptor antagonists improved measures of diastolic function. 16,17 However, their effect on clinical outcomes in such patients has not been rigorously [doi.org]
Gastrointestinal
- Vomiting
vomit that looks like coffee grounds, dark urine, yellowing of the eyes / skin, easy bruising/bleeding. [webmd.com]
Symptoms of overdose may include the following: drowsiness confusion rash nausea vomiting dizziness diarrhea tingling in arms and legs loss of muscle tone weakness or heaviness in legs irregular or slow heartbeat Keep all appointments with your doctor [nlm.nih.gov]
Common spironolactone side effects may include: mild nausea or vomiting, diarrhea ; breast swelling or tenderness; dizziness, headache, mild drowsiness; leg cramps; or impotence, difficulty having an erection. [drugs.com]
Common side effects may include: mild nausea or vomiting, diarrhea; breast swelling or tenderness; dizziness, headache, mild drowsiness; leg cramps; or impotence, difficulty having an erection. [wa.kaiserpermanente.org]
- Diarrhea
We report on a girl having congenital chloride diarrhea (CCD) who has been followed for 7 years and 6 months sequentially. [ncbi.nlm.nih.gov]
Side Effects Drowsiness, dizziness, lightheadedness, stomach upset, diarrhea, nausea, vomiting, or headache may occur. To minimize lightheadedness, get up slowly when rising from a seated or lying position. [webmd.com]
Adverse reactions CNS: headache, drowsiness, lethargy, ataxia, confusion GI: vomiting, diarrhea, cramping, gastritis, GI ulcers, GI bleeding GU: gynecomastia, irregular menses or amenorrhea, postmenopausal bleeding, erectile dysfunction, breast cancer [medical-dictionary.thefreedictionary.com]
Symptoms of overdose may include the following: drowsiness confusion rash nausea vomiting dizziness diarrhea tingling in arms and legs loss of muscle tone weakness or heaviness in legs irregular or slow heartbeat Keep all appointments with your doctor [nlm.nih.gov]
Low potassium (hypokalemia) may be caused by diarrhea,... Heart Disease Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to... [medicinenet.com]
Cardiovascular
- Heart Failure
failure in patients with systolic heart failure and mild symptoms ( P 9 A further study in patients with diastolic heart failure is under way. [pharmaceutical-journal.com]
In RALES, spironolactone also reduced hospitalisation for worsening heart failure and improved the symptoms of heart failure. [ncbi.nlm.nih.gov]
Skin
- Eruptions
We describe a patient who developed a maculopapular eruption while on spironolactone with a positive reaction upon rechallenge with the drug. The cutaneous associations of spironolactone in the English literature have been reviewed. [ncbi.nlm.nih.gov]
Skin: hirsutism, urticaria, maculopapular eruptions. Other: gynecomastia, breast soreness in women, drug fever. Effects on lab test results • May increase BUN and potassium levels. May decrease sodium level. • May decrease granulocyte count. [glowm.com]
Uncommon side effects (0.1–1.0%) were postural hypotension, depression, diarrhea, muscle pain, increased appetite, drowsiness, rashes/drug eruptions, chloasma-like skin pigmentation, polydipsia, weakness, edema of the legs, change in libido, and palpitations [doi.org]
Psychiatrical
- Withdrawn
It disappeared again when spironolactone was withdrawn. This response to spironolactone is good evidence that it and not chlorothiazide was responsible for the rash. The latter drug has been reported to cause SLE-like skin changes. [ncbi.nlm.nih.gov]
Treatment Congestive Heart Failure (CHF) / End Stage Renal Disease (ESRD) 1 4 Withdrawn Treatment End Stage Renal Disease (ESRD) / Hemodialysis Treatment 1 4 Withdrawn Treatment Female Androgenetic Alopecia 1 4 Withdrawn Treatment Heart Failure 1 Not [drugbank.ca]
An additional 27 patients discontinued spironolactone therapy because of adverse events (n = 23) or because of withdrawn consent for nonmedical reasons (n = 4). Figure 1 shows the random assignment and the follow-up of the patients. [content.onlinejacc.org]
However, despite its increasing use in this specialty, spironolactone is not currently licensed for the treatment of hypertension in the UK; the licence was withdrawn in 1988 after concerns of malignancy in animal models. 4 The British National Formulary [bmj.com]
Urogenital
- Anuria
Off-label uses • Acne vulgaris • Familial male precocious puberty (given with other drugs) • Premenstrual syndrome Contraindications • Anuria, acute renal insufficiency, significant impairment of renal excretory function • Hyperkalemia Precautions Use [medical-dictionary.thefreedictionary.com]
Unknown 1-2 hours 2-3 days Contraindications and precautions Contraindicated in patients with anuria, acute or progressive renal insufficiency, or hyperkalemia and in those receiving amiloride or triamterene. [glowm.com]
Spironolattone [DCIT] Contraindications Aldactone is contraindicated for patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, or hyperkalemia. [minclinic.ru]
Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood potassium ( hyperkalemia ), inability to urinate (anuria), kidney problems, liver problems, untreated [medicinenet.com]
- Kidney Failure
Kidney Failure (Symptoms, Signs, Stages, Causes, Treatment, and Life Expectancy) Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss,... [medicinenet.com]
Spiro can potentially even lead to death from severe allergic reactions, hyperkalemia, kidney failure and more, although I have not read about this happening to any hair loss forum members. [hairlosscure2020.com]
Used to treat hypertension, edema of congestive heart failure, cirrhosis, and kidney failure. 0 スピロノラクトン 上流と下流の製品情報 原材料 準備製品 [chemicalbook.com]
Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. [nlm.nih.gov]
- Renal Injury
Autophagy has been reported to have a protective role against renal injury. [ncbi.nlm.nih.gov]
Am Heart J 156:662–673 PubMed CrossRef Google Scholar Orena S, Maurer TS, She L, Eudy R, Bernardo V, Dash D et al (2013) PF-03882845, a non-steroidal mineralocorticoid receptor antagonist, prevents renal injury with reduced risk of hyperkalemia in an [doi.org]
(AKI) / Acute Renal Injury 1 Not Available Unknown Status Prevention Diabetes Mellitus (DM) / Endocrine System Diseases / Glucose Metabolism Disorders / Metabolic Diseases 1 Not Available Unknown Status Treatment Nonvalvular Atrial Fibrillation 1 Not [drugbank.ca]
- Relative Impotence
impotence in males, menstrual irregularities, amenorrhea, postmenopausal bleeding, increased BUN concentrations. 256 265 a Interactions for Spironolactone Specific Drugs, Foods, and Laboratory Tests Drug, Food, or Test Interaction Comments ACE inhibitor [web.archive.org]
impotence in males, menstrual irregularities, amenorrhea, postmenopausal bleeding, increased BUN concentrations. 256 265 Interactions for Spironolactone Specific Drugs, Foods, and Laboratory Tests Drug, Food, or Test Interaction Comments ACE inhibitors [drugs.com]
Neurologic
- Headache
If potassium levels increase, anticipated symptoms would include cardiac irregularities, leg cramps, dryness of mouth, thirst, lethargy, drowsiness, and headaches. [aocd.org]
Spironolactone is known to ameliorate mood and tension headache or migraine in women with premenstrual syndrome or clinical signs of hyperandrogenism. [ncbi.nlm.nih.gov]
Spironolactone has been known to cause headache, heartburn, sores, foul breath, ulcers, vomiting, changes to urine and bowel functions, chills, fever, weakness and fatigue, among others, according to Drugs.com Diet and Exercise This medicine may help [livestrong.com]
Possible side effects may include: Irregular menstrual bleeding (if not taking the Pill) Frequent urination Rash Dry mouth, thirst Loose bowel movements Nausea Tiredness Headache Other things to know about Spironolactone: Before taking Spironolactone, [youngwomenshealth.org]
- Stroke
But six million Britons also take drugs to reduce their blood pressure, which raises the risk of early death, heart attacks and strokes. [dailymail.co.uk]
Lowering blood pressure can reduce the risk of strokes and heart attacks. Spironolactone is also used to lessen the need for hospitalization for heart failure. [mayoclinic.org]
The causes of death were classified into cardiovascular events (CCV events other than stroke and TIA), cerebrovascular events (stroke and TIA), and others. [content.onlinejacc.org]
"While these patients also suffer heart attacks and strokes, hospitalizations for heart failure represent their predominant problem, which is also a major burden to society," said Eldrin Lewis, MD, advanced heart failure specialist, BWH Division of Cardiovascular [sciencedaily.com]
- Confusion
Adverse reactions CNS: headache, drowsiness, lethargy, ataxia, confusion GI: vomiting, diarrhea, cramping, gastritis, GI ulcers, GI bleeding GU: gynecomastia, irregular menses or amenorrhea, postmenopausal bleeding, erectile dysfunction, breast cancer [medical-dictionary.thefreedictionary.com]
irregular periods, confusion, sweating, cramps, hair loss or unwanted hair growth, and skin rash If any of these become troublesome, speak with your doctor If you experience any other symptoms which you think may be due to this medicine, speak with [patient.info]
Adverse reactions CNS: headache, drowsiness, lethargy, confusion, ataxia. GI: diarrhea, gastric bleeding, ulceration, cramping, gastritis, vomiting. GU: inability to maintain erection, menstrual disturbances in women. Hematologic: agranulocytosis. [glowm.com]
- Ataxia
Adverse reactions CNS: headache, drowsiness, lethargy, ataxia, confusion GI: vomiting, diarrhea, cramping, gastritis, GI ulcers, GI bleeding GU: gynecomastia, irregular menses or amenorrhea, postmenopausal bleeding, erectile dysfunction, breast cancer [medical-dictionary.thefreedictionary.com]
Adverse reactions CNS: headache, drowsiness, lethargy, confusion, ataxia. GI: diarrhea, gastric bleeding, ulceration, cramping, gastritis, vomiting. GU: inability to maintain erection, menstrual disturbances in women. Hematologic: agranulocytosis. [glowm.com]
Other side effects include ataxia, erectile dysfunction, drowsiness and rashes. A carcinogenic effect has been demonstrated in rats. [psychology.wikia.com]
[…] concentrations periodically. 256 265 Transient elevations of BUN reported. 265 Common Adverse Effects Hyperkalemia, hyponatremia, anorexia, nausea, vomiting, diarrhea, abdominal cramping, gastritis, gastric bleeding, ulceration, headache, drowsiness, lethargy, ataxia [web.archive.org]
- Slurred Speech
What you should do about this interaction: Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.If you experience new or worsened tremors, fatigue, muscle weakness, confusion, slurred speech [webmd.com]
speech, severe weakness, loss of coordination, feeling unsteady. [drugs.com]
Workup
Schlosser suggested considering an endocrinology workup in adult women who exhibit hirsutism, androgenetic alopecia, signs of virilization (deep voice, increased muscularity), acanthosis nigricans, central or abdominal obesity, oligomenorrhea/amenorrhea [medpagetoday.com]
Serum
- Potassium Increased
Blood urea nitrogen, potassium: increased levels Digoxin assays: false digoxin elevation Granulocytes: decreased count Drug-food. Potassium-containing salt substitutes, potassium-rich diet: increased risk of hyperkalemia Drug-herbs. [medical-dictionary.thefreedictionary.com]
If serum potassium increases during Spironolactona administration but drops when Spironolactona is discontinued, a presumptive diagnosis of primary hyperaldosteronism should be considered. [ndrugs.com]
Serum potassium increased by mean 0.41 mmol/L (95% CI: 0.37 to 0.44 mmol/L), sodium decreased by 1.7 mmol/L (95% CI: 1.5 to 1.9 mmol/L), and creatinine increased by 13.2 μmol/L (95% CI: 12.0 to 14.4 μmol/L). [hyper.ahajournals.org]
Food increases the bioavailability of spironolactone by almost 100%. Spironolactone may decrease the excretion of potassium. Salt substitutes containing potassium increase the risk of hyperkalemia. [drugbank.ca]
- Neutropenia
20 mg daily in divided doses Caution with creatinine level > 3 mg per dL (265 mmol per L); do not use in pregnancy 53 (46 to 53) Fosinopril (Monopril) 20 to 40 daily, single dose 29 Lisinopril (Zestril, Prinivil) 5 to 20 mg daily, single dose Risk of neutropenia [aafp.org]
/ Intra-Abdominal Infections / Life-threatening Fungal Infections / Lower Respiratory Tract Infection (LRTI) / Meningitis, Bacterial / Methicillin Resistant Staphylococcus Aureus (MRSA) / Migraine / Muscle Spasms / Nausea / Neuromuscular Blockade / Neutropenias [drugbank.ca]
Treatment
[…] compared with standard care of £4,457 per quality-adjusted life year, assuming two years treatment, rising to £7,893 per QALY for a lifetime of treatment. [pharmaceutical-journal.com]
It is concluded that the patient had a calcium-sensing receptor mutation, and that treatment with spironolactone induced an effect on renal handling of calcium in this condition. It is suggested that this treatment be tried in other similar patients. [ncbi.nlm.nih.gov]
The moderate side effects in no case forced interruption of the treatment. Hair growth diminished substantially in 23 of the patients, the effect becoming evident 3-5 months after the commencement of treatment. [doi.org]
Prognosis
It has been reported that mineralocorticoid receptor antagonist improves the prognosis of chronic heart failure (CHF). [ncbi.nlm.nih.gov]
Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125(13):1635–42 CrossRef 6. Rosa J, Widimský P, Waldauf P. [springermedizin.de]
McKinlay, Ph.D. for the TOPCAT Investigators * Article Figures/Media Metrics 36 References 744 Citing Articles 2 Comments Abstract Background Mineralocorticoid-receptor antagonists improve the prognosis for patients with heart failure and a reduced left [doi.org]
Etiology
Kim and Donald Tredway, Hirsutism: Implications, etiology, and management, American Journal of Obstetrics and Gynecology, 140, 7, (815), (1981). K.R. JONES, M. KATZ, C. KEYZER and W. [doi.org]
1 1 Completed Basic Science Healthy Volunteers 1 1 Completed Treatment Healthy Volunteers 1 1 Completed Treatment Heart Failure 1 1 Completed Treatment High Blood Pressure (Hypertension) 1 1 Not Yet Recruiting Diagnostic Cardiomyopathy With Unknown Etiology [drugbank.ca]
Epidemiology
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Sivamani, Epidemiology and Management of Acne in Adult Women, Current Dermatology Reports, 3, 1, (29), (2014) ., Take specific considerations into account when treating acne in patients with skin of colour, Drugs & Therapy Perspectives, 30, 7, (252), [doi.org]
Dieleman, senior researcher 1, Bruno Stricker, professor of pharmacoepidemiology 2, Miriam Sturkenboom, associate professor of pharmacoepidemiology 1 1 Department of Medical Informatics, Erasmus MC, PO Box 1738, 3000 Rotterdam, Netherlands 2 Department of Epidemiology [dx.doi.org]
Pathophysiology
Abstract: Mineralocorticoid receptor (MR) antagonism has proven to effectively attenuate the pathophysiological effects of aldosterone in clinical and experimental settings of hypertension and heart failure. [doi.org]
Since the isolation and purification of aldosterone from adrenal extracts 50 years ago (Experientia 9 (1953) 33), scientists have learned a great deal about how and where aldosterone acts, the factors that control its release, what is its role in the pathophysiology [ncbi.nlm.nih.gov]
Prevention
Diabetes predicts cardiovascular disease (CVD); some drugs are effective for CVD prevention but increase the risk of diabetes. [ncbi.nlm.nih.gov]