Identification

Name
Spironolactone
Accession Number
DB00421  (APRD01234)
Type
Small Molecule
Groups
Approved
Description

A potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827)

Structure
Thumb
Synonyms
  • Espironolactona
  • Spironolactone
  • Spironolactonum
  • Spironolattone
External IDs
NSC-150399 / SC-9420
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
AldactoneTablet, film coated50 mg/1OralG.D. Searle LLC Division of Pfizer Inc1960-01-21Not applicableUs
AldactoneTablet, film coated100 mg/1OralG.D. Searle LLC Division of Pfizer Inc1960-01-21Not applicableUs
AldactoneTablet, film coated25 mg/1OralG.D. Searle LLC Division of Pfizer Inc1960-01-21Not applicableUs
Aldactone 100 mgTablet100 mgOralPfizer1975-12-31Not applicableCanada
Aldactone 25 mgTablet25 mgOralPfizer1959-12-31Not applicableCanada
CaroSpirSuspension25 mg/5mLOralCmp Pharma, Inc.2017-08-04Not applicableUs
Ntp-spironolactoneTablet100 mgOralNt Pharma Canada LtdNot applicableNot applicableCanada
Ntp-spironolactoneTablet25 mgOralNt Pharma Canada LtdNot applicableNot applicableCanada
SpironolactoneTablet, film coated25 mg/1OralGreenstone, Llc1960-01-212021-03-31Us59762 5011 01 nlmimage10 1d230ec8
SpironolactoneTablet, film coated100 mg/1OralGreenstone, Llc1960-01-212018-10-31Us
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
SpironolactoneTablet, film coated100 mg/1OralPhysicians Total Care, Inc.2004-03-09Not applicableUs
SpironolactoneTablet, film coated50 mg/1OralProficient Rx LP2013-02-01Not applicableUs
SpironolactoneTablet50 mg/1OralMajor2009-11-022016-12-16Us
SpironolactoneTablet, film coated100 mg/1OralActavis Pharma Company2007-01-03Not applicableUs
SpironolactoneTablet, film coated50 mg/1OralMylan Institutional2002-02-20Not applicableUs
SpironolactoneTablet25 mg/1OralMc Kesson Packaging Services A Buisness Unit Of Mc Kesson Corporation2011-06-01Not applicableUs
SpironolactoneTablet, film coated25 mg/1OralDispensing Solutions, Inc.2006-08-29Not applicableUs
SpironolactoneTablet, film coated25 mg/1OralRebel Distributors2007-01-03Not applicableUs
SpironolactoneTablet25 mg/1OralRemedy Repack2014-06-24Not applicableUs
SpironolactoneTablet, film coated25 mg/1OralState of Florida DOH Central Pharmacy2009-07-01Not applicableUs
Unapproved/Other Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
SpironolactoneTablet, film coated100 mg/1OralPd Rx Pharmaceuticals, Inc.2006-08-29Not applicableUs
SpironolactoneTablet, film coated50 mg/1OralPreferreed Pharmaceuticals Inc.2017-11-06Not applicableUs
International/Other Brands
Osyrol / Spiresis / Spiretic / Spiroctan / Uractone / Verospiron / Xenalon
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
AldactazideSpironolactone (50 mg/1) + Hydrochlorothiazide (50 mg/1)Tablet, film coatedOralG.D. Searle LLC Division of Pfizer Inc1978-01-01Not applicableUs00025 1021 31 nlmimage10 b146d8b6
AldactazideSpironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)Tablet, film coatedOralG.D. Searle LLC Division of Pfizer Inc1978-01-01Not applicableUs
Aldactazide 25Spironolactone (25 mg) + Hydrochlorothiazide (25 mg)TabletOralPfizer1960-12-31Not applicableCanada
Aldactazide 50Spironolactone (50 mg) + Hydrochlorothiazide (50 mg)TabletOralPfizer1983-12-31Not applicableCanada
Apo-spirozide TabSpironolactone (25 mg) + Hydrochlorothiazide (25 mg)TabletOralApotex Corporation1991-12-312011-08-05Canada
Spironolactone and HydrochlorothiazideSpironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)Tablet, film coatedOralA S Medication Solutions1978-01-012017-06-20Us
Spironolactone and HydrochlorothiazideSpironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)TabletOralAmerincan Health Packaging2015-03-312018-02-28Us53489 0144 01 nlmimage10 4f0ea785
Spironolactone and HydrochlorothiazideSpironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)TabletOralMylan Pharmaceuticals2017-03-31Not applicableUs
Spironolactone and HydrochlorothiazideSpironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)TabletOralMylan Institutional2017-05-12Not applicableUs
Spironolactone and HydrochlorothiazideSpironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)Tablet, film coatedOralGreenstone, Llc1978-01-01Not applicableUs
Categories
UNII
27O7W4T232
CAS number
52-01-7
Weight
Average: 416.573
Monoisotopic: 416.202130202
Chemical Formula
C24H32O4S
InChI Key
LXMSZDCAJNLERA-ZHYRCANASA-N
InChI
InChI=1S/C24H32O4S/c1-14(25)29-19-13-15-12-16(26)4-8-22(15,2)17-5-9-23(3)18(21(17)19)6-10-24(23)11-7-20(27)28-24/h12,17-19,21H,4-11,13H2,1-3H3/t17-,18-,19+,21+,22-,23-,24+/m0/s1
IUPAC Name
(1'S,2R,2'R,9'R,10'R,11'S,15'S)-9'-(acetylsulfanyl)-2',15'-dimethylspiro[oxolane-2,14'-tetracyclo[8.7.0.0²,⁷.0¹¹,¹⁵]heptadecan]-6'-ene-5,5'-dione
SMILES
[H][[email protected]@]12CC[[email protected]@]3(CCC(=O)O3)[[email protected]@]1(C)CC[[email protected]@]1([H])[[email protected]@]2([H])[[email protected]@]([H])(CC2=CC(=O)CC[[email protected]]12C)SC(C)=O

Pharmacology

Indication

Used primarily to treat low-renin hypertension, hypokalemia, and Conn's syndrome.

Structured Indications
Pharmacodynamics

Spironolactone is a synthetic 17-lactone steroid which is a renal competitive aldosterone antagonist in a class of pharmaceuticals called potassium-sparing diuretics. On its own, spironolactone is only a weak diuretic, but it can be combined with other diuretics. Due to its anti-androgen effect, it can also be used to treat hirsutism, and is a common component in hormone therapy for male-to-female transgendered people. Spironolactone inhibits the effect of aldosterone by competing for intracellular aldosterone receptor in the distal tubule cells. This increases the secretion of water and sodium, while decreasing the excretion of potassium. Spironolactone has a fairly slow onset of action, taking several days to develop and similarly the effect diminishes slowly.

Mechanism of action

Spironolactone is a specific pharmacologic antagonist of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule. Spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained. Spironolactone acts both as a diuretic and as an antihypertensive drug by this mechanism. It may be given alone or with other diuretic agents which act more proximally in the renal tubule. Aldosterone interacts with a cytoplasmic mineralocorticoid receptor to enhance the expression of the Na+, K+-ATPase and the Na+ channel involved in a Na+ K+ transport in the distal tubule . Spironolactone bind to this mineralcorticoid receptor, blocking the actions of aldosterone on gene expression. Aldosterone is a hormone; its primary function is to retain sodium and excrete potassium in the kidneys.

TargetActionsOrganism
AMineralocorticoid receptor
antagonist
Human
UAndrogen receptor
antagonist
Human
UProgesterone receptor
agonist
Human
UGlucocorticoid receptor
antagonist
Human
UCytochrome P450 11B2, mitochondrial
antagonist
Human
U17alpha-hydroxylase
antagonist
Human
U17,20-desmolase
antagonist
Human
U3-oxo-5-alpha-steroid 4-dehydrogenase
antagonist
USex hormone-binding globulin
binder
Human
UVoltage-dependent calcium channelNot AvailableHuman
UDihydrotestosterone receptorNot AvailableHuman
UNuclear receptor subfamily 1 group I member 2Not AvailableHuman
Absorption

Fairly rapidly absorbed from the gastrointestinal tract. Food increases the bioavailability of unmetabolized spironolactone by almost 100%.

Volume of distribution
Not Available
Protein binding

Spironolactone and its metabolites are more than 90% bound to plasma proteins.

Metabolism

Rapidly and extensively metabolized. The metabolic pathway of spironolactone is complex and can be divided into two main routes: those in which the sulfur moiety is retained and those in which the sulfur moiety is removed by dethioacetylation. Spironolactone is transformed to a reactive metabolite that can inactivate adrenal and testicular cytochrome P450 enzymes. It also has anti-androgenic activity.

Route of elimination

The metabolites are excreted primarily in the urine and secondarily in bile.

Half life

10 minutes

Clearance
Not Available
Toxicity

The oral LD50 of spironolactone is greater than 1,000 mg/kg in mice, rats, and rabbits. Acute overdosage of spironolactone may be manifested by drowsiness, mental confusion, maculopapular or erythematous rash, nausea, vomiting, dizziness, or diarrhea. Spironolactone has been shown to be a tumorigen in chronic toxicity studies in rats.

Affected organisms
  • Humans and other mammals
Pathways
PathwayCategory
Spironolactone Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
AbirateroneThe therapeutic efficacy of Abiraterone can be decreased when used in combination with Spironolactone.Approved
AcebutololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Acebutolol.Approved
AceclofenacAceclofenac may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
AcemetacinAcemetacin may decrease the antihypertensive activities of Spironolactone.Approved, Experimental, Investigational
AcetyldigitoxinThe therapeutic efficacy of Acetyldigitoxin can be decreased when used in combination with Spironolactone.Approved
AcetyldigoxinThe therapeutic efficacy of Acetyldigoxin can be decreased when used in combination with Spironolactone.Experimental
Acetylsalicylic acidAcetylsalicylic acid may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
AdapaleneAdapalene may decrease the antihypertensive activities of Spironolactone.Approved
AdrafinilSpironolactone may decrease the vasoconstricting activities of Adrafinil.Withdrawn
AfatinibThe serum concentration of Afatinib can be increased when it is combined with Spironolactone.Approved
AlclofenacAlclofenac may decrease the antihypertensive activities of Spironolactone.Approved, Withdrawn
AldesleukinThe risk or severity of adverse effects can be increased when Aldesleukin is combined with Spironolactone.Approved
AlfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Spironolactone.Approved, Illicit
AliskirenThe risk or severity of adverse effects can be increased when Spironolactone is combined with Aliskiren.Approved, Investigational
AlminoprofenAlminoprofen may decrease the antihypertensive activities of Spironolactone.Experimental
AlphacetylmethadolThe risk or severity of adverse effects can be increased when Alphacetylmethadol is combined with Spironolactone.Experimental, Illicit
AlphaprodineThe risk or severity of adverse effects can be increased when Alphaprodine is combined with Spironolactone.Illicit
AmibegronSpironolactone may decrease the vasoconstricting activities of Amibegron.Investigational
AmifostineThe risk or severity of adverse effects can be increased when Amifostine is combined with Spironolactone.Approved, Investigational
AmilorideAmiloride may increase the hyperkalemic activities of Spironolactone.Approved
AmiodaroneThe risk or severity of adverse effects can be increased when Amiodarone is combined with Spironolactone.Approved, Investigational
AmitrazSpironolactone may decrease the vasoconstricting activities of Amitraz.Vet Approved
AmlodipineThe risk or severity of adverse effects can be increased when Amlodipine is combined with Spironolactone.Approved
Ammonium chlorideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Ammonium chloride.Approved, Vet Approved
AmobarbitalAmobarbital may increase the hypotensive activities of Spironolactone.Approved, Illicit
AmodiaquineThe serum concentration of Amodiaquine can be increased when it is combined with Spironolactone.Approved, Investigational
Amphotericin BThe risk or severity of adverse effects can be increased when Amphotericin B is combined with Spironolactone.Approved, Investigational
Amyl NitriteThe risk or severity of adverse effects can be increased when Spironolactone is combined with Amyl Nitrite.Approved
AndrographolideAndrographolide may decrease the antihypertensive activities of Spironolactone.Investigational
AnisodamineSpironolactone may decrease the vasoconstricting activities of Anisodamine.Investigational
AntipyrineAntipyrine may decrease the antihypertensive activities of Spironolactone.Approved
ApocyninApocynin may decrease the antihypertensive activities of Spironolactone.Investigational
ApomorphineThe risk or severity of adverse effects can be increased when Apomorphine is combined with Spironolactone.Approved, Investigational
ApraclonidineSpironolactone may decrease the vasoconstricting activities of Apraclonidine.Approved
ApremilastApremilast may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
ArbutamineSpironolactone may decrease the vasoconstricting activities of Arbutamine.Approved
ArdeparinArdeparin may increase the hyperkalemic activities of Spironolactone.Approved, Investigational, Withdrawn
ArformoterolSpironolactone may decrease the vasoconstricting activities of Arformoterol.Approved, Investigational
AripiprazoleAripiprazole may increase the hypotensive activities of Spironolactone.Approved, Investigational
ArotinololThe risk or severity of adverse effects can be increased when Arotinolol is combined with Spironolactone.Approved, Investigational
Arsenic trioxideThe risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Spironolactone.Approved, Investigational
AtenololThe risk or severity of adverse effects can be increased when Atenolol is combined with Spironolactone.Approved
AtorvastatinThe risk or severity of adverse effects can be increased when Atorvastatin is combined with Spironolactone.Approved
Atracurium besylateSpironolactone may increase the neuromuscular blocking activities of Atracurium besylate.Approved
AzapropazoneAzapropazone may decrease the antihypertensive activities of Spironolactone.Withdrawn
AzelastineAzelastine may decrease the antihypertensive activities of Spironolactone.Approved
Azilsartan medoxomilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Azilsartan medoxomil.Approved
BalsalazideBalsalazide may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
BarbexacloneBarbexaclone may increase the hypotensive activities of Spironolactone.Experimental
BarbitalBarbital may increase the hypotensive activities of Spironolactone.Illicit
BarnidipineThe risk or severity of adverse effects can be increased when Barnidipine is combined with Spironolactone.Approved
BefunololSpironolactone may decrease the vasoconstricting activities of Befunolol.Experimental
BemiparinBemiparin may increase the hyperkalemic activities of Spironolactone.Approved, Investigational
BenazeprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Benazepril.Approved, Investigational
BendazacBendazac may decrease the antihypertensive activities of Spironolactone.Experimental
BendroflumethiazideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Bendroflumethiazide.Approved
BenorilateBenorilate may decrease the antihypertensive activities of Spironolactone.Experimental
BenoxaprofenBenoxaprofen may decrease the antihypertensive activities of Spironolactone.Withdrawn
BenzydamineBenzydamine may decrease the antihypertensive activities of Spironolactone.Approved
BepridilThe risk or severity of adverse effects can be increased when Bepridil is combined with Spironolactone.Approved, Withdrawn
BetaxololThe risk or severity of adverse effects can be increased when Betaxolol is combined with Spironolactone.Approved
BevoniumBevonium may decrease the antihypertensive activities of Spironolactone.Experimental
BezitramideThe risk or severity of adverse effects can be increased when Bezitramide is combined with Spironolactone.Experimental, Illicit, Withdrawn
BisoprololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Bisoprolol.Approved
BitolterolSpironolactone may decrease the vasoconstricting activities of Bitolterol.Withdrawn
BortezomibThe risk or severity of adverse effects can be increased when Bortezomib is combined with Spironolactone.Approved, Investigational
BosutinibThe serum concentration of Bosutinib can be increased when it is combined with Spironolactone.Approved
Brentuximab vedotinThe serum concentration of Brentuximab vedotin can be increased when it is combined with Spironolactone.Approved
BretyliumThe risk or severity of adverse effects can be increased when Spironolactone is combined with Bretylium.Approved
BrimonidineSpironolactone may decrease the vasoconstricting activities of Brimonidine.Approved
BromfenacBromfenac may decrease the antihypertensive activities of Spironolactone.Approved
BromocriptineThe risk or severity of adverse effects can be increased when Bromocriptine is combined with Spironolactone.Approved, Investigational
BucillamineBucillamine may decrease the antihypertensive activities of Spironolactone.Investigational
BufexamacBufexamac may decrease the antihypertensive activities of Spironolactone.Experimental
BumadizoneBumadizone may decrease the antihypertensive activities of Spironolactone.Experimental
BumetanideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Bumetanide.Approved
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Spironolactone.Approved, Investigational
BuprenorphineThe risk or severity of adverse effects can be increased when Buprenorphine is combined with Spironolactone.Approved, Illicit, Investigational, Vet Approved
ButorphanolThe risk or severity of adverse effects can be increased when Butorphanol is combined with Spironolactone.Approved, Illicit, Vet Approved
CanagliflozinCanagliflozin may increase the hyperkalemic activities of Spironolactone.Approved
CandesartanCandesartan may increase the hyperkalemic activities of Spironolactone.Experimental
Candesartan cilexetilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Candesartan cilexetil.Approved
CandoxatrilSpironolactone may increase the hyperkalemic activities of Candoxatril.Experimental
CaptoprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Captopril.Approved
CarbetocinThe risk or severity of adverse effects can be increased when Carbetocin is combined with Spironolactone.Approved
CarfentanilThe risk or severity of adverse effects can be increased when Carfentanil is combined with Spironolactone.Illicit, Investigational, Vet Approved
CarprofenCarprofen may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved, Withdrawn
CarteololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Carteolol.Approved
CarvedilolThe risk or severity of adverse effects can be increased when Spironolactone is combined with Carvedilol.Approved, Investigational
CastanospermineCastanospermine may decrease the antihypertensive activities of Spironolactone.Experimental
CelecoxibCelecoxib may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
CertoparinCertoparin may increase the hyperkalemic activities of Spironolactone.Approved, Investigational
ChloroquineChloroquine may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
ChlorothiazideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Chlorothiazide.Approved, Vet Approved
ChlorpromazineThe risk or severity of adverse effects can be increased when Chlorpromazine is combined with Spironolactone.Approved, Vet Approved
ChlorthalidoneThe risk or severity of adverse effects can be increased when Chlorthalidone is combined with Spironolactone.Approved
CholestyramineThe risk or severity of adverse effects can be increased when Cholestyramine is combined with Spironolactone.Approved
Choline magnesium trisalicylateCholine magnesium trisalicylate may decrease the antihypertensive activities of Spironolactone.Approved
CilazaprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Cilazapril.Approved
CilnidipineThe risk or severity of adverse effects can be increased when Cilnidipine is combined with Spironolactone.Approved, Investigational
CiprofloxacinSpironolactone may increase the arrhythmogenic activities of Ciprofloxacin.Approved, Investigational
CirazolineSpironolactone may decrease the vasoconstricting activities of Cirazoline.Experimental
ClenbuterolSpironolactone may decrease the vasoconstricting activities of Clenbuterol.Approved, Investigational, Vet Approved
ClevidipineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Clevidipine.Approved
ClofarabineThe risk or severity of adverse effects can be increased when Clofarabine is combined with Spironolactone.Approved, Investigational
ClomipramineThe risk or severity of adverse effects can be increased when Clomipramine is combined with Spironolactone.Approved, Vet Approved
ClonidineSpironolactone may decrease the vasoconstricting activities of Clonidine.Approved
ClonixinClonixin may decrease the antihypertensive activities of Spironolactone.Approved
ClozapineThe risk or severity of adverse effects can be increased when Clozapine is combined with Spironolactone.Approved
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Spironolactone.Approved, Illicit
ColchicineThe serum concentration of Colchicine can be increased when it is combined with Spironolactone.Approved
ConivaptanThe risk or severity of adverse effects can be increased when Conivaptan is combined with Spironolactone.Approved, Investigational
CurcuminCurcumin may decrease the antihypertensive activities of Spironolactone.Investigational
CyclosporineSpironolactone may increase the hyperkalemic activities of Cyclosporine.Approved, Investigational, Vet Approved
CymarinThe therapeutic efficacy of Cymarin can be decreased when used in combination with Spironolactone.Experimental
D-LimoneneD-Limonene may decrease the antihypertensive activities of Spironolactone.Investigational
Dabigatran etexilateThe serum concentration of the active metabolites of Dabigatran etexilate can be increased when Dabigatran etexilate is used in combination with Spironolactone.Approved
DalteparinDalteparin may increase the hyperkalemic activities of Spironolactone.Approved
DapagliflozinThe risk or severity of adverse effects can be increased when Spironolactone is combined with Dapagliflozin.Approved
DelaprilSpironolactone may increase the hyperkalemic activities of Delapril.Experimental
DesfluraneThe risk or severity of adverse effects can be increased when Desflurane is combined with Spironolactone.Approved
DeslanosideThe therapeutic efficacy of Deslanoside can be decreased when used in combination with Spironolactone.Approved
DetomidineSpironolactone may decrease the vasoconstricting activities of Detomidine.Vet Approved
DexmedetomidineSpironolactone may decrease the vasoconstricting activities of Dexmedetomidine.Approved, Vet Approved
DextromoramideThe risk or severity of adverse effects can be increased when Dextromoramide is combined with Spironolactone.Experimental, Illicit
DextropropoxypheneThe risk or severity of adverse effects can be increased when Dextropropoxyphene is combined with Spironolactone.Approved, Illicit, Investigational, Withdrawn
DezocineThe risk or severity of adverse effects can be increased when Dezocine is combined with Spironolactone.Approved, Investigational
DiclofenacDiclofenac may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
DiclofenamideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Diclofenamide.Approved
DifenpiramideDifenpiramide may decrease the antihypertensive activities of Spironolactone.Experimental
DiflunisalDiflunisal may decrease the antihypertensive activities of Spironolactone.Approved
DigitoxinThe therapeutic efficacy of Digitoxin can be decreased when used in combination with Spironolactone.Approved, Investigational
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Spironolactone.Approved
Digoxin Immune Fab (Ovine)The therapeutic efficacy of Digoxin Immune Fab (Ovine) can be decreased when used in combination with Spironolactone.Approved
DihydrocodeineThe risk or severity of adverse effects can be increased when Dihydrocodeine is combined with Spironolactone.Approved, Illicit
DihydroetorphineThe risk or severity of adverse effects can be increased when Dihydroetorphine is combined with Spironolactone.Experimental, Illicit
DihydromorphineThe risk or severity of adverse effects can be increased when Dihydromorphine is combined with Spironolactone.Experimental, Illicit
DiltiazemThe risk or severity of adverse effects can be increased when Diltiazem is combined with Spironolactone.Approved
DinutuximabThe risk or severity of adverse effects can be increased when Spironolactone is combined with Dinutuximab.Approved
DiphenoxylateThe risk or severity of adverse effects can be increased when Diphenoxylate is combined with Spironolactone.Approved, Illicit
DipivefrinSpironolactone may decrease the vasoconstricting activities of Dipivefrin.Approved
DipyridamoleThe risk or severity of adverse effects can be increased when Spironolactone is combined with Dipyridamole.Approved
DobutamineSpironolactone may decrease the vasoconstricting activities of Dobutamine.Approved
DopexamineSpironolactone may decrease the vasoconstricting activities of Dopexamine.Investigational
DoxazosinThe risk or severity of adverse effects can be increased when Spironolactone is combined with Doxazosin.Approved
DoxorubicinThe serum concentration of Doxorubicin can be increased when it is combined with Spironolactone.Approved, Investigational
DPDPEThe risk or severity of adverse effects can be increased when DPDPE is combined with Spironolactone.Experimental
DrospirenoneDrospirenone may increase the hyperkalemic activities of Spironolactone.Approved
DroxicamDroxicam may decrease the antihypertensive activities of Spironolactone.Approved
DroxidopaSpironolactone may decrease the vasoconstricting activities of Droxidopa.Approved, Investigational
DuloxetineSpironolactone may increase the orthostatic hypotensive activities of Duloxetine.Approved
DuvelisibDuvelisib may decrease the antihypertensive activities of Spironolactone.Investigational
E-6201E-6201 may decrease the antihypertensive activities of Spironolactone.Investigational
EdoxabanThe serum concentration of Edoxaban can be increased when it is combined with Spironolactone.Approved
EfonidipineThe risk or severity of adverse effects can be increased when Efonidipine is combined with Spironolactone.Approved, Investigational
EmpagliflozinThe risk or severity of adverse effects can be increased when Spironolactone is combined with Empagliflozin.Approved
EnalaprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Enalapril.Approved, Vet Approved
EnalaprilatSpironolactone may increase the hyperkalemic activities of Enalaprilat.Approved
EnoxaparinEnoxaparin may increase the hyperkalemic activities of Spironolactone.Approved
EphedrineSpironolactone may decrease the vasoconstricting activities of Ephedrine.Approved
EpinastineSpironolactone may decrease the vasoconstricting activities of Epinastine.Approved, Investigational
EpinephrineSpironolactone may decrease the vasoconstricting activities of Epinephrine.Approved, Vet Approved
EpirizoleEpirizole may decrease the antihypertensive activities of Spironolactone.Approved
EplerenoneEplerenone may increase the hyperkalemic activities of Spironolactone.Approved
EpoprostenolThe risk or severity of adverse effects can be increased when Epoprostenol is combined with Spironolactone.Approved
EprosartanThe risk or severity of adverse effects can be increased when Spironolactone is combined with Eprosartan.Approved
ErgotamineSpironolactone may decrease the vasoconstricting activities of Ergotamine.Approved
EsmololThe risk or severity of adverse effects can be increased when Esmolol is combined with Spironolactone.Approved
Etacrynic acidThe risk or severity of adverse effects can be increased when Spironolactone is combined with Etacrynic acid.Approved
EtanerceptEtanercept may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
EthenzamideEthenzamide may decrease the antihypertensive activities of Spironolactone.Experimental
EthylmorphineThe risk or severity of adverse effects can be increased when Ethylmorphine is combined with Spironolactone.Approved, Illicit
EtilefrineSpironolactone may decrease the vasoconstricting activities of Etilefrine.Withdrawn
EtodolacEtodolac may decrease the antihypertensive activities of Spironolactone.Approved, Investigational, Vet Approved
EtofenamateEtofenamate may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
EtoricoxibEtoricoxib may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
EtorphineThe risk or severity of adverse effects can be increased when Etorphine is combined with Spironolactone.Illicit, Vet Approved
Evening primrose oilEvening primrose oil may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
EverolimusThe serum concentration of Everolimus can be increased when it is combined with Spironolactone.Approved
exisulindexisulind may decrease the antihypertensive activities of Spironolactone.Investigational
FelbinacFelbinac may decrease the antihypertensive activities of Spironolactone.Experimental
FelodipineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Felodipine.Approved, Investigational
FenbufenFenbufen may decrease the antihypertensive activities of Spironolactone.Approved
FenoldopamThe risk or severity of adverse effects can be increased when Fenoldopam is combined with Spironolactone.Approved
FenoprofenFenoprofen may decrease the antihypertensive activities of Spironolactone.Approved
FenoterolSpironolactone may decrease the vasoconstricting activities of Fenoterol.Approved, Investigational
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Spironolactone.Approved, Illicit, Investigational, Vet Approved
FentiazacFentiazac may decrease the antihypertensive activities of Spironolactone.Experimental
FeprazoneFeprazone may decrease the antihypertensive activities of Spironolactone.Experimental
Ferulic acidFerulic acid may decrease the antihypertensive activities of Spironolactone.Experimental
FimasartanThe risk or severity of adverse effects can be increased when Fimasartan is combined with Spironolactone.Approved, Investigational
FloctafenineFloctafenine may decrease the antihypertensive activities of Spironolactone.Approved, Withdrawn
FlunixinFlunixin may decrease the antihypertensive activities of Spironolactone.Vet Approved
FlunoxaprofenFlunoxaprofen may decrease the antihypertensive activities of Spironolactone.Experimental
FlurbiprofenFlurbiprofen may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
ForasartanForasartan may increase the hyperkalemic activities of Spironolactone.Experimental
FormoterolSpironolactone may decrease the vasoconstricting activities of Formoterol.Approved, Investigational
FosinoprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Fosinopril.Approved
FurosemideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Furosemide.Approved, Vet Approved
GitoformateThe therapeutic efficacy of Gitoformate can be decreased when used in combination with Spironolactone.Experimental
GuacetisalGuacetisal may decrease the antihypertensive activities of Spironolactone.Experimental
GuanabenzSpironolactone may decrease the vasoconstricting activities of Guanabenz.Approved, Investigational
GuanfacineSpironolactone may decrease the vasoconstricting activities of Guanfacine.Approved, Investigational
HalothaneThe risk or severity of adverse effects can be increased when Halothane is combined with Spironolactone.Approved, Vet Approved
HeparinHeparin may increase the hyperkalemic activities of Spironolactone.Approved, Investigational
HeroinThe risk or severity of adverse effects can be increased when Heroin is combined with Spironolactone.Approved, Illicit, Investigational
HexobarbitalHexobarbital may increase the hypotensive activities of Spironolactone.Approved
HexoprenalineSpironolactone may decrease the vasoconstricting activities of Hexoprenaline.Approved, Withdrawn
HigenamineSpironolactone may decrease the vasoconstricting activities of Higenamine.Investigational
HydralazineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Hydralazine.Approved
HydrochlorothiazideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Hydrochlorothiazide.Approved, Vet Approved
HydrocodoneThe risk or severity of adverse effects can be increased when Hydrocodone is combined with Spironolactone.Approved, Illicit
HydroflumethiazideThe risk or severity of adverse effects can be increased when Hydroflumethiazide is combined with Spironolactone.Approved, Investigational
HydromorphoneThe risk or severity of adverse effects can be increased when Hydromorphone is combined with Spironolactone.Approved, Illicit
IbuprofenIbuprofen may decrease the antihypertensive activities of Spironolactone.Approved
IbuproxamIbuproxam may decrease the antihypertensive activities of Spironolactone.Withdrawn
IcatibantIcatibant may decrease the antihypertensive activities of Spironolactone.Approved
IloprostThe risk or severity of adverse effects can be increased when Iloprost is combined with Spironolactone.Approved, Investigational
ImidaprilThe risk or severity of adverse effects can be increased when Imidapril is combined with Spironolactone.Investigational
Imidazole salicylateImidazole salicylate may decrease the antihypertensive activities of Spironolactone.Experimental
ImipramineThe risk or severity of adverse effects can be increased when Imipramine is combined with Spironolactone.Approved
IndapamideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Indapamide.Approved
IndobufenIndobufen may decrease the antihypertensive activities of Spironolactone.Investigational
IndomethacinIndomethacin may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
IndoprofenIndoprofen may decrease the antihypertensive activities of Spironolactone.Withdrawn
IndoraminThe risk or severity of adverse effects can be increased when Indoramin is combined with Spironolactone.Withdrawn
IrbesartanThe risk or severity of adverse effects can be increased when Spironolactone is combined with Irbesartan.Approved, Investigational
IsocarboxazidThe risk or severity of adverse effects can be increased when Isocarboxazid is combined with Spironolactone.Approved
IsoetarineSpironolactone may decrease the vasoconstricting activities of Isoetarine.Approved
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Spironolactone.Approved, Vet Approved
IsoprenalineSpironolactone may decrease the vasoconstricting activities of Isoprenaline.Approved
Isosorbide DinitrateThe risk or severity of adverse effects can be increased when Spironolactone is combined with Isosorbide Dinitrate.Approved
Isosorbide MononitrateThe risk or severity of adverse effects can be increased when Spironolactone is combined with Isosorbide Mononitrate.Approved
IsoxicamIsoxicam may decrease the antihypertensive activities of Spironolactone.Withdrawn
IsoxsuprineSpironolactone may decrease the vasoconstricting activities of Isoxsuprine.Approved, Withdrawn
IsradipineThe risk or severity of adverse effects can be increased when Isradipine is combined with Spironolactone.Approved
KebuzoneKebuzone may decrease the antihypertensive activities of Spironolactone.Experimental
KetobemidoneThe risk or severity of adverse effects can be increased when Ketobemidone is combined with Spironolactone.Approved, Investigational
KetoprofenKetoprofen may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
KetorolacKetorolac may decrease the antihypertensive activities of Spironolactone.Approved
LabetalolThe risk or severity of adverse effects can be increased when Spironolactone is combined with Labetalol.Approved
LacidipineThe risk or severity of adverse effects can be increased when Lacidipine is combined with Spironolactone.Approved, Investigational
Lanatoside CThe therapeutic efficacy of Lanatoside C can be decreased when used in combination with Spironolactone.Experimental
LedipasvirThe serum concentration of Ledipasvir can be increased when it is combined with Spironolactone.Approved
LeflunomideLeflunomide may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
LercanidipineThe risk or severity of adverse effects can be increased when Lercanidipine is combined with Spironolactone.Approved, Investigational
LevobunololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Levobunolol.Approved
LevobupivacaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Spironolactone.Approved, Investigational
LevodopaSpironolactone may increase the orthostatic hypotensive activities of Levodopa.Approved
Levomethadyl AcetateThe risk or severity of adverse effects can be increased when Levomethadyl Acetate is combined with Spironolactone.Approved, Investigational
LevorphanolThe risk or severity of adverse effects can be increased when Levorphanol is combined with Spironolactone.Approved
LevosimendanThe risk or severity of adverse effects can be increased when Levosimendan is combined with Spironolactone.Approved, Investigational
LisinoprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Lisinopril.Approved, Investigational
LisofyllineLisofylline may decrease the antihypertensive activities of Spironolactone.Investigational
LofentanilThe risk or severity of adverse effects can be increased when Lofentanil is combined with Spironolactone.Illicit
LofexidineSpironolactone may decrease the vasoconstricting activities of Lofexidine.Approved, Investigational
LonazolacLonazolac may decrease the antihypertensive activities of Spironolactone.Experimental
LornoxicamLornoxicam may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
LosartanThe risk or severity of adverse effects can be increased when Spironolactone is combined with Losartan.Approved
LoxoprofenLoxoprofen may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
LumiracoxibLumiracoxib may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
Magnesium salicylateMagnesium salicylate may decrease the antihypertensive activities of Spironolactone.Approved
MannitolThe risk or severity of adverse effects can be increased when Spironolactone is combined with Mannitol.Approved, Investigational
MasoprocolMasoprocol may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
MecamylamineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Mecamylamine.Approved
Meclofenamic acidMeclofenamic acid may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
MedetomidineSpironolactone may decrease the vasoconstricting activities of Medetomidine.Vet Approved
Mefenamic acidMefenamic acid may decrease the antihypertensive activities of Spironolactone.Approved
MeloxicamMeloxicam may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
MephentermineSpironolactone may decrease the vasoconstricting activities of Mephentermine.Approved
MeptazinolThe risk or severity of adverse effects can be increased when Meptazinol is combined with Spironolactone.Experimental
MesalazineMesalazine may decrease the antihypertensive activities of Spironolactone.Approved
MetamizoleMetamizole may decrease the antihypertensive activities of Spironolactone.Investigational, Withdrawn
MetaraminolSpironolactone may decrease the vasoconstricting activities of Metaraminol.Approved, Investigational
MethadoneThe risk or severity of adverse effects can be increased when Methadone is combined with Spironolactone.Approved
Methadyl AcetateThe risk or severity of adverse effects can be increased when Methadyl Acetate is combined with Spironolactone.Approved, Illicit
MethazolamideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Methazolamide.Approved
MethohexitalMethohexital may increase the hypotensive activities of Spironolactone.Approved
MethoxamineSpironolactone may decrease the vasoconstricting activities of Methoxamine.Approved, Investigational
MethoxyphenamineSpironolactone may decrease the vasoconstricting activities of Methoxyphenamine.Experimental
MethyclothiazideThe risk or severity of adverse effects can be increased when Methyclothiazide is combined with Spironolactone.Approved
MethyldopaSpironolactone may decrease the vasoconstricting activities of Methyldopa.Approved
MethylphenobarbitalMethylphenobarbital may increase the hypotensive activities of Spironolactone.Approved
MetildigoxinThe therapeutic efficacy of Metildigoxin can be decreased when used in combination with Spironolactone.Experimental
MetipranololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Metipranolol.Approved
MetolazoneThe risk or severity of adverse effects can be increased when Spironolactone is combined with Metolazone.Approved
MetoprololThe risk or severity of adverse effects can be increased when Metoprolol is combined with Spironolactone.Approved, Investigational
MidodrineSpironolactone may decrease the vasoconstricting activities of Midodrine.Approved
MinoxidilThe risk or severity of adverse effects can be increased when Minoxidil is combined with Spironolactone.Approved
MirabegronSpironolactone may decrease the vasoconstricting activities of Mirabegron.Approved
MitotaneThe therapeutic efficacy of Mitotane can be decreased when used in combination with Spironolactone.Approved
MivacuriumSpironolactone may increase the neuromuscular blocking activities of Mivacurium.Approved
MizoribineMizoribine may decrease the antihypertensive activities of Spironolactone.Investigational
MoexiprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Moexipril.Approved
MofebutazoneMofebutazone may decrease the antihypertensive activities of Spironolactone.Experimental
MorphineThe risk or severity of adverse effects can be increased when Morphine is combined with Spironolactone.Approved, Investigational
MoxonidineThe risk or severity of adverse effects can be increased when Moxonidine is combined with Spironolactone.Approved, Investigational
Mycophenolate mofetilMycophenolate mofetil may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
Mycophenolic acidMycophenolic acid may decrease the antihypertensive activities of Spironolactone.Approved
NabiloneThe risk or severity of adverse effects can be increased when Nabilone is combined with Spironolactone.Approved, Investigational
NabumetoneNabumetone may decrease the antihypertensive activities of Spironolactone.Approved
NadololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Nadolol.Approved
NadroparinNadroparin may increase the hyperkalemic activities of Spironolactone.Approved
NafamostatNafamostat may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
NaftifineNaftifine may decrease the antihypertensive activities of Spironolactone.Approved
NalbuphineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Spironolactone.Approved
NaloxegolThe serum concentration of Naloxegol can be increased when it is combined with Spironolactone.Approved
NaphazolineSpironolactone may decrease the vasoconstricting activities of Naphazoline.Approved
NaproxenNaproxen may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
NebivololSpironolactone may decrease the vasoconstricting activities of Nebivolol.Approved, Investigational
NepafenacNepafenac may decrease the antihypertensive activities of Spironolactone.Approved
NesiritideThe risk or severity of adverse effects can be increased when Spironolactone is combined with Nesiritide.Approved, Investigational
NicardipineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Nicardipine.Approved
NicomorphineThe risk or severity of adverse effects can be increased when Nicomorphine is combined with Spironolactone.Experimental
NicorandilNicorandil may increase the hypotensive activities of Spironolactone.Approved, Investigational
NifedipineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Nifedipine.Approved
NifenazoneNifenazone may decrease the antihypertensive activities of Spironolactone.Experimental
Niflumic AcidNiflumic Acid may decrease the antihypertensive activities of Spironolactone.Approved
NilvadipineThe risk or severity of adverse effects can be increased when Nilvadipine is combined with Spironolactone.Approved, Investigational
NimesulideNimesulide may decrease the antihypertensive activities of Spironolactone.Approved, Investigational, Withdrawn
NimodipineThe risk or severity of adverse effects can be increased when Nimodipine is combined with Spironolactone.Approved
NisoldipineThe risk or severity of adverse effects can be increased when Nisoldipine is combined with Spironolactone.Approved
NitrendipineThe risk or severity of adverse effects can be increased when Nitrendipine is combined with Spironolactone.Approved, Investigational
Nitric OxideThe risk or severity of adverse effects can be increased when Nitric Oxide is combined with Spironolactone.Approved
NitroaspirinNitroaspirin may decrease the antihypertensive activities of Spironolactone.Investigational
NitrofurantoinNitrofurantoin may increase the hyperkalemic activities of Spironolactone.Approved, Vet Approved
NitroglycerinThe risk or severity of adverse effects can be increased when Spironolactone is combined with Nitroglycerin.Approved, Investigational
NitroprussideThe risk or severity of adverse effects can be increased when Nitroprusside is combined with Spironolactone.Approved
NorepinephrineSpironolactone may decrease the vasoconstricting activities of Norepinephrine.Approved
NorfenefrineSpironolactone may decrease the vasoconstricting activities of Norfenefrine.Experimental
NormethadoneThe risk or severity of adverse effects can be increased when Normethadone is combined with Spironolactone.Approved, Illicit
NylidrinSpironolactone may decrease the vasoconstricting activities of Nylidrin.Approved
ObinutuzumabThe risk or severity of adverse effects can be increased when Obinutuzumab is combined with Spironolactone.Approved
OctopamineSpironolactone may decrease the vasoconstricting activities of Octopamine.Experimental
OleandrinThe therapeutic efficacy of Oleandrin can be decreased when used in combination with Spironolactone.Experimental, Investigational
OlmesartanThe risk or severity of adverse effects can be increased when Olmesartan is combined with Spironolactone.Approved, Investigational
OlodaterolSpironolactone may decrease the vasoconstricting activities of Olodaterol.Approved
OlopatadineOlopatadine may decrease the antihypertensive activities of Spironolactone.Approved
OlsalazineOlsalazine may decrease the antihypertensive activities of Spironolactone.Approved
OmapatrilatSpironolactone may increase the hyperkalemic activities of Omapatrilat.Investigational
OpiumThe risk or severity of adverse effects can be increased when Opium is combined with Spironolactone.Approved, Illicit
OrciprenalineSpironolactone may decrease the vasoconstricting activities of Orciprenaline.Approved
OrgoteinOrgotein may decrease the antihypertensive activities of Spironolactone.Vet Approved
OuabainThe therapeutic efficacy of Ouabain can be decreased when used in combination with Spironolactone.Approved
OxaprozinOxaprozin may decrease the antihypertensive activities of Spironolactone.Approved
OxprenololThe risk or severity of adverse effects can be increased when Oxprenolol is combined with Spironolactone.Approved
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Spironolactone.Approved, Illicit, Investigational
OxyfedrineSpironolactone may decrease the vasoconstricting activities of Oxyfedrine.Experimental
OxymetazolineSpironolactone may decrease the vasoconstricting activities of Oxymetazoline.Approved
OxymorphoneThe risk or severity of adverse effects can be increased when Oxymorphone is combined with Spironolactone.Approved, Investigational, Vet Approved
OxyphenbutazoneOxyphenbutazone may decrease the antihypertensive activities of Spironolactone.Approved, Withdrawn
PaclitaxelThe risk or severity of adverse effects can be increased when Paclitaxel is combined with Spironolactone.Approved, Vet Approved
PapaverineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Papaverine.Approved
ParecoxibParecoxib may decrease the antihypertensive activities of Spironolactone.Approved
ParnaparinParnaparin may increase the hyperkalemic activities of Spironolactone.Approved, Investigational
ParthenolideParthenolide may decrease the antihypertensive activities of Spironolactone.Investigational
PazopanibThe serum concentration of Pazopanib can be increased when it is combined with Spironolactone.Approved
PenbutololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Penbutolol.Approved, Investigational
PentazocineThe risk or severity of adverse effects can be increased when Pentazocine is combined with Spironolactone.Approved, Vet Approved
PentobarbitalPentobarbital may increase the hypotensive activities of Spironolactone.Approved, Vet Approved
PerindoprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Perindopril.Approved
PeruvosideThe therapeutic efficacy of Peruvoside can be decreased when used in combination with Spironolactone.Experimental
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Spironolactone.Approved
PhenazocineThe risk or severity of adverse effects can be increased when Phenazocine is combined with Spironolactone.Experimental
PhenelzineThe risk or severity of adverse effects can be increased when Phenelzine is combined with Spironolactone.Approved
PhenobarbitalPhenobarbital may increase the hypotensive activities of Spironolactone.Approved
PhenoperidineThe risk or severity of adverse effects can be increased when Phenoperidine is combined with Spironolactone.Experimental
PhenoxybenzamineThe risk or severity of adverse effects can be increased when Phenoxybenzamine is combined with Spironolactone.Approved
PhentolamineThe risk or severity of adverse effects can be increased when Phentolamine is combined with Spironolactone.Approved
PhenylbutazonePhenylbutazone may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
PhenylephrineSpironolactone may decrease the vasoconstricting activities of Phenylephrine.Approved
PhenylpropanolamineSpironolactone may decrease the vasoconstricting activities of Phenylpropanolamine.Approved, Vet Approved, Withdrawn
PimecrolimusPimecrolimus may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
PindololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Pindolol.Approved
PipamperoneThe risk or severity of adverse effects can be increased when Pipamperone is combined with Spironolactone.Approved, Investigational
PirbuterolSpironolactone may decrease the vasoconstricting activities of Pirbuterol.Approved
PirfenidonePirfenidone may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
PiritramideThe risk or severity of adverse effects can be increased when Piritramide is combined with Spironolactone.Investigational
PiroxicamPiroxicam may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
PirprofenPirprofen may decrease the antihypertensive activities of Spironolactone.Experimental
PramipexoleThe risk or severity of adverse effects can be increased when Pramipexole is combined with Spironolactone.Approved, Investigational
PranoprofenPranoprofen may decrease the antihypertensive activities of Spironolactone.Experimental, Investigational
PrazosinThe risk or severity of adverse effects can be increased when Spironolactone is combined with Prazosin.Approved
PrenalterolSpironolactone may decrease the vasoconstricting activities of Prenalterol.Experimental
PrimidonePrimidone may increase the hypotensive activities of Spironolactone.Approved, Vet Approved
ProcaterolSpironolactone may decrease the vasoconstricting activities of Procaterol.Approved, Investigational
ProglumetacinProglumetacin may decrease the antihypertensive activities of Spironolactone.Experimental
PropacetamolPropacetamol may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Spironolactone.Approved, Investigational, Vet Approved
PropranololThe risk or severity of adverse effects can be increased when Spironolactone is combined with Propranolol.Approved, Investigational
PropyphenazonePropyphenazone may decrease the antihypertensive activities of Spironolactone.Experimental
ProquazoneProquazone may decrease the antihypertensive activities of Spironolactone.Experimental
ProscillaridinThe therapeutic efficacy of Proscillaridin can be decreased when used in combination with Spironolactone.Experimental
PrucaloprideThe serum concentration of Prucalopride can be increased when it is combined with Spironolactone.Approved
PseudoephedrineSpironolactone may decrease the vasoconstricting activities of Pseudoephedrine.Approved
PTC299PTC299 may decrease the antihypertensive activities of Spironolactone.Investigational
QuetiapineThe risk or severity of adverse effects can be increased when Spironolactone is combined with Quetiapine.Approved
QuinaprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Quinapril.Approved, Investigational
QuinidineThe therapeutic efficacy of Quinidine can be decreased when used in combination with Spironolactone.Approved
RacepinephrineSpironolactone may decrease the vasoconstricting activities of Racepinephrine.Approved
RactopamineSpironolactone may decrease the vasoconstricting activities of Ractopamine.Vet Approved
RamiprilThe risk or severity of adverse effects can be increased when Ramipril is combined with Spironolactone.Approved
RanolazineThe serum concentration of Ranolazine can be increased when it is combined with Spironolactone.Approved, Investigational
RapacuroniumSpironolactone may increase the neuromuscular blocking activities of Rapacuronium.Withdrawn
RasagilineThe risk or severity of adverse effects can be increased when Rasagiline is combined with Spironolactone.Approved
RemifentanilThe risk or severity of adverse effects can be increased when Remifentanil is combined with Spironolactone.Approved
ReproterolSpironolactone may decrease the vasoconstricting activities of Reproterol.Investigational
RescinnamineSpironolactone may increase the hyperkalemic activities of Rescinnamine.Approved
ReserpineThe risk or severity of adverse effects can be increased when Reserpine is combined with Spironolactone.Approved, Investigational
ResveratrolResveratrol may decrease the antihypertensive activities of Spironolactone.Approved, Experimental, Investigational
ReviparinReviparin may increase the hyperkalemic activities of Spironolactone.Approved, Investigational
RifaximinThe serum concentration of Rifaximin can be increased when it is combined with Spironolactone.Approved, Investigational
RilmenidineSpironolactone may decrease the vasoconstricting activities of Rilmenidine.Investigational
RimiterolSpironolactone may decrease the vasoconstricting activities of Rimiterol.Experimental
RiociguatThe risk or severity of adverse effects can be increased when Spironolactone is combined with Riociguat.Approved
RisperidoneSpironolactone may increase the hypotensive activities of Risperidone.Approved, Investigational
RitobegronSpironolactone may decrease the vasoconstricting activities of Ritobegron.Investigational
RitodrineSpironolactone may decrease the vasoconstricting activities of Ritodrine.Approved, Investigational
RofecoxibRofecoxib may decrease the antihypertensive activities of Spironolactone.Investigational, Withdrawn
RomifidineSpironolactone may decrease the vasoconstricting activities of Romifidine.Vet Approved
RopiniroleThe risk or severity of adverse effects can be increased when Ropinirole is combined with Spironolactone.Approved, Investigational
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Spironolactone.Approved
RotigotineThe risk or severity of adverse effects can be increased when Rotigotine is combined with Spironolactone.Approved
SacubitrilSacubitril may increase the hyperkalemic activities of Spironolactone.Approved
SalbutamolSpironolactone may decrease the vasoconstricting activities of Salbutamol.Approved, Vet Approved
SalicylamideSalicylamide may decrease the antihypertensive activities of Spironolactone.Approved
Salicylic acidSalicylic acid may decrease the antihypertensive activities of Spironolactone.Approved, Vet Approved
SalmeterolSpironolactone may decrease the vasoconstricting activities of Salmeterol.Approved
SalsalateSalsalate may decrease the antihypertensive activities of Spironolactone.Approved
SaprisartanSaprisartan may increase the hyperkalemic activities of Spironolactone.Experimental
SaralasinSaralasin may increase the hyperkalemic activities of Spironolactone.Investigational
SecobarbitalSecobarbital may increase the hypotensive activities of Spironolactone.Approved, Vet Approved
SelegilineThe risk or severity of adverse effects can be increased when Selegiline is combined with Spironolactone.Approved, Investigational, Vet Approved
SemapimodSemapimod may decrease the antihypertensive activities of Spironolactone.Investigational
SeratrodastSeratrodast may decrease the antihypertensive activities of Spironolactone.Approved
SerrapeptaseSerrapeptase may decrease the antihypertensive activities of Spironolactone.Investigational
SevofluraneThe risk or severity of adverse effects can be increased when Sevoflurane is combined with Spironolactone.Approved, Vet Approved
SilodosinThe serum concentration of Silodosin can be increased when it is combined with Spironolactone.Approved
Sodium NitriteThe risk or severity of adverse effects can be increased when Sodium Nitrite is combined with Spironolactone.Approved
Sodium phosphateSpironolactone may increase the nephrotoxic activities of Sodium phosphate.Approved
SolabegronSpironolactone may decrease the vasoconstricting activities of Solabegron.Investigational
SotalolThe risk or severity of adverse effects can be increased when Spironolactone is combined with Sotalol.Approved
SpiraprilSpironolactone may increase the hyperkalemic activities of Spirapril.Approved
SRT501SRT501 may decrease the antihypertensive activities of Spironolactone.Investigational
StreptokinaseThe risk or severity of adverse effects can be increased when Streptokinase is combined with Spironolactone.Approved, Investigational
SufentanilThe risk or severity of adverse effects can be increased when Sufentanil is combined with Spironolactone.Approved, Investigational
SulfasalazineSulfasalazine may decrease the antihypertensive activities of Spironolactone.Approved
SulindacSulindac may decrease the antihypertensive activities of Spironolactone.Approved
SuprofenSuprofen may decrease the antihypertensive activities of Spironolactone.Approved, Withdrawn
SuxibuzoneSuxibuzone may decrease the antihypertensive activities of Spironolactone.Experimental
SynephrineSpironolactone may decrease the vasoconstricting activities of Synephrine.Experimental
TacrolimusSpironolactone may increase the hyperkalemic activities of Tacrolimus.Approved, Investigational
TamsulosinThe risk or severity of adverse effects can be increased when Tamsulosin is combined with Spironolactone.Approved, Investigational
TapentadolThe risk or severity of adverse effects can be increased when Tapentadol is combined with Spironolactone.Approved
TarenflurbilTarenflurbil may decrease the antihypertensive activities of Spironolactone.Investigational
TasosartanTasosartan may increase the hyperkalemic activities of Spironolactone.Approved
TelmisartanThe risk or severity of adverse effects can be increased when Spironolactone is combined with Telmisartan.Approved, Investigational
TemocaprilSpironolactone may increase the hyperkalemic activities of Temocapril.Experimental, Investigational
TenidapTenidap may decrease the antihypertensive activities of Spironolactone.Experimental
TenoxicamTenoxicam may decrease the antihypertensive activities of Spironolactone.Approved
TepoxalinTepoxalin may decrease the antihypertensive activities of Spironolactone.Vet Approved
TerazosinThe risk or severity of adverse effects can be increased when Spironolactone is combined with Terazosin.Approved
TerbutalineSpironolactone may decrease the vasoconstricting activities of Terbutaline.Approved
TeriflunomideTeriflunomide may decrease the antihypertensive activities of Spironolactone.Approved
ThalidomideThe risk or severity of adverse effects can be increased when Thalidomide is combined with Spironolactone.Approved, Investigational, Withdrawn
ThiamylalThiamylal may increase the hypotensive activities of Spironolactone.Approved, Vet Approved
ThiopentalThiopental may increase the hypotensive activities of Spironolactone.Approved, Vet Approved
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Spironolactone.Approved, Withdrawn
Tiaprofenic acidTiaprofenic acid may decrease the antihypertensive activities of Spironolactone.Approved
TilidineThe risk or severity of adverse effects can be increased when Tilidine is combined with Spironolactone.Experimental
TimololThe risk or severity of adverse effects can be increased when Timolol is combined with Spironolactone.Approved
TinoridineTinoridine may decrease the antihypertensive activities of Spironolactone.Investigational
TinzaparinTinzaparin may increase the hyperkalemic activities of Spironolactone.Approved
TizanidineSpironolactone may decrease the vasoconstricting activities of Tizanidine.Approved
TolazolineThe risk or severity of adverse effects can be increased when Tolazoline is combined with Spironolactone.Approved, Vet Approved
TolcaponeThe risk or severity of adverse effects can be increased when Tolcapone is combined with Spironolactone.Approved, Withdrawn
Tolfenamic AcidTolfenamic Acid may decrease the antihypertensive activities of Spironolactone.Approved
TolmetinTolmetin may decrease the antihypertensive activities of Spironolactone.Approved
TolvaptanTolvaptan may increase the hyperkalemic activities of Spironolactone.Approved
TopotecanThe serum concentration of Topotecan can be increased when it is combined with Spironolactone.Approved, Investigational
TorasemideThe risk or severity of adverse effects can be increased when Torasemide is combined with Spironolactone.Approved
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Spironolactone.Approved, Investigational
TrandolaprilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Trandolapril.Approved
TranilastTranilast may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
TranylcypromineThe risk or severity of adverse effects can be increased when Tranylcypromine is combined with Spironolactone.Approved
TretinoinThe risk or severity of adverse effects can be increased when Tretinoin is combined with Spironolactone.Approved, Investigational, Nutraceutical
TretoquinolSpironolactone may decrease the vasoconstricting activities of Tretoquinol.Experimental
TriamtereneTriamterene may increase the hyperkalemic activities of Spironolactone.Approved
TribenosideTribenoside may decrease the antihypertensive activities of Spironolactone.Experimental
TrimethoprimTrimethoprim may increase the hyperkalemic activities of Spironolactone.Approved, Vet Approved
TriptolideTriptolide may decrease the antihypertensive activities of Spironolactone.Investigational
TulobuterolSpironolactone may decrease the vasoconstricting activities of Tulobuterol.Investigational
ValdecoxibValdecoxib may decrease the antihypertensive activities of Spironolactone.Investigational, Withdrawn
ValsartanThe risk or severity of adverse effects can be increased when Valsartan is combined with Spironolactone.Approved, Investigational
VerapamilThe risk or severity of adverse effects can be increased when Spironolactone is combined with Verapamil.Approved
VincristineThe serum concentration of Vincristine can be increased when it is combined with Spironolactone.Approved, Investigational
XamoterolSpironolactone may decrease the vasoconstricting activities of Xamoterol.Experimental
XylazineSpironolactone may decrease the vasoconstricting activities of Xylazine.Vet Approved
YM-178Spironolactone may decrease the vasoconstricting activities of YM-178.Investigational
ZaltoprofenZaltoprofen may decrease the antihypertensive activities of Spironolactone.Approved, Investigational
ZileutonZileuton may decrease the antihypertensive activities of Spironolactone.Approved, Investigational, Withdrawn
ZofenoprilSpironolactone may increase the hyperkalemic activities of Zofenopril.Experimental
ZomepiracZomepirac may decrease the antihypertensive activities of Spironolactone.Withdrawn
Food Interactions
  • Avoid alcohol.
  • 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.

References

Synthesis Reference

Giuseppe Bernini, "Process for preparing micronized spironolactone." U.S. Patent US4332721, issued July, 1975.

US4332721
General References
  1. Berardesca E, Gabba P, Ucci G, Borroni G, Rabbiosi G: Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris. Int J Tissue React. 1988;10(2):115-9. [PubMed:2972662]
  2. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999 Sep 2;341(10):709-17. [PubMed:10471456]
  3. Wandelt-Freerksen E: [Aldactone in the treatment of sarcoidosis of the lungs (author's transl)]. Z Erkr Atmungsorgane. 1977 Jul;149(1):156-9. [PubMed:607621]
External Links
Human Metabolome Database
HMDB14565
KEGG Drug
D00443
KEGG Compound
C07310
PubChem Compound
5833
PubChem Substance
46508525
ChemSpider
5628
BindingDB
50228080
ChEBI
9241
ChEMBL
CHEMBL1393
Therapeutic Targets Database
DAP000297
PharmGKB
PA451483
IUPHAR
2875
Guide to Pharmacology
GtP Drug Page
HET
SNL
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
PDRhealth
PDRhealth Drug Page
Wikipedia
Spironolactone
ATC Codes
C03DA01 — Spironolactone
AHFS Codes
  • 24:32.20 — Mineralocorticoid (Aldosterone) Receptor Antagonists
PDB Entries
2ab2 / 2oax / 3vhu
FDA label
Download (395 KB)
MSDS
Download (72.6 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
0CompletedTreatmentPolycystic Ovaries Syndrome1
1CompletedNot AvailableHealthy Volunteers1
1CompletedBasic ScienceHealthy Volunteers1
1CompletedTreatmentHealthy Volunteers1
1CompletedTreatmentHeart Failure, Unspecified1
1CompletedTreatmentHigh Blood Pressure (Hypertension)1
1Not Yet RecruitingDiagnosticCardiomyopathy With Unknown Etiology1
1RecruitingOtherPolycystic Ovaries Syndrome1
1TerminatedBasic ScienceType 2 Diabetic Nephropathy1
1, 2CompletedTreatmentCentral Serous Chorioretinitis1
1, 2RecruitingTreatmentLeukemia Acute Myeloid Leukemia (AML)1
1, 2RecruitingTreatmentPulmonary Arterial Hypertension (PAH)1
2Active Not RecruitingSupportive CareDermatologic Complications / Neoplasms, Malignant1
2Active Not RecruitingTreatmentEnd-Stage Renal Disease (ESRD)1
2CompletedPreventionCutaneous Atrophy Due to Corticosteroids1
2CompletedPreventionHeart Failure, Unspecified1
2CompletedTreatmentACTH / Cortisol Resistance / Glucocorticoid therapy / Mineralcorticoid / Negative Feedback1
2CompletedTreatmentAcanthosis Nigricans / Polycystic Ovaries Syndrome1
2CompletedTreatmentCardiovascular Disease (CVD) / Chronic Kidney Disease (CKD)1
2CompletedTreatmentChronic Kidney Disease (CKD) / High Blood Pressure (Hypertension) / Hyperkalemia1
2CompletedTreatmentCongenital Heart Disease (CHD) / Endomyocardial Fibrosis / Heart Failure, Unspecified1
2CompletedTreatmentFemale Pattern Hair Loss1
2CompletedTreatmentHeart Failure, Unspecified2
2CompletedTreatmentHypertension,Essential1
2CompletedTreatmentPuberty, Precocious1
2RecruitingPreventionAcute Kidney Injury (AKI) / IHD / Prophylaxis of Contrast-induced nephropathy1
2RecruitingPreventionCardiovascular Disease (CVD) / Diabetes Mellitus (DM) / High Blood Pressure (Hypertension)1
2RecruitingTreatmentAlbuminuria / Chronic Kidney Disease (CKD)1
2RecruitingTreatmentCancers1
2RecruitingTreatmentHigh Blood Pressure (Hypertension)1
2RecruitingTreatmentHyperkalemia / Resistant Hypertension1
2SuspendedTreatmentTransplant, Kidney1
2TerminatedTreatmentHigh Blood Pressure (Hypertension)1
2Unknown StatusTreatmentEnd Stage Renal Disease / Hemodialysis1
2WithdrawnTreatmentAcute Heart Failure (AHF)1
2, 3CompletedPreventionDiabetic Nephropathies / Glomerulonephritis / Kidney Diseases / Proteinuria1
2, 3CompletedPreventionNonvalvular Atrial Fibrillation1
2, 3RecruitingDiagnosticDiabetic Nephropathies / Retinopathy, Diabetic1
2, 3RecruitingPreventionCancers / Critically Ill1
2, 3RecruitingTreatmentChronic Lung Disease of Prematurity / Chronic Lung Diseases1
2, 3RecruitingTreatmentHeart Failure, Unspecified1
3Active Not RecruitingTreatmentDuchenne's Muscular Dystrophy (DMD)1
3Active Not RecruitingTreatmentGlucose tolerance impaired / Heart Failure, Unspecified / Type 2 Diabetes Mellitus1
3Active Not RecruitingTreatmentNonvalvular Atrial Fibrillation1
3CompletedPreventionCalcifications, Vascular / Coronary Artery Calcifications1
3CompletedPreventionEnd Stage Renal Disease (ESRD)1
3CompletedPreventionHeart Failure, Unspecified1
3CompletedTreatmentArterial Hypertension / Diabetes Mellitus (DM) / Hypertension, Resistant to Conventional Therapy1
3CompletedTreatmentCardiovascular Disease (CVD) / Congestive Heart Failure (CHF) / Heart Diseases1
3CompletedTreatmentCongestive Heart Failure (CHF) / Diastolic Heart Failure1
3CompletedTreatmentHeart Failure, Unspecified1
3CompletedTreatmentHypertension,Essential1
3CompletedTreatmentMyocardial Infarction (MI)1
3Not Yet RecruitingPreventionAcute Kidney Injury (AKI)1
3Not Yet RecruitingTreatmentAcne Vulgaris1
3Not Yet RecruitingTreatmentST Elevation Myocardial Infarction1
3RecruitingPreventionEndstage Renal Disease1
3RecruitingTreatmentEnd Stage Renal Failure on Dialysis1
4Active Not RecruitingDiagnosticHeart Failure, Unspecified / Nonischemic Dilated Cardiomyopathy1
4Active Not RecruitingTreatmentCardio-Renal Syndrome / Renal Insufficiency,Chronic1
4Active Not RecruitingTreatmentHypertension, Resistant to Conventional Therapy1
4Active Not RecruitingTreatmentNonvalvular Atrial Fibrillation1
4CompletedDiagnosticHeart Failure, Unspecified1
4CompletedPreventionAnthracycline Induced Cardiotoxicity1
4CompletedPreventionEnd-stage Renal Failure (ESRF)1
4CompletedPreventionHigh Blood Pressure (Hypertension)1
4CompletedTreatmentArterial Elasticity / Arterial Stiffness1
4CompletedTreatmentAscites / Liver Cirrhosis1
4CompletedTreatmentChronic Stable Heart Failure2
4CompletedTreatmentDiabetes Mellitus (DM) / Hypertension, Resistant to Conventional Therapy1
4CompletedTreatmentDiabetes Mellitus (DM) / Type 2 Diabetes Mellitus1
4CompletedTreatmentDiabetic Nephropathies1
4CompletedTreatmentDiastolic Heart Failure1
4CompletedTreatmentHeart Failure, Unspecified1
4CompletedTreatmentHeart Failure, Unspecified / Ventricular Dysfunction, Left1
4CompletedTreatmentHigh Blood Pressure (Hypertension)2
4CompletedTreatmentKidney Failure,Chronic1
4Enrolling by InvitationPreventionDisorder Related to Renal Transplantation1
4Not Yet RecruitingTreatmentCardiomyopathy Right Ventricular / Chronic Right-Sided Heart Failure / Pulmonary Arterial Hypertension (PAH) / Pulmonary Hypertension, Primary, 2 / Pulmonary Hypertension, Primary, 3 / Pulmonary Hypertension, Primary, 41
4Not Yet RecruitingTreatmentFibrosis / Hypertrophic Cardiomyopathy1
4Not Yet RecruitingTreatmentHeart Failure With Preserved Ejection Fraction (HFpEF)1
4RecruitingPreventionBlood Pressures / High Blood Pressure (Hypertension) / Strokes1
4RecruitingTreatmentAtherosclerosis1
4RecruitingTreatmentHypertension Resistant To Conventional Therapy1
4RecruitingTreatmentLiver Cirrhosis / Portal Hypertension1
4RecruitingTreatmentPulmonary Hypertension (PH)1
4RecruitingTreatmentTransplantation, Liver1
4SuspendedTreatmentAlcoholism / Cardiomyopathy, Alcoholic1
4TerminatedPreventionPatients With Fungic Infections1
4Unknown StatusTreatmentDiabetic Nephropathies1
4Unknown StatusTreatmentHigh Blood Pressure (Hypertension)3
4Unknown StatusTreatmentHypertrophic Cardiomyopathy / Myocardial Fibrosis1
4Unknown StatusTreatmentKidney Failure,Chronic1
4Unknown StatusTreatmentKnee Osteoarthritis (Knee OA)1
4Unknown StatusTreatmentLiver Cirrhosis / Portal Hypertension1
4Unknown StatusTreatmentRenal Failure1
4Unknown StatusTreatmentHemodialysis-dependent patients1
4WithdrawnTreatmentCongestive Heart Failure (CHF) / End Stage Renal Disease (ESRD)1
4WithdrawnTreatmentEnd Stage Renal Disease (ESRD) / Hemodialysis-dependent patients1
4WithdrawnTreatmentFemale Androgenetic Alopecia1
4WithdrawnTreatmentHeart Failure, Unspecified1
Not AvailableCompletedNot AvailableFractures, Bone / Type 2 Diabetes Mellitus1
Not AvailableCompletedDiagnosticCardiovascular Disease (CVD)1
Not AvailableCompletedPreventionBMI >30 kg/m2 / Insulin Resistance1
Not AvailableCompletedPreventionCardiovascular Disease (CVD) / Coronary Heart Disease (CHD) / Heart Diseases1
Not AvailableCompletedTreatmentAutosomal Dominant Polycystic Kidney Disease (ADPKD)1
Not AvailableCompletedTreatmentChronic Kidney Disease (CKD) / Proteinuria1
Not AvailableCompletedTreatmentCongenital Disorders1
Not AvailableCompletedTreatmentCongestive Heart Failure (CHF)1
Not AvailableCompletedTreatmentDiabetic Nephropathies1
Not AvailableCompletedTreatmentHyperaldosteronism / Obstructive Sleep Apnea (OSA) / Resistant Hypertension1
Not AvailableCompletedTreatmentHypertension,Essential1
Not AvailableCompletedTreatmentHypokalemia Caused by Thiazide Diuretics / Idiopathic Hypercalciuria1
Not AvailableCompletedTreatmentMajor Depressive Disorder (MDD)1
Not AvailableCompletedTreatmentPolycystic Ovaries Syndrome1
Not AvailableCompletedTreatmentType 2 Diabetes Mellitus / Vascular Diseases1
Not AvailableEnrolling by InvitationPreventionLong Qt Syndrome 1-2 / Sudden Cardiac Death1
Not AvailableRecruitingNot AvailableAlport Syndrome / Familial Benign Hematuria / Hereditary Kidney Disease / Pediatric Kidney Disease / Thin Basement Membrane Disease1
Not AvailableRecruitingBasic ScienceBMI >30 kg/m2 / Hyperandrogenemia / Polycystic Ovaries Syndrome1
Not AvailableRecruitingBasic SciencePrimary Aldosteronism1
Not AvailableRecruitingTreatmentAcute Decompensated Heart Failure (ADHF)1
Not AvailableRecruitingTreatmentDiabetes, Diabetes Mellitus Type 11
Not AvailableTerminatedTreatmentCongestive Heart Failure (CHF)1
Not AvailableUnknown StatusPreventionAcute Kidney Injury (AKI) / Acute Renal Injury / Kidney Injuries, Acute1
Not AvailableUnknown StatusPreventionDiabetes Mellitus (DM) / Endocrine System Diseases / Glucose Metabolism Disorders / Metabolic Diseases1
Not AvailableUnknown StatusTreatmentNonvalvular Atrial Fibrillation1
Not AvailableWithdrawnTreatmentCongestive Heart Failure (CHF)2
Not AvailableWithdrawnTreatmentDiastolic Heart Failure1
Not AvailableWithdrawnTreatmentHigh Blood Pressure (Hypertension)1
Not AvailableWithdrawnTreatmentPulmonary Hypertension (PH) / Right Heart Failure1

Pharmacoeconomics

Manufacturers
  • Gd searle llc
  • Actavis elizabeth llc
  • Amneal pharmaceuticals
  • Ascot hosp pharmaceuticals inc div travenol laboratories inc
  • Ivax pharmaceuticals inc
  • Lederle laboratories div american cyanamid co
  • Mutual pharmaceutical co inc
  • Mylan pharmaceuticals inc
  • Purepac pharmaceutical co
  • Sandoz inc
  • Superpharm corp
  • Upsher smith laboratories inc
  • Vangard laboratories inc div midway medical co
  • Vintage pharmaceuticals llc
  • Warner chilcott div warner lambert co
  • Watson laboratories inc
Packagers
Dosage forms
FormRouteStrength
TabletOral100 mg
TabletOral25 mg
SuspensionOral25 mg/5mL
TabletOral100 mg/1
TabletOral25 mg/1
TabletOral50 mg/1
Tablet, film coatedOral100 mg/1
Tablet, film coatedOral25 mg/1
Tablet, film coatedOral50 mg/1
TabletOral
Tablet, film coatedOral
Prices
Unit descriptionCostUnit
Spironolactone powder12.56USD g
Aldactone 100 mg tablet2.14USD tablet
Aldactazide 50-50 mg tablet2.02USD tablet
Aldactazide 50-50 tablet1.92USD tablet
Aldactone 50 mg tablet1.84USD tablet
Spironolactone 100 mg tablet1.45USD tablet
Aldactazide 25-25 mg tablet1.26USD tablet
Aldactazide 25-25 tablet1.04USD tablet
Spironolactone 50 mg tablet0.83USD tablet
Aldactone 25 mg tablet0.8USD tablet
Spironolactone-HCTZ 25-25 mg tablet0.57USD tablet
Spironolactone 25 mg tablet0.5USD tablet
Novo-Spiroton 100 mg Tablet0.25USD tablet
Novo-Spiroton 25 mg Tablet0.11USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US9757394No2016-10-282036-10-28Us

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)134.5 °CPhysProp
water solubility22 mg/L (at 25 °C)YALKOWSKY,SH & DANNENFELSER,RM (1992)
logP2.78HANSCH,C ET AL. (1995)
logS-4.28ADME Research, USCD
Predicted Properties
PropertyValueSource
Water Solubility0.00198 mg/mLALOGPS
logP3.1ALOGPS
logP3.64ChemAxon
logS-5.3ALOGPS
pKa (Strongest Acidic)18.01ChemAxon
pKa (Strongest Basic)-4.9ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count3ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area60.44 Å2ChemAxon
Rotatable Bond Count2ChemAxon
Refractivity113.5 m3·mol-1ChemAxon
Polarizability46.03 Å3ChemAxon
Number of Rings5ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9912
Blood Brain Barrier+0.932
Caco-2 permeable+0.5432
P-glycoprotein substrateSubstrate0.5691
P-glycoprotein inhibitor IInhibitor0.6807
P-glycoprotein inhibitor IIInhibitor0.8388
Renal organic cation transporterNon-inhibitor0.727
CYP450 2C9 substrateNon-substrate0.7897
CYP450 2D6 substrateNon-substrate0.9116
CYP450 3A4 substrateSubstrate0.6638
CYP450 1A2 substrateNon-inhibitor0.9045
CYP450 2C9 inhibitorNon-inhibitor0.9071
CYP450 2D6 inhibitorNon-inhibitor0.9276
CYP450 2C19 inhibitorNon-inhibitor0.9025
CYP450 3A4 inhibitorNon-inhibitor0.8309
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.8681
Ames testNon AMES toxic0.9158
CarcinogenicityNon-carcinogens0.9288
BiodegradationNot ready biodegradable0.9696
Rat acute toxicity2.0150 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9427
hERG inhibition (predictor II)Non-inhibitor0.7002
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Mass Spectrum (Electron Ionization)MSsplash10-0006-9836000000-9f600bd39c3b914c0b17
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-014i-0000900000-5e2e1944e45fcef225d1
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-014i-0000900000-406c100eed5b6cdc3286

Taxonomy

Description
This compound belongs to the class of organic compounds known as spironolactones and derivatives. These are steroid lactones with a structure based on the spironolactone skeleton.
Kingdom
Organic compounds
Super Class
Lipids and lipid-like molecules
Class
Steroids and steroid derivatives
Sub Class
Steroid lactones
Direct Parent
Spironolactones and derivatives
Alternative Parents
3-oxo delta-4-steroids / Delta-4-steroids / Cyclohexenones / Gamma butyrolactones / Tetrahydrofurans / Thioesters / Carboxylic acid esters / Carbothioic S-esters / Sulfenyl compounds / Oxacyclic compounds
show 3 more
Substituents
Spironolactone / 3-oxo-delta-4-steroid / 3-oxosteroid / Oxosteroid / Delta-4-steroid / Cyclohexenone / Gamma butyrolactone / Tetrahydrofuran / Carboxylic acid ester / Carbothioic s-ester
show 17 more
Molecular Framework
Aliphatic heteropolycyclic compounds
External Descriptors
thioester, 3-oxo steroid, methyl ketone, oxaspiro compound, steroid lactone (CHEBI:9241) / Pregnane and derivatives [Fig] (C07310)

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Antagonist
General Function
Zinc ion binding
Specific Function
Receptor for both mineralocorticoids (MC) such as aldosterone and glucocorticoids (GC) such as corticosterone or cortisol. Binds to mineralocorticoid response elements (MRE) and transactivates targ...
Gene Name
NR3C2
Uniprot ID
P08235
Uniprot Name
Mineralocorticoid receptor
Molecular Weight
107066.575 Da
References
  1. Sitruk-Ware R: Progestogens in hormonal replacement therapy: new molecules, risks, and benefits. Menopause. 2002 Jan-Feb;9(1):6-15. [PubMed:11791081]
  2. Rogerson FM, Yao YZ, Smith BJ, Dimopoulos N, Fuller PJ: Determinants of spironolactone binding specificity in the mineralocorticoid receptor. J Mol Endocrinol. 2003 Dec;31(3):573-82. [PubMed:14664717]
  3. Gertner RA, Klein JD, Bailey JL, Kim DU, Luo XH, Bagnasco SM, Sands JM: Aldosterone decreases UT-A1 urea transporter expression via the mineralocorticoid receptor. J Am Soc Nephrol. 2004 Mar;15(3):558-65. [PubMed:14978157]
  4. Frishman WH, Stier CT Jr: Aldosterone and aldosterone antagonism in systemic hypertension. Curr Hypertens Rep. 2004 Jun;6(3):195-200. [PubMed:15128471]
  5. Rogerson FM, Yao Y, Smith BJ, Fuller PJ: Differences in the determinants of eplerenone, spironolactone and aldosterone binding to the mineralocorticoid receptor. Clin Exp Pharmacol Physiol. 2004 Oct;31(10):704-9. [PubMed:15554912]
  6. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352]
  7. Sica DA: Pharmacokinetics and pharmacodynamics of mineralocorticoid blocking agents and their effects on potassium homeostasis. Heart Fail Rev. 2005 Jan;10(1):23-9. [PubMed:15947888]
  8. Rossi G, Boscaro M, Ronconi V, Funder JW: Aldosterone as a cardiovascular risk factor. Trends Endocrinol Metab. 2005 Apr;16(3):104-7. [PubMed:15808807]
Details
2. Androgen receptor
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Antagonist
General Function
Zinc ion binding
Specific Function
Steroid hormone receptors are ligand-activated transcription factors that regulate eukaryotic gene expression and affect cellular proliferation and differentiation in target tissues. Transcription ...
Gene Name
AR
Uniprot ID
P10275
Uniprot Name
Androgen receptor
Molecular Weight
98987.9 Da
References
  1. Ye P, Yamashita T, Pollock DM, Sasano H, Rainey WE: Contrasting effects of eplerenone and spironolactone on adrenal cell steroidogenesis. Horm Metab Res. 2009 Jan;41(1):35-9. doi: 10.1055/s-0028-1087188. Epub 2008 Sep 25. [PubMed:18819053]
Details
3. Progesterone receptor
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Agonist
General Function
Zinc ion binding
Specific Function
The steroid hormones and their receptors are involved in the regulation of eukaryotic gene expression and affect cellular proliferation and differentiation in target tissues. Progesterone receptor ...
Gene Name
PGR
Uniprot ID
P06401
Uniprot Name
Progesterone receptor
Molecular Weight
98979.96 Da
References
  1. Fagart J, Hillisch A, Huyet J, Barfacker L, Fay M, Pleiss U, Pook E, Schafer S, Rafestin-Oblin ME, Kolkhof P: A new mode of mineralocorticoid receptor antagonism by a potent and selective nonsteroidal molecule. J Biol Chem. 2010 Sep 24;285(39):29932-40. doi: 10.1074/jbc.M110.131342. Epub 2010 Jul 22. [PubMed:20650892]
Details
4. Glucocorticoid receptor
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Antagonist
General Function
Zinc ion binding
Specific Function
Receptor for glucocorticoids (GC). Has a dual mode of action: as a transcription factor that binds to glucocorticoid response elements (GRE), both for nuclear and mitochondrial DNA, and as a modula...
Gene Name
NR3C1
Uniprot ID
P04150
Uniprot Name
Glucocorticoid receptor
Molecular Weight
85658.57 Da
References
  1. Fagart J, Hillisch A, Huyet J, Barfacker L, Fay M, Pleiss U, Pook E, Schafer S, Rafestin-Oblin ME, Kolkhof P: A new mode of mineralocorticoid receptor antagonism by a potent and selective nonsteroidal molecule. J Biol Chem. 2010 Sep 24;285(39):29932-40. doi: 10.1074/jbc.M110.131342. Epub 2010 Jul 22. [PubMed:20650892]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Antagonist
General Function
Steroid 11-beta-monooxygenase activity
Specific Function
Preferentially catalyzes the conversion of 11-deoxycorticosterone to aldosterone via corticosterone and 18-hydroxycorticosterone.
Gene Name
CYP11B2
Uniprot ID
P19099
Uniprot Name
Cytochrome P450 11B2, mitochondrial
Molecular Weight
57559.62 Da
References
  1. Cheng SC, Suzuki K, Sadee W, Harding BW: Effects of spironolactone, canrenone and canrenoate-K on cytochrome P450, and 11beta- and 18-hydroxylation in bovine and human adrenal cortical mitochondria. Endocrinology. 1976 Oct;99(4):1097-106. [PubMed:976190]
6. 17alpha-hydroxylase
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Antagonist
References
  1. Authors unspecified: Spironolactone and endocrine dysfunction. Ann Intern Med. 1976 Nov;85(5):630-6. [PubMed:984618]
  2. Desai; Meena P.; Vijayalakshmi Bhatia & P.S.N. Menon (2001). Pediatric Endocrine Disorders. Orient Blackswan. [ISBN:978-81-250-2025-7]
7. 17,20-desmolase
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Antagonist
References
  1. Authors unspecified: Spironolactone and endocrine dysfunction. Ann Intern Med. 1976 Nov;85(5):630-6. [PubMed:984618]
  2. Desai; Meena P.; Vijayalakshmi Bhatia & P.S.N. Menon (2001). Pediatric Endocrine Disorders. Orient Blackswan. [ISBN:978-81-250-2025-7]
Kind
Protein group
Organism
Not Available
Pharmacological action
Unknown
Actions
Antagonist
General Function
Electron carrier activity
Specific Function
Converts testosterone into 5-alpha-dihydrotestosterone and progesterone or corticosterone into their corresponding 5-alpha-3-oxosteroids. It plays a central role in sexual differentiation and andro...

Components:
References
  1. Corvol P, Michaud A, Menard J, Freifeld M, Mahoudeau J: Antiandrogenic effect of spirolactones: mechanism of action. Endocrinology. 1975 Jul;97(1):52-8. [PubMed:166833]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Binder
General Function
Androgen binding
Specific Function
Functions as an androgen transport protein, but may also be involved in receptor mediated processes. Each dimer binds one molecule of steroid. Specific for 5-alpha-dihydrotestosterone, testosterone...
Gene Name
SHBG
Uniprot ID
P04278
Uniprot Name
Sex hormone-binding globulin
Molecular Weight
43778.755 Da
References
  1. Braunstein GD: Clinical practice. Gynecomastia. N Engl J Med. 2007 Sep 20;357(12):1229-37. [PubMed:17881754]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Voltage-gated calcium channel activity
Specific Function
This protein is a subunit of the dihydropyridine (DHP) sensitive calcium channel. Plays a role in excitation-contraction coupling. The skeletal muscle DHP-sensitive Ca(2+) channel may function only...
Gene Name
CACNG1
Uniprot ID
Q06432
Uniprot Name
Voltage-dependent calcium channel gamma-1 subunit
Molecular Weight
25028.105 Da
References
  1. Sorrentino R, Autore G, Cirino G, d'Emmanuele de Villa Bianca R, Calignano A, Vanasia M, Alfieri C, Sorrentino L, Pinto A: Effect of spironolactone and its metabolites on contractile property of isolated rat aorta rings. J Cardiovasc Pharmacol. 2000 Aug;36(2):230-5. [PubMed:10942165]
  2. Melander A, Danielson K, Schersten B, Thulin T, Wahlin E: Enhancement by food of canrenone bioavailability from spironolactone. Clin Pharmacol Ther. 1977 Jul;22(1):100-3. [PubMed:872489]
11. Dihydrotestosterone receptor
Kind
Protein
Organism
Human
Pharmacological action
Unknown
References
  1. Berardesca E, Gabba P, Ucci G, Borroni G, Rabbiosi G: Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris. Int J Tissue React. 1988;10(2):115-9. [PubMed:2972662]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
Zinc ion binding
Specific Function
Nuclear receptor that binds and is activated by variety of endogenous and xenobiotic compounds. Transcription factor that activates the transcription of multiple genes involved in the metabolism an...
Gene Name
NR1I2
Uniprot ID
O75469
Uniprot Name
Nuclear receptor subfamily 1 group I member 2
Molecular Weight
49761.245 Da
References
  1. Kretschmer XC, Baldwin WS: CAR and PXR: xenosensors of endocrine disrupters? Chem Biol Interact. 2005 Aug 15;155(3):111-28. [PubMed:16054614]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2C8
Uniprot ID
P10632
Uniprot Name
Cytochrome P450 2C8
Molecular Weight
55824.275 Da
References
  1. Walsky RL, Gaman EA, Obach RS: Examination of 209 drugs for inhibition of cytochrome P450 2C8. J Clin Pharmacol. 2005 Jan;45(1):68-78. [PubMed:15601807]
  2. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
Inducer
General Function
Steroid 11-beta-monooxygenase activity
Specific Function
Has steroid 11-beta-hydroxylase activity. In addition to this activity, the 18 or 19-hydroxylation of steroids and the aromatization of androstendione to estrone have also been ascribed to cytochro...
Gene Name
CYP11B1
Uniprot ID
P15538
Uniprot Name
Cytochrome P450 11B1, mitochondrial
Molecular Weight
57572.44 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256]
  2. Cheng SC, Suzuki K, Sadee W, Harding BW: Effects of spironolactone, canrenone and canrenoate-K on cytochrome P450, and 11beta- and 18-hydroxylation in bovine and human adrenal cortical mitochondria. Endocrinology. 1976 Oct;99(4):1097-106. [PubMed:976190]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inducer
General Function
Organic anion transmembrane transporter activity
Specific Function
Mediates hepatobiliary excretion of numerous organic anions. May function as a cellular cisplatin transporter.
Gene Name
ABCC2
Uniprot ID
Q92887
Uniprot Name
Canalicular multispecific organic anion transporter 1
Molecular Weight
174205.64 Da
References
  1. Johnson DR, Klaassen CD: Regulation of rat multidrug resistance protein 2 by classes of prototypical microsomal enzyme inducers that activate distinct transcription pathways. Toxicol Sci. 2002 Jun;67(2):182-9. [PubMed:12011477]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
ABCB1
Uniprot ID
P08183
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da
References
  1. Wang E, Lew K, Barecki M, Casciano CN, Clement RP, Johnson WW: Quantitative distinctions of active site molecular recognition by P-glycoprotein and cytochrome P450 3A4. Chem Res Toxicol. 2001 Dec;14(12):1596-603. [PubMed:11743742]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent transport of organic anions such as sulfobromophthalein (BSP) and conjugated (taurocholate) and unconjugated (cholate) bile acids (By similarity). Selectively inhibit...
Gene Name
SLCO1A2
Uniprot ID
P46721
Uniprot Name
Solute carrier organic anion transporter family member 1A2
Molecular Weight
74144.105 Da
References
  1. Kanai N, Lu R, Bao Y, Wolkoff AW, Schuster VL: Transient expression of oatp organic anion transporter in mammalian cells: identification of candidate substrates. Am J Physiol. 1996 Feb;270(2 Pt 2):F319-25. [PubMed:8779893]

Drug created on June 13, 2005 07:24 / Updated on December 10, 2017 17:18