Spiractin 25 (Spironolactone)

Spiractin general information

What is Spiractin used for?

Spiractin tablets 25mg are used to reduce fluid retention and swelling (oedema) which is caused by several conditions, including congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease.  Spiractin 25 can be used alone to treat hypertension or in combination with other antihypertensive medications like beta blockers, to enhance their activity.  Spiractin tablets 25mg is also used to increase blood potassium levels, which occurs in a condition called hypokalaemia (low blood potassium) and to treat hyperaldosteronism, which is caused by excess secretion by the adrenal gland of the hormone aldosterone (involved in regulating sodium and potassium levels), both of which can cause fluid retention.  Spiractin 25 has anti-androgen activity which is used in the treatment of female hirsutism (androgen-related increase in facial and body hair) and can be used as an anti-androgen component of transgender hormone therapy, to help stimulate the development of female sexual characteristics for male to female transsexuals.    

How does Spiractin work?

Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic (water pill) that acts as an antagonist of the hormone aldosterone, by binding to the aldosterone receptor blocking its action.  This action of spironolactone in Spiractin tablets 25mg increases sodium excretion and reduces potassium loss at the distal renal tubule of the kidney.  The overall effect of this action is to increase water excretion in the urine which reduces fluid build-up in the tissues, increase blood potassium levels and lower sblood pressure.  Spironolactone in Spiractin tablets 25mg also has moderate anti-androgenic activity as it binds to the androgen receptor competing with dihydrotestosterone (DHT) an active metabolite of testosterone.  Binding of DHT to the androgen receptor promotes male characteristics therefore, blocking the action of DHT helps reduce male characteristics.  Another anti-androgenic action of Spiractin 25 is that it blocks the synthesis of a testosterone by the ovaries. 

What does Spiractin contain?

Spiractin tablets 25mg contain the active ingredient spironolactone, a potassium-sparing diuretic used to treat oedema in various conditions.  They also contain quinoline yellow, sunset yellow, erythrosine, polysorbate, peppermint oil, povidone, microcrystalline cellulose, maize starch, sodium starch glycollate, talc, magnesium stearate and lactose.

Treating oedema with Spiractin

Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic (water pill) that is used to treat fluid retention (oedema) caused by several conditions, including congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease.  Spironolactone in Spiractin tablets 25mg works by blocking the action of the hormone aldosterone on the kidneys, which increases excretion of excess water and sodium from the body while at the same time maintaining blood potassium levels. 

Spiractin for hypertension

Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic that is used to treat hypertension or high blood pressure, which increases risk of cardiovascular disease and if uncontrolled can cause kidney damage, stroke, heart attack and heart failure.  Spironolactone in Spiractin tablets 25mg binds to the receptor for the hormone aldosterone on the kidneys, blocking the action of aldosterone, which increases sodium excretion and reduces potassium loss at the distal renal tubule of the kidney.  This action of spironolactone in Spiractin tablets 25mg increases water excretion in the urine which reduces fluid build-up in the tissues, increase blood potassium levels and lowers blood pressure. 

Spiractin for transgender treatment

Spiractin tablets 25mg contain spironolactone, which is primarily used as a diuretic, to reduce fluid retention in conditions such as congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease.  Spironolactone in Spiractin tablets 25mg also acts as an anti-androgen by binding to the androgen receptor and competing with dihydrotestosterone (DHT), the active metabolite of testosterone, which promotes male characteristics, thereby blocking the action of DHT.  Using an anti-androgen like spironolactone (usually in high doses of 200–400 mg per day) allows the amount of oestrogen administered for feminising hormone therapy to be reduced while optimising the hormone regime needed to stimulate breast development, feminisation of skin, and female fat distribution. 

What are the side effects of Spiractin?

The most commonly reported side effects when taking Spiractin includes nausea, vomiting, headache, abdominal cramps and pain, diarrhoea, headache, drowsiness, lethargy, hair loss and excessive hair growth.  Other side effects include skin rash, menstrual period changes in women, breast enlargement (gynaecomastia) and sexual problems (impotence) in men.

When should Spiractin not be used?

You should not use Spiractin tablets 25mg if you:

• are allergic to spironolactone or any ingredients in Spiractin
• are pregnant or are breastfeeding
• have kidney or liver disease
• have high potassium levels in your blood due to a potassium rich diet or if you are taking medications or supplements that increase blood potassium levels
• are not producing or passing urine
• are taking other medications that may interact with Spiractin, such as potassium supplements, non-steroidal anti-inflammatory drugs like indomethacin or mefenamic acid, aspirin, digoxin for heart failure, carbenoxolone for mouth ulcers, other diuretics, the ACE inhibitors antihypertensives, ammonium chloride in some cough medications, cholestyramine for lowering blood cholesterol

What medications interact with Spiractin?

Several medications interact with Spiractin tablets 25mg and should either not be taken while you are taking Spiractin or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Spiractin: potassium supplements, ammonium chloride in some cough medications, cholestyramine for lowering blood cholesterol, the ACE inhibitors antihypertensives
• Drugs that affect Spiractin: non-steroidal anti-inflammatory drugs like indomethacin or mefenamic acid and aspirin, carbenoxolone for mouth ulcers
• Drugs that are affected by Spiractin: digoxin for heart failure

How should Spiractin be taken?

You should take your Spiractin tablets 25mg with a glass of water with or without food, once or twice daily.  The dose you take depends on your condition and what you are being treated for and should be as recommended by your doctor.  You should continue taking your Spiractin tablets 25mg even if you are feeling well, which may be for a few days or several weeks and your doctor may increase your dose during treatment. 

How long should you take Spiractin?

You should continue taking your Spiractin tablets 25mg even if you are feeling well, which may be for a few days or several weeks and your doctor may increase your dose during treatment. 

Missed dose of Spiractin

If you miss a dose of Spiractin tablets 25mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Spiractin be stored?

You should store your Spiractin tablets 25mg below 30°C in a cool dry place.