Spironolactonedosage

Heart Failure: Initiate treatment at 25 mg once daily.

Hypertension: Initiate treatment at 25 mg to 100 mg daily in either single or divided doses.

Edema: Initiate therapy in a hospital setting and titrate slowly. The recommended initial daily dose is 100 mg in single or divided doses.

Primary hyperaldosteronism: Initiate treatment at 100 mg to 400 mg in preparation for surgery. In patients unsuitable for surgery use the lowest effective dosage determined for the individual patient.

2.1 General

Considerations Spironolactone can be taken with or without food, but should be taken consistently with respect to food.

2.2 Treatment of

Heart Failure In patients with serum potassium ≤5.0 mEq/L and eGFR >50 mL/min/1.73 m 2, initiate treatment at 25 mg once daily. Patients who tolerate 25 mg once daily may have their dosage increased to 50 mg once daily as clinically indicated. Patients who develop hyperkalemia on 25 mg once daily may have their dosage reduced to 25 mg every other day. In patients with an eGFR between 30 and 50 mL/min/1.73 m 2, consider initiating therapy at 25 mg every other day because of the risk of hyperkalemia.

2.3 Treatment of

Essential Hypertension The recommended initial daily dose is 25 mg to 100 mg of spironolactone administered in either single or divided doses is recommended. Dosage can be titrated at two-week intervals. Doses greater than 100 mg/day generally do not provide additional reductions in blood pressure.

2.4 Treatment of

Edema In patients with cirrhosis, initiate therapy in a hospital setting and titrate slowly. The recommended initial daily dosage is 100 mg of spironolactone administered in either single or divided doses, but may range from 25 mg to 200 mg daily. When given as the sole agent for diuresis, administer for at least five days before increasing dose to obtain desired effect.

2.5 Treatment of

Primary Hyperaldosteronism Administer spironolactone in doses of 100 mg to 400 mg daily in preparation for surgery. For patients who are considered unsuitable for surgery, spironolactone can be used as long-term maintenance therapy at the lowest effective dosage determined for the individual patient.