Spironolactonedosage

Spironolactone oral suspension is not therapeutically equivalent to Aldactone Heart Failure: Initiate treatment at 20 mg once daily.

Hypertension: Initiate treatment at 20 to 75 mg daily in either single or divided doses Edema associated with Hepatic Cirrhosis: Initiate therapy in a hospital setting and titrate slowly. The initial recommended daily dose is 75 mg in either single or divided doses

2.1 General

Considerations Spironolactone oral suspension is not therapeutically equivalent to Aldactone. Follow dosing instructions given here. In patients requiring a dose greater than 100 mg, use another formulation. Doses of the suspension greater than 100 mg may result in spironolactone concentrations higher than expected. Spironolactone oral suspension 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/1.73m 2, initiate treatment at 20 mg (4 mL) once daily. Patients who tolerate 20 mg (4 mL) once daily may have their dosage increased to 37.5 mg (7.5 mL) once daily as clinically indicated. Patients who develop hyperkalemia on 20 mg (4 mL) once daily may have their dosage reduced to 20 mg (4 mL) every other day. In patients with an eGFR between 30 and 50 mL/min/1.73m 2, consider initiating treatment at 10 mg (2 mL) because of the risk of hyperkalemia.

2.3 Treatment of

Essential Hypertension The recommended initial daily dose is 20 mg (4 mL) to 75 mg (15 mL) administered in either single or divided doses. Dosage can be titrated at two-week intervals. Doses >75 mg/day generally do not provide additional reductions in blood pressure.

2.4 Treatment of

Edema Associated with Hepatic Cirrhosis In patients with cirrhosis, initiate therapy in a hospital setting and titrate slowly. The recommended initial daily dose is 75 mg (15 mL) administered in either single or divided doses. In patients requiring titration above 100 mg, use another formulation. When given as the sole agent for diuresis, administer for at least five days before increasing dose to obtain desired effect.