Why these medications are prescribed?
Spironolactone is prescribed in low doses for people
with advanced systolic heart failure to improve outcomes and to prevent symptoms
from becoming worse. Eplerenone is prescribed
for patients who develop left ventricular dysfunction (an ejection fraction of
less than or equal to 40%) following a heart attack. When given early after a
heart attack, it may prevent heart muscle damage from worsening. Both
spironolactone and eplerenone block a certain chemical (aldosterone) in the body
that causes salt and fluid build-up and stiffening of the heart muscle.
When to take spironolactone or eplerenone
Follow the label directions on how often to take these
medications. The number of doses you take each day, the time allowed between
doses, and how long you need to take the medication will depend on your
condition. These medications can be taken with or without food.
Special directions for spironolactone or eplerenone
- Weigh yourself at the same time every day (on the
same scale) and record your weight. Call your doctor or nurse if you gain 3
pounds in one day or 5 pounds in one week.
- While taking these medications, have your blood
potassium level tested regularly, as advised by your doctor or nurse. Lab tests
will be performed three days after you start taking the medication, then at one
week, every month for three months, and every three months thereafter. The tests
are needed because these drugs can increase blood potassium levels.
Before these medications are prescribed, tell your
doctor or nurse if you have diabetes, kidney disease, liver disease, gout, a
history of kidney stones, menstrual problems, breast enlargement (in men),
and/or high potassium (hyperkalemia).
Food and drug interactions
These medications are generally prescribed in
combination with other heart failure medications. If you experience an increase
in side effects after taking your medications together, contact your doctor or
nurse. You may need to change the times you are taking each medication.
Before these medications are prescribed, tell your doctor or nurse if you are taking medications for high
blood pressure, cyclosporine, potassium-containing medications, digoxin, lithium, or arthritis
medications such as ibuprofen.
Follow your health care provider’s dietary advice, including:
- Following a low-sodium diet
- Limiting potassium supplements or decreasing potassium intake (such as bananas and orange juice)
Do not use salt substitutes, as they contain potassium and these medications can cause the body to retain potassium.
Learn how to read food labels so you can identify the potassium content. A dietitian can help you select the appropriate foods.
Side effects and how to manage them
- Extreme tiredness: This side effect may be strongest when you first start
taking the medication. It should decrease as your body adjusts to the
medication. Contact your doctor or nurse if this symptom persists.
- Increased urination: This is normal and may last for up to 6 hours after a dose.
- Upset stomach: Take the medication with meals or milk to reduce this
symptom. Contact your doctor or nurse if this symptom persists or is severe.
- Skin rash or itching: Stop taking the medication and contact your doctor or nurse right away.
- Shortness of breath: Contact your doctor or nurse right away.
- Confusion; irregular heartbeat; nervousness; numbness or tingling in the hands, feet, or lips:
Contact your doctor or nurse right away.
Contact your doctor or nurse right away if you have any other symptoms that cause concern.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/1/2010...#12859