Aldosterone antagonists block the action of aldosterone, which is a hormone your adrenal glands make. By stopping aldosterone, these drugs cause your kidneys to put extra water and salt into your pee. These medicines also keep your body from getting rid of potassium.
Aldosterone antagonists, or aldosterone receptor antagonists, are prescription drugs that work against aldosterone, a hormone your adrenal glands make. These drugs are sometimes called mineralocorticoid receptor antagonists (MRAs) or potassium-sparing diuretics.
Your body uses the aldosterone it makes to raise your blood pressure when necessary. However, people who already have high blood pressure or are retaining excess fluid because of heart failure can benefit from aldosterone antagonists that keep aldosterone from working, helping to lower your blood pressure.
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Aldosterone antagonist examples are:
Aldosterone antagonists (mineralocorticoid receptor antagonists) make your kidneys move extra water and salt into your pee so they’re out of your body. They do this while preventing you from losing potassium, which aldosterone makes your kidneys eliminate.
They work by blocking the receptor for the hormone aldosterone, which your body makes. Aldosterone makes your kidneys hold on to salt and water, which raises your blood pressure. Aldosterone is one of the ways your body adjusts blood pressure naturally in your blood vessels.
When you take an aldosterone blocker, your kidneys are able to release excess water and salt from your blood. The extra water and salt come out in your pee.
Fluids build up in people who have heart failure because their hearts aren’t able to pump blood the way they should. Aldosterone antagonists help people with heart failure get rid of excess fluid in their bodies. When there’s less fluid to pump, it’s easier on your heart.
Aldosterone antagonists treat several medical conditions, including:
Spironolactone is one of the top 100 prescribed medicines in the United States.
Aldosterone antagonists help people get excess water and salt out of their bodies without losing potassium. They help people with heart failure:
People with acute (happening now) heart failure have more than 1 million hospital stays a year in the United States. About half of them will be admitted to the hospital again or will pass away within six months of their hospital stay. Aldosterone antagonists can lower the risk of sudden cardiac death by about 20% in people who have heart failure and/or a problem with the left ventricle of their heart.
Like other diuretics, aldosterone antagonists will make you pee more often than usual.
Other side effects of aldosterone antagonists may include:
Because spironolactone may affect other types of receptors (androgen and progesterone) in your body, it may also cause:
For this reason, some people with heart failure want to take eplerenone instead. However, a number of studies have found that spironolactone works better. Also, spironolactone costs less than eplerenone.
It may take several weeks for aldosterone antagonist drugs to reach their full effectiveness.
Contact your healthcare provider if you’re having a hard time with the side effects of an aldosterone blocker. Your provider may be able to adjust your dose or switch you to a different brand. You should also let them know if you’ve been taking aldosterone antagonist drugs for a few weeks but your symptoms aren’t better.
A note from Cleveland Clinic
Whenever you get a new prescription, tell your healthcare provider what prescriptions you’re already taking. They’ll also want to know about supplements or herbs you take. Follow the instructions that come with your prescription medicine. The label should tell you how much to take and when to take it. It’s best to take medicine consistently, so take it at the same time of day each day. This helps you remember to take it. Don’t take two doses at a time to make up for one you forgot. Ask your provider before drinking grapefruit juice or using salt alternatives that may contain potassium.
Last reviewed by a Cleveland Clinic medical professional on 04/29/2022.
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