Spironolactone

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 ( 2. 4). 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. 5). 2.1 General Considerations Spironolactone tablets 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 .