Spironolactone

(speer-on-oh-lak-tone)

Description: Diuretic Agent

Other names for this medication: Aldactone®

Spironolactone may be given with or without food. If your animal vomits or acts sick after receiving this medication on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.

•This drug is commonly used in combination with other medications to treat heart failure; it may also be used to relieve signs associated with liver disease.

•The animal must always have access to fresh, clean water while on this medication, as spironolactone will cause your animal to drink and urinate more.

•Because this drug can change electrolytes (salts) in the blood, regular blood testing will be necessary to keep your animal safe.

•Contact your veterinarian immediately if your animal develops skin sores, facial itching (cats), persistent or severe lack of appetite, vomiting, or diarrhea, or if your animal has low energy, increased breathing rate or effort, trouble walking or balancing, or stops drinking or urinating.

•The National Institute for Occupational Safety and Health (NIOSH) classifies spironolactone as a hazardous drug; wearing gloves should be considered (especially if you are pregnant) when giving this medicine to your dog.

How is this medication useful?

Spironolactone is a diuretic that works in the kidneys to remove excess fluid and salt from the body. This medication is used in combination with other drugs to treat heart failure and relieve extra pressure on the heart; it may also have some protective effects on the heart muscle. Spironolactone may also be used in dogs to treat fluid buildup in the abdomen that can occur with end-stage liver failure. The FDA (U.S. Food & Drug Administration) has approved this drug for use in humans, but it is not officially approved for use in animals. The FDA allows veterinarians to prescribe products containing this drug in different species or for other conditions in certain situations. You and your veterinarian can discuss why this drug is the most appropriate choice.

What should I tell my veterinarian to see if this medication can be safely given?

Many things might affect how well this drug will work in your animal. Be sure to discuss the following with your veterinarian so together you can make the best treatment decisions.

•Other drugs can interact with spironolactone so be sure to tell your veterinarian and pharmacist what medications (including vitamins, supplements, or herbal therapies) you are giving your animal, as well as the amount and schedule of each.

•Tell your veterinarian about any conditions or diseases your animal may have or had in the past.

•If your animal has been treated for the same disease or condition in the past, tell your veterinarian about the treatment and how well it did or didn't work.

•Spironolactone use should be avoided in pregnant or nursing animals whenever possible, as it may cause birth defects. If your animal is pregnant or nursing, talk to your veterinarian about the risks of using this drug.

•Tell your veterinarian and pharmacist about any medication side effects (including allergic reactions, lack of appetite, diarrhea, itching, hair loss) your animal has developed in the past.

How long until I will know if this medication is working, and how long will the effects of this medication last?

This medication should start having effects within 1 to 2 hours; however, you will not see the effects of this medication outwardly. Your veterinarian will need to run further tests to determine if the medication is working appropriately.

The effects of this medication are short-lived, meaning they will stop working within 24 hours, although the benefits may be prolonged if your animal has decreased kidney and/or liver function.

When should this medication not be used or be used very carefully?

No drug is 100% safe in all patients, but your veterinarian will discuss with you any specific concerns about using this drug in your animal.

This drug SHOULD NOT be used in patients:

•That cannot produce urine or have severe kidney disease.

•That have had an allergic reaction to it.

•That have elevated potassium levels.

This drug should be used WITH CAUTION in patients:

•That are pregnant or nursing.

•With reduced kidney function.

•With uncontrolled diabetes mellitus or other conditions where body water, blood sugar, or blood electrolytes (salts) are out of balance.

•That are vomiting or have diarrhea.

If your animal matches any of these conditions, talk to your veterinarian about the possible risks of using the drug versus the benefits it may have.

What are the side effects of this medication?

Common but not serious side effects include:

•Excessive thirst and greater need to urinate.

•Low energy. This temporary effect should improve with time.

•Water and electrolyte imbalances.

•Spironolactone can cause enlarged breasts in men; it is not known if this occurs in animals, but if the animal’s nipples or breasts enlarge, contact your veterinarian.

•Vomiting and/or diarrhea.

You don’t have to be overly concerned if you see any of these effects unless they are severe, worsen, or continue to be a problem. Contact your veterinarian if this happens.

Side effects that may be serious or indicate a serious problem:

•Cats: severe, itchy sores on face. Seen most often in Maine coon cats.

•Excessive thirst with no urination.

•Excessive weakness or collapse; unable to get up.

•Fast heartbeat.

Contact your veterinarian immediately if you notice any of these effects.

If my animal gets too much of this medication (an overdose), what should I do?

Overdoses of spironolactone may be serious. If you witness or suspect an overdose, contact your veterinarian or an animal poison control center for further advice. Animal poison control centers that are open 24 hours a day include: Pet Poison HELPLINE (855-764-7661) and ASPCA Animal Poison Control Center (888-426-4435); a consultation fee is charged for these services.

How should this medication be given?

For this medication to work, give it exactly as your veterinarian has prescribed. It’s a good idea to always check the prescription label to be sure you are giving the drug correctly.

•Unless your veterinarian tells you differently, make sure that your animal always has plenty of fresh, clean water available while getting this drug.

•This medicine may be given with or without food. If your animal vomits or acts sick after receiving the drug on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.

•Since this medication may cause your animal to urinate more often than normal, try to avoid giving the last dose of the day within a few hours of bedtime to reduce the need to get up during the night to let your animal out to urinate. Your veterinarian can suggest the best times to give this drug to your animal to help avoid this problem. NEVER withhold water to avoid your animal’s need to urinate more frequently.

•Compounded liquid forms of this medication must be measured carefully. Your veterinarian or pharmacist can help by providing special measuring spoons or syringes.

•If you have difficulty getting your animal to take this medication, contact your veterinarian or pharmacist for tips to help dosing and reducing the stress of medication time.

•This medication can be given for various lengths of time. Be sure you understand how long your veterinarian wants you to continue giving this medication. Prescription refills may be necessary before the therapy will be complete. Before stopping this medication, talk to your veterinarian, as there may be important reasons to continue its use.

What should I do if I miss giving a dose of this medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time. After that, return to the regular dosing schedule. Do not double-up or give extra doses.

How should I store this medication?

•Spironolactone tablets should be stored in tightly closed child- and light-resistant containers at room temperature; protect tablets from moisture.

•If your veterinarian or pharmacist has made (compounded) a special formulation for your animal, follow the noted storage recommendations and expiration date for the product. Compounded liquid forms of this medication are usually stored in the refrigerator and protected from light or freezing.

•Keep away from children and other animals.

•Wash your hands after handling any medication.

Can handling this medication be hazardous to me, my family, or other animals?

•In case of accidental skin contact, wash area thoroughly with water. Avoid contact with eyes. In case of accidental ingestion by humans, contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans.

•Keep this and all drugs our of reach of other animals and children.

How should I dispose of this medication if I don’t use it all?

•Do not flush this medication down the toilet or wash it down the sink. If a community drug “take-back” program is available, use this option. If there is no take-back program, mix the drug with coffee grounds or cat litter (to make it undesirable to children and animals and unrecognizable to people who might go through your trash), place the mixture in a sealable plastic bag to keep it from leaking out, and throw the bag out with the regular trash.

•Do not save leftover medication for future use or give it to others to use.

What other information is important for this medication?

•The use of spironolactone in performance horses is regulated state by state.

•Use of this drug may not be allowed in certain animal competitions. Check rules and regulations before entering your animal in a competition or performance while this medication is being administered.

•While your animal is taking this medication, your veterinarian will need to do periodic examinations and blood tests to monitor your animal. Do not miss these important follow-up visits.