Q: At a recent presentation by a local physician, I learned of an old drug that is being “rediscovered” as a miracle for high blood pressure – spironolactone. Specific mention was new research done at the Mayo Clinic.
It’s a low-cost generic so we aren’t going to be seeing advertisements for it by the drug companies but is this a drug I should be considering to control my blood pressure?
A: Spironolactone is a diuretic (water pill) that works in a variety of ways. It is sometimes used in combination with other medications to treat hypertension, congestive heart failure. It prevents a person’s potassium levels from dropping too low, keeps the body from absorbing too much salt, helps control fluid retention in both liver cirrhosis and a kidney disorder known as nephrotic syndrome. It also treats a condition that can result in too much aldosterone in the body. Aldosterone is a hormone produced by the adrenal glands that, when working properly, regulates a person’s salt/water balance efficiently.
There are circumstances in which the drug is ill-advised, such as when a person consumes too much salt or products containing potassium, drinking alcohol, and when becoming dehydrated. The consumption of too much salt will cause the body to retain water. Salt substitutes and low-sodium milk products can cause potassium levels to rise to unsafe levels, a condition known as hyperkalemia. Alcohol can exacerbate the side effects of the drug; and, lastly, drinking too much liquid following periods of excessive sweating or with dehydration can be unsafe.
A patient should take the medication specifically as recommended by his or her physician. Each dose should be taken with a full eight ounce glass of water and the individual should have periodic blood tests to avoid unwanted side effects. Ordinary dosing for hypertension, fluid retention, and hypokalemia is between 25 and 200 mg daily by mouth in one or two divided doses. Doses vary for the treatment of congestive heart failure, hyperaldosteronism and excessive body hair.
Side effects include muscle pain or weakness, decreased urinary output, tremors, confusion, paresthesias, an uneven heart rate, nausea, dry mouth, irregular menses, abnormal hair growth on various parts of the body, vomiting, headache, skin rash and more. As I have stated frequently, some individuals can take a medication and have extremely good results without any side effects, while others may be unable to tolerate a drug – even if it is over-the-counter ibuprofen. It appears you are fortunate and without unwanted issues.
Individuals considering the drug should give their health care providers information on all other drugs they currently take, including prednisone, non-steroidal anti-inflammatories to include ibuprofen, naproxen, numerous prescription drugs, and over-the-counter therapies such as potassium supplements and herbals.
Readers who would like related information can request Dr. Gott’s Health Reports “Hypertension: and “Consumer Tips on Medicine” by sending a self-addressed, stamped number 10 envelope and a $2 (for each report) US check or money order to Peter H. Gott, M.D. Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print an order form from www.AskDrGottMD.com.