Contraindications

Children under 18 years
Addison's disease
Anuria
Breastfeeding
Dehydration
Galactosaemia
Hyperkalaemia
Hypovolaemia
Long QT syndrome
Porphyria
Renal damage secondary to nephrotoxic agents
Renal impairment - creatinine clearance below 30ml/minute/1.73m sq
Renal impairment associated with hepatic coma
Renal impairment secondary to hepatotoxic agents
Severe hypokalaemia
Severe hyponatraemia
Torsade de pointes

Precautions and Warnings

Elderly
Family history of long QT syndrome
Hypoproteinaemia
Predisposition to hypotension
Predisposition to hypovolaemia
Predisposition to radio-contrast induced nephropathy
Predisposition towards electrolyte imbalance
Diabetes mellitus
Electrolyte imbalance
Glucose-galactose malabsorption syndrome
Gout
Hepato-renal syndrome
History of torsade de pointes
Hypotension
Lactose intolerance
Pregnancy
Prostate cancer
Renal impairment - creatinine clearance 30-60ml/minute/1.73m sq
Systemic lupus erythematosus
Urinary obstruction

Pregnancy and Lactation

Pregnancy

Use spironolactone with furosemide with caution in pregnancy.

Avoid use during pregnancy if possible. Diuretics are no longer used as standard therapy during pregnancy and should only be used for particular indications. Furosemide may be used when treatment of cardiac or renal failure requires a diuretic. Spironolactone should only be chosen if therapy with an aldosterone antagonist is absolutely necessary.

Lactation

Spironolactone with furosemide is contraindicated in breastfeeding.

Side Effects

Abnormal vision
Acute generalised exanthematous pustulosis
Agranulocytosis
Allergic reaction
Anaphylactic reaction
Anaphylactoid reaction
Androgen type effects
Aplastic anaemia
Ataxia
Blood urea increased
Bone marrow depression
Bullous pemphigoid
Bullous reactions
Cardiac arrhythmias
Confusion
Decrease in blood pressure
Decrease in plasma calcium
Decreased glucose tolerance
Dehydration
Diarrhoea
Dizziness
Drowsiness
Drug rash with eosinophilia and systemic symptoms (DRESS)
Dry mouth
Elevated triglyceride levels
Eosinophilia
Erythema multiforme
Exacerbation of systemic lupus erythematosus
Exfoliative dermatitis
Fever
Fluctuating serum potassium levels
Fluid and electrolyte disturbances
Gastro-intestinal symptoms
Gout
Gynaecomastia
Haemolytic anaemia
Headache
Hearing disturbances
Hepatic encephalopathy
Hirsutism
Hyperglycaemia
Hypochloraemic alkalosis
Hyponatraemia
Hypotension
Hypovolaemia
Impaired concentration
Increase in plasma cholesterol
Increase of liver transaminases
Increased uric acid level
Interstitial nephritis
Intrahepatic cholestasis
Itching
Leucopenia