Aldactone vs Spironolactone

Introduction

According to the World Heart Federation, hypertension affects every one in four adults and is considered the major risk factor for fatalities worldwide. With hypertension becoming a common health concern, scientists have developed several medications to help people maintain controlled hypertension levels. Aldactone and Spironolactone are two medications commonly prescribed by healthcare providers for patients with hypertension. Aldactone is a brand-name medication containing the active ingredient Spironolactone. Spironolactone is also available as a generic drug.[1][2]

About Aldactone and Spironolactone

What is Aldactone?

Aldactone was approved by the FDA in 2001. It is a potassium-sparing diuretic, also known as an aldosterone antagonist, prescribed to treat several conditions, including hypertension, heart failure, etc. It contains the active ingredient spironolactone and is available worldwide only on a prescription basis. Aldactone's superiority over other diuretics is one element that makes it a preferred medication among healthcare practitioners. Unlike other diuretic drugs, Aldactone does not lead to a decrease in potassium levels in the human body.[3][4]

What conditions is Aldactone approved to treat?

Aldactone is approved to treat several health conditions, including:

• Hypertension
• Heart failure
• Cirrhosis of the liver
• Nephrotic syndrome (kidney disorder)
• Hyperaldosteronism (when the body produces an excessive amount of hormone called aldosterone)

How does Aldactone work for Hypertension?

Aldactone is a pharmacologic antagonist that blocks the hormone aldosterone, allowing the kidneys to eliminate extra fluid and sodium. This helps lower the fluid and sodium levels in the bloodstream and leads to excessive urination without lowering potassium levels. This mechanism of action allows Aldactone to serve both as an antihypertensive medication and a diuretic.[5]

What is Spironolactone?

Spironolactone is an aldosterone blocker initially reported by Robert C. Tweit and John A. Cella in 1959. It is mentioned in the World Health Organization's List of Essential Medicines. Spironolactone is sold under the brand-name drug Aldactone and is also available as a generic medication (generic Aldactone). It is a potassium-sparing diuretic widely prescribed to treat hypertension, fluid buildup, and several other conditions.[6][7]

What conditions is Spironolactone approved to treat?

• Spironolactone is approved by the FDA (Food and Drug Administration) to treat several health conditions, including[8]:
• Edema (fluid retention or swelling in the legs or abdomen)
• Heart failure
• Hyperaldosteronism (when the body produces an excessive amount of hormone called aldosterone)
• High blood pressure

How does Spironolactone work for Hypertension?

Spironolactone lowers blood pressure by blocking sodium-potassium exchange channels in the distal convoluted tubule. This enables water and sodium excretion, which has an antihypertensive and diuretic impact. Unlike other diuretics, Spironolactone aids in potassium retention.[9]

Effectiveness

How effective are Aldactone and Spironolactone for treating Hypertension?

Both Spironolactone and Aldactone are highly effective medications in the treatment of hypertension. Since Spironolactone is the active drug in Aldactone, they are treated as identical drugs, and there are no separate studies on the two. The effectiveness of Spironolactone can be measured by a 2020 study conducted on the clinical efficacy and safety of Spironolactone in individuals with resistant hypertension.

The study summarized all available information from the control and randomized trial studies based on the efficiency and safety of Spironolactone in individuals with resistant hypertension. The study produced a quantitative assessment that highlighted that Spironolactone could substantially reduce blood pressure in individuals with resistant hypertension within three months.[10]

Dosage information

How is Aldactone administered for Hypertension?

Aldactone is sold in three strengths: 25, 50, and 100 mg in tablet form. It is administered in either a single or divided dose. These tablets must be administered with food around the same time every day to be most effective.[11]

Aldactone dosage information

The table below includes important dosage information for Aldactone for treating hypertension.[12]

How is Spironolactone administered for Hypertension?

Spironolactone comes in two forms: a suspension (liquid: Carospir) and a tablet, which are meant to be administered orally. Spironolactone suspension must be taken with or without food every time and administered around the same timeframe daily. Spironolactone suspension and tablets release the drug into the body in different ways. Therefore, they must not be substituted by one another.

Spironolactone dosage information

The table below includes important dosage information for Spironolactone for treating hypertension.[13][14]

Side Effects

What are the most common side effects of Aldactone?

Breast swelling or tenderness are the most common side effects of Aldactone.[15]

Are there any potential serious side effects of Aldactone?

Potentially serious side effects of Aldactone include:

• Allergic reaction (swelling of tongue, lips, or throat, difficulty breathing, hives)
• Feeling of lightheadedness
• Little to no urination
• High potassium levels (loss of movement, irregular heartbeat, nausea, chest pain, tingly feet, weakness)
• Symptoms of electrolyte imbalance (vomiting, muscle pain, confusion, feeling unsteady, severe weakness, slurred speech, increased urination or thirst)

Note! If you experience any of the above serious side effects, seek medical help immediately.

Are there the most common side effects of Spironolactone?

Breast swelling or tenderness are the most common side effects of Spironolactone.[16]

Are there any potential serious side effects of Spironolactone?

Potentially serious side effects of Spironolactone include:

• Allergic reaction (swelling of tongue, lips, or throat, difficulty breathing, hives)
• Feeling of lightheadedness
• Little to no urination
• High potassium levels (loss of movement, irregular heartbeat, nausea, chest pain, tingly feet, weakness)
• Symptoms of electrolyte imbalance (vomiting, muscle pain, confusion, feeling unsteady, severe weakness, slurred speech, increased urination or thirst)

Note! If you experience any of the above serious side effects, seek medical help immediately.

Contraindications and interactions

Warnings and general precautions for Aldactone and Spironolactone

Aldactone and Spironolactone are known to cause hyperkalemia (increased potassium levels). Therefore, it is strongly advised for individuals on these medications to avoid consuming potassium-rich foods or supplements.

Patients are also advised to monitor their potassium levels when on Aldactone or Spironolactone and decrease the dose or discontinue the medication if their potassium levels are elevated (after consulting their doctor). It is also critical to inform your doctor if you are pregnant, breastfeeding, or planning to become pregnant while on Aldactone and Spironolactone. Patients on Aldactone and Spironolactone must also avoid alcohol consumption since alcohol can cause excessive dizziness or lightheadedness and worsen other side effects.[17]

Contraindications and important interactions for Aldactone and Spironolactone

Cost Comparison

How much do Aldactone and Spironolactone cost?

25 mg Aldactone oral tablets cost approximately $292 (100 tablets), whereas 25 mg Spironolactone oral tablets cost approximately $13 (30 tablets). The cost of both medications may vary depending on your insurance, geographical location, and the pharmacy you visit.[18][19]

Popularity of Aldactone and Spironolactone

Aldactone and Spironolactone are highly popular treatment options for hypertension. Spironolactone was rated 51st on the list of the most commonly prescribed drugs in the United States in 2020, with over 13 million prescriptions. Healthcare practitioners more commonly prescribe Spironolactone since it is significantly cheaper than Aldactone when sold separately as a generic medicine.[20]

Conclusion

Takeaway

Both Aldactone and Spironolactone have a promising history of helping hypertensive individuals control their hypertension levels. There are several studies indicating Aldactone and Spironolactone as effective treatments in the management of hypertension. Spironolactone is the key ingredient in Aldactone. Therefore, both medications are the same and have identical side effect profiles.

However, Spironolactone is also sold separately as a generic medication which offers significant cost-saving benefits for individuals who may not be able to afford Aldactone. For both drugs, patients must closely monitor their symptoms and potassium levels and seek immediate medical attention if they notice the onset of any serious side effects.