Spironolactone

Identification

Name

Spironolactone

Accession Number

DB00421

Description

Spironolactone is a potassium sparing diuretic like eplerenone that competitively inhibits mineralocorticoid receptors in the distal convoluted tubule to promote sodium and water excretion and potassium retention.⁸. Spironolactone was originally developed purely for this ability before other pharmacodynamic properties of the drug were discovered.^8,11 It is indicated to treat a number of conditions including heart failure, deem, hyperaldosteronism, adrenal hyperplasia, hypertension, and nephrotic syndrome.^Label Off label uses of spironolactone involving its antiandrogenic activity include hirsutism, female pattern hair loss, and adult acne vulgaris.⁴ Spironolactone is also frequently used in medical gender transition.⁵

Spironolactone was developed in 1957, marketed in 1959, and approved by the FDA on January 21, 1960.^10,12

Type

Small Molecule

Groups

Approved

Structure

3D

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MOLSDF3D-SDFPDBSMILESInChI

Similar Structures

Structure for Spironolactone (DB00421)

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Weight

Average: 416.573
Monoisotopic: 416.202130202

Chemical Formula

C₂₄H₃₂O₄S

Synonyms

• Espironolactona
• Spironolactone
• Spironolactonum
• Spironolattone

External IDs

• NSC-150399
• SC-9420

Pharmacology

Indication

Spironolactone is indicated for the treatment of New York Heart Association Class III-IV heart failure, management of edema in cirrhotic adults not responsive to fluid and sodium restrictions, primary hyperaldosteronism short-term preoperatively, primary hyperaldosteronism long-term in patients with aldosterone producing adrenal adenomas that are not candidates for surgery or patients with bilarteral micro/macronodular adrenal hyperplasia, as an add-on therapy in hypertension, and in nephrotic syndrome when treatment of the disease as well as fluid and sodium restriction with other diuretics is inadequate.^Label

Spironolactone has antiandrogenic activity which leads to many of its off label uses. Spironolactone is used off label in the treatment of hirsutism, female pattern hair loss, and adult acne vulgaris.⁴

Spironolactone is also frequently used for its antiandrogenic effects in transgender female patients due to its low cost and reducing male-pattern hair growth.⁵

Associated Conditions

• Acne
• Ascites
• Congestive Heart Failure (CHF)
• Edema
• High Blood Pressure (Hypertension)
• Hirsutism
• Hypokalemia
• Nephrotic Syndrome
• Primary Hyperaldosteronism
• Chronic heart failure with reduced ejection fraction (NYHA Class III)
• Chronic heart failure with reduced ejection fraction (NYHA Class IV)
• Idiopathic hyperaldosteronism

Contraindications & Blackbox Warnings

Learn about our commercial Contraindications & Blackbox Warnings data.

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Pharmacodynamics

Originally spironolactone was only studied for its potassium sparing diuretic effect.⁸ Spironolactone competitively inhibits mineralocorticoid receptors in the distal convoluted tubule to promote sodium and water excretion and potassium retention.⁸. Inhibition of this receptor leads to increased renin and aldosterone levels.⁸

Spironolactone is structurally similar to progesterone and as a result is associated with progestogenic and antiandrogenic effects.⁸

Mechanism of action

Spironolactone competitively inhibits aldosterone dependant sodium potassium exchange channels in the distal convoluted tubule.^Label This action leads to increased sodium and water excretion, but more potassium retention.^Label The increased excretion of water leads to diuretic and also antihypertensive effects.^Label

Target	Actions	Organism
AMineralocorticoid receptor	antagonist	Humans
UAndrogen receptor	antagonist	Humans
UProgesterone receptor	agonist	Humans
UGlucocorticoid receptor	antagonist	Humans
UCytochrome P450 11B2, mitochondrial	antagonist	Humans
USteroid 17-alpha-hydroxylase/17,20 lyase	antagonist	Humans
U3-oxo-5-alpha-steroid 4-dehydrogenase	antagonist	Humans
USex hormone-binding globulin	binder	Humans
UVoltage-dependent calcium channel	inhibitor	Humans
UNuclear receptor subfamily 1 group I member 2	Not Available	Humans

Absorption

Spironolactone reaches a maximum concentration in 2.6 hours and an active metabolite (canrenone) reaches a maximum concentration in 4.3 hours.^Label When taken with food, the bioavailability of spironolactone increases to 95.4%.^Label

Giving spironolactone with food increases the maximum concentration from 209ng/mL to 301ng/mL.⁶ The time to maximum concentration also increases from 2.28 hours to 3.05 hours.⁶ The area under the curve varies from 2103ng/mL*hr to 4544ng/mL*hr.⁶

Volume of distribution

Volume of distribution data is not readily available.^Label,7

Protein binding

>90%.^Label Canrenone is as much as 98% protein bound.⁶

Metabolism

Spironolactone is deacetylated to 7α-thiospironolactone.^2,3 7α-thiospironolactone is S-methylated to 7α-thiomethylspironolactone or undergoes an elimination reaction to canrenone.^2,3 7α-thiomethylspironolactone is reduced to 3α-hydroxythiomethylspironolactone or 3β-hydroxythiomethylspironolactone.^2,3

Canrenone was originally thought to be the primary circulating metabolite, however more recent studies have demonstrated that the primary metabolite is actually 7α-thiomethylspironolactone.^8,9

Hover over products below to view reaction partners

• Spironolactone
  • 7alpha-thiospironolactone
    • 7alpha-thiomethylspironolactone
      • 3beta-hydroxythiomethylspironolactone
      • 3alpha-hydroxythiomethylspironolactone
    • Canrenone

Route of elimination

Metabolites of spironolactone are excreted 42-56% in urine, and 14.2-14.6% in the feces.⁶ No unmetabolized spironolactone is present in the urine.⁶

Half-life

1.4 hours.^Label,7

Canrenone has a half life of 16.5 hours, 7-α-thiomethylspirolactone has a half life of 13.8 hours, and 6-ß-hydroxy-7-α-thiomethylspirolactone has a half life of 15 hours.^Label,7

Clearance

Clearance data is not readily available.^Label,7

Adverse Effects

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Toxicity

Patients experiencing an overdose may present with drowsiness, mental confusion, maculopapular or erythematous rash, nausea, vomiting, dizziness, or diarrhea. Vomiting is generally induced or a gastric lavage is performed.^Label Supportive treatment involves maintining hydration, electrolyte balance, and vital functions^Label.

The oral LD50 in mice, rats, and rabbits is >1g/kg.^Label

Spironolactone should be avoided in pregnancy due to reports of feminization of male fetuses in animal studies.^Label Active metabolites of spironolactone are present in breast milk and levels that are likely inconsequential, though the long term effects have not been studied.^Label

In animal studies, spironolactone slowed follicle development, ovulation, and implantation.^Label Spironolactone increased the incidence of benign adenomas in the testes of male rats, benign uterine endometrial stromal polyps in female rats, and thyroid follicular cell adenomas in both sexes of rats.^Label Spironolactone and canrenone are generally not considered to be mutagenic in tests but canrenone occasionally tests positive for mutagenicity with metabolic activation and spironolactone has occasionally tested inconclusive though slightly positive for mutagenicity.^Label

Affected organisms

• Humans and other mammals

Pathways

Pathway	Category
Spironolactone Action Pathway	Drug action

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drug	Interaction
Unlock Additional Data
Abacavir	Spironolactone may increase the excretion rate of Abacavir which could result in a lower serum level and potentially a reduction in efficacy.
Abiraterone	The therapeutic efficacy of Abiraterone can be decreased when used in combination with Spironolactone.
Acarbose	Spironolactone may increase the excretion rate of Acarbose which could result in a lower serum level and potentially a reduction in efficacy.
Acebutolol	The risk or severity of hyperkalemia can be increased when Spironolactone is combined with Acebutolol.
Aceclofenac	The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Aceclofenac is combined with Spironolactone.
Acemetacin	The therapeutic efficacy of Spironolactone can be decreased when used in combination with Acemetacin.
Acetaminophen	Spironolactone may increase the excretion rate of Acetaminophen which could result in a lower serum level and potentially a reduction in efficacy.
Acetyldigitoxin	Spironolactone may decrease the excretion rate of Acetyldigitoxin which could result in a higher serum level.
Acetylsalicylic acid	Acetylsalicylic acid may decrease the excretion rate of Spironolactone which could result in a higher serum level.
Aclidinium	Spironolactone may increase the excretion rate of Aclidinium which could result in a lower serum level and potentially a reduction in efficacy.

Additional Data Available

Extended Description
Extended Description
Extended description of the mechanism of action and particular properties of each drug interaction.
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Severity
Severity
A severity rating for each drug interaction, from minor to major.
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Evidence Level
Evidence Level
A rating for the strength of the evidence supporting each drug interaction.
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Action
Action
An effect category for each drug interaction. Know how this interaction affects the subject drug.
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Food Interactions

• Avoid alcohol.
• Avoid potassium-containing products. Potassium products increase the risk of hyperkalemia.
• Take with or without food. Food increases the bioavailability of spironolactone by nearly 100%. It should be taken at a consistent time in regards to food.

Products

Product Images

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International/Other Brands

Osyrol / Spiresis / Spiretic / Spiroctan / Uractone / Verospiron / Xenalon

Brand Name Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Unlock Additional Data
Aldactone	Tablet, film coated	100 mg/1	Oral	G.D. Searle LLC Division of Pfizer Inc	1960-01-21	Not applicable
Aldactone	Tablet, film coated	25 mg/1	Oral	REMEDYREPACK INC.	2018-08-31	2020-05-20
Aldactone	Tablet, film coated	50 mg/1	Oral	G.D. Searle LLC Division of Pfizer Inc	1960-01-21	Not applicable
Aldactone	Tablet, film coated	50 mg/1	Oral	Physicians Total Care, Inc.	1995-04-24	2011-06-30
Aldactone	Tablet, film coated	25 mg/1	Oral	G.D. Searle LLC Division of Pfizer Inc	1960-01-21	Not applicable
Aldactone 100 mg	Tablet		Oral	Pfizer Canada Ulc	1975-12-31	Not applicable
Aldactone 25 mg	Tablet		Oral	Pfizer Canada Ulc	1959-12-31	Not applicable
CaroSpir	Suspension	25 mg/5mL	Oral	Cmp Pharma, Inc.	2017-08-04	Not applicable
CaroSpir	Suspension	25 mg/5mL	Oral	Atlantic Biologicals Corp.	2018-08-22	Not applicable
Spironolactone	Tablet, film coated	25 mg/1	Oral	Vintage Pharmaceuticals, LLC	2006-10-31	2006-10-31

Additional Data Available

Application Number
Application Number
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
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Product Code
Product Code
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
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Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Unlock Additional Data
Mint-spironolactone	Tablet		Oral	Mint Pharmaceuticals Inc	2020-02-06	Not applicable
Mint-spironolactone	Tablet		Oral	Mint Pharmaceuticals Inc	2020-02-06	Not applicable
Ntp-spironolactone	Tablet		Oral	Nt Pharma Canada Ltd	Not applicable	Not applicable
Ntp-spironolactone	Tablet		Oral	Nt Pharma Canada Ltd	Not applicable	Not applicable
Spironolactone	Tablet, film coated	100 mg/1	Oral	PD-Rx Pharmaceuticals, Inc.	2017-06-02	Not applicable
Spironolactone	Tablet, film coated	50 mg/1	Oral	Nucare Pharmaceuticals, Inc.	1986-07-23	Not applicable
Spironolactone	Tablet, film coated	25 mg/1	Oral	bryant ranch prepack	2017-06-02	Not applicable
Spironolactone	Tablet, film coated	50 mg/1	Oral	bryant ranch prepack	2020-06-05	Not applicable
Spironolactone	Tablet, film coated	25 mg/1	Oral	Ncs Health Care Of Ky, Inc Dba Vangard Labs	2001-08-20	Not applicable
Spironolactone	Tablet, film coated	25 mg/1	Oral	Preferred Pharmaceuticals Inc.	2017-02-13	Not applicable

Additional Data Available

Application Number
Application Number
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
Learn more
Product Code
Product Code
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
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Mixture Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End	Region	Image
Aldactazide	Spironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)	Tablet, film coated	Oral	G.D. Searle LLC Division of Pfizer Inc	1978-01-01	Not applicable
Aldactazide	Spironolactone (50 mg/1) + Hydrochlorothiazide (50 mg/1)	Tablet, film coated	Oral	G.D. Searle LLC Division of Pfizer Inc	1978-01-01	Not applicable
Aldactazide 25	Spironolactone (25 mg) + Hydrochlorothiazide (25 mg)	Tablet	Oral	Pfizer Canada Ulc	1960-12-31	2020-04-01
Aldactazide 50	Spironolactone (50 mg) + Hydrochlorothiazide (50 mg)	Tablet	Oral	Pfizer Canada Ulc	1983-12-31	2020-04-01
Apo-spirozide Tab	Spironolactone (25 mg) + Hydrochlorothiazide (25 mg)	Tablet	Oral	Apotex Corporation	1991-12-31	2011-08-05
Spironolactone and Hydrochlorothiazide	Spironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)	Tablet, film coated	Oral	A S Medication Solutions	1978-01-01	Not applicable
Spironolactone and Hydrochlorothiazide	Spironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)	Tablet	Oral	Mylan Pharmaceuticals Inc.	1979-08-03	Not applicable
Spironolactone and Hydrochlorothiazide	Spironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)	Tablet	Oral	bryant ranch prepack	2020-06-10	Not applicable
Spironolactone and Hydrochlorothiazide	Spironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)	Tablet	Oral	Amerincan Health Packaging	2015-03-31	2018-02-28
Spironolactone and Hydrochlorothiazide	Spironolactone (25 mg/1) + Hydrochlorothiazide (25 mg/1)	Tablet	Oral	bryant ranch prepack	2020-06-10	Not applicable

Unapproved/Other Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End	Region	Image
011054 Niacinamide 4% / Spironolactone 5%	Spironolactone (5 g/100g) + Nicotinamide (4 g/100g)	Gel	Topical	Sincerus Florida, LLC	2020-07-02	Not applicable
011218 Niacinamide 2% / Spironolactone 5% / Tretinoin 0.025%	Spironolactone (5 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.025 g/100g)	Gel	Topical	Sincerus Florida, LLC	2020-07-02	Not applicable
011220 Niacinamide 2% / Spironolactone 5% / Tretinoin 0.05%	Spironolactone (5 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.05 g/100g)	Gel	Topical	Sincerus Florida, LLC	2020-07-02	Not applicable
011503 Dapsone 6% / Niacinamide 2% / Spironolactone 5%	Spironolactone (5 g/100g) + Dapsone (6 g/100g) + Nicotinamide (2 g/100g)	Gel	Topical	Sincerus Florida, LLC	2020-07-02	Not applicable
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Spironolactone 2%	Spironolactone (2 g/100g) + Benzoyl peroxide (5 g/100g) + Clindamycin phosphate (1 g/100g) + Nicotinamide (2 g/100g)	Gel	Topical	Sincerus Florida, LLC	2019-05-11	Not applicable
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Spironolactone 2% / Tretinoin 0.025%	Spironolactone (2 g/100g) + Benzoyl peroxide (5 g/100g) + Clindamycin phosphate (1 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.025 g/100g)	Gel	Topical	Sincerus Florida, LLC	2019-05-04	Not applicable
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Spironolactone 2% / Tretinoin 0.05%	Spironolactone (2 g/100g) + Benzoyl peroxide (5 g/100g) + Clindamycin phosphate (1 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.05 g/100g)	Gel	Topical	Sincerus Florida LLC	2019-05-03	Not applicable
Clindamycin 1% / Niacinamide 4% / Spironolactone 2% / Tretinoin 0.025%	Spironolactone (2 g/100g) + Clindamycin phosphate (1 g/100g) + Nicotinamide (4 g/100g) + Tretinoin (0.025 g/100g)	Gel	Topical	Sincerus Florida, LLC	2019-05-04	Not applicable
Dapsone 6% / Niacinamide 2% / Spironolactone 5%	Spironolactone (5 g/100g) + Dapsone (6 g/100g) + Nicotinamide (2 g/100g)	Gel	Topical	Sincerus Florida, LLC	2019-05-11	Not applicable
Dapsone 8.5% / Niacinamide 2% / Spironolactone 5%	Spironolactone (5 g/100g) + Dapsone (8.5 g/100g) + Nicotinamide (2 g/100g)	Gel	Topical	Sincerus Florida, LLC	2019-05-10	Not applicable

Categories

ATC Codes

C03DA01 — Spironolactone

• C03DA — Aldosterone antagonists
• C03D — POTASSIUM-SPARING AGENTS
• C03 — DIURETICS
• C — CARDIOVASCULAR SYSTEM

Drug Categories

• Agents causing hyperkalemia
• Antihypertensive Agents
• Antihypertensive Agents Indicated for Hypertension
• BSEP/ABCB11 Substrates
• Cardiovascular Agents
• Cytochrome P-450 CYP2C8 Inhibitors
• Cytochrome P-450 CYP2C8 Inhibitors (moderate)
• Cytochrome P-450 Enzyme Inhibitors
• Diuretics
• Fused-Ring Compounds
• Hormone Antagonists
• Hormones, Hormone Substitutes, and Hormone Antagonists
• Hypotensive Agents
• Lactones
• Mineralocorticoid (Aldosterone) Receptor Antagonists
• Mineralocorticoid Receptor Antagonists
• Natriuretic Agents
• P-glycoprotein inducers
• Potassium-Sparing Diuretics
• Pregnanes
• Pregnenes
• Steroids

Chemical TaxonomyProvided by Classyfire

Description

This compound belongs to the class of organic compounds known as spironolactones and derivatives. These are steroid lactones with a structure based on the spironolactone skeleton.

Kingdom

Organic compounds

Super Class

Lipids and lipid-like molecules

Class

Steroids and steroid derivatives

Sub Class

Steroid lactones

Direct Parent

Spironolactones and derivatives

Alternative Parents

3-oxo delta-4-steroids / Delta-4-steroids / Cyclohexenones / Gamma butyrolactones / Tetrahydrofurans / Thioesters / Carboxylic acid esters / Carbothioic S-esters / Sulfenyl compounds / Oxacyclic compounds / Monocarboxylic acids and derivatives / Organic oxides / Hydrocarbon derivatives

show 3 more

Substituents

3-oxo-delta-4-steroid / 3-oxosteroid / Aliphatic heteropolycyclic compound / Carbonyl group / Carbothioic s-ester / Carboxylic acid derivative / Carboxylic acid ester / Cyclic ketone / Cyclohexenone / Delta-4-steroid / Gamma butyrolactone / Hydrocarbon derivative / Ketone / Lactone / Monocarboxylic acid or derivatives / Organic oxide / Organic oxygen compound / Organoheterocyclic compound / Organooxygen compound / Organosulfur compound / Oxacycle / Oxosteroid / Spironolactone / Sulfenyl compound / Tetrahydrofuran / Thiocarboxylic acid ester / Thiocarboxylic acid or derivatives

show 17 more

Molecular Framework

Aliphatic heteropolycyclic compounds

External Descriptors

thioester, 3-oxo steroid, methyl ketone, oxaspiro compound, steroid lactone (CHEBI:9241) / Pregnane and derivatives [Fig] (C07310)

Chemical Identifiers

UNII

27O7W4T232

CAS number

52-01-7

InChI Key

LXMSZDCAJNLERA-ZHYRCANASA-N

InChI

InChI=1S/C24H32O4S/c1-14(25)29-19-13-15-12-16(26)4-8-22(15,2)17-5-9-23(3)18(21(17)19)6-10-24(23)11-7-20(27)28-24/h12,17-19,21H,4-11,13H2,1-3H3/t17-,18-,19+,21+,22-,23-,24+/m0/s1

IUPAC Name

(1'S,2R,2'R,9'R,10'R,11'S,15'S)-9'-(acetylsulfanyl)-2',15'-dimethylspiro[oxolane-2,14'-tetracyclo[8.7.0.0²,⁷.0¹¹,¹⁵]heptadecan]-6'-ene-5,5'-dione

SMILES

[H][[email protected]@]12CC[[email protected]@]3(CCC(=O)O3)[[email protected]@]1(C)CC[[email protected]@]1([H])[[email protected]@]2([H])[[email protected]@]([H])(CC2=CC(=O)CC[[email protected]]12C)SC(C)=O

References

Synthesis Reference

Giuseppe Bernini, "Process for preparing micronized spironolactone." U.S. Patent US4332721, issued July, 1975.

US4332721

General References

1. Takamura N, Maruyama T, Ahmed S, Suenaga A, Otagiri M: Interactions of aldosterone antagonist diuretics with human serum proteins. Pharm Res. 1997 Apr;14(4):522-6. [PubMed:9144743]
2. LaCagnin LB, Lutsie P, Colby HD: Conversion of spironolactone to 7 alpha-thiomethylspironolactone by hepatic and renal microsomes. Biochem Pharmacol. 1987 Oct 15;36(20):3439-44. [PubMed:3675606]
3. Los LE, Pitzenberger SM, Ramjit HG, Coddington AB, Colby HD: Hepatic metabolism of spironolactone. Production of 3-hydroxy-thiomethyl metabolites. Drug Metab Dispos. 1994 Nov-Dec;22(6):903-8. [PubMed:7895608]
4. Kim GK, Del Rosso JQ: Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris: Practical Considerations for the Clinician Based on Current Data and Clinical Experience. J Clin Aesthet Dermatol. 2012 Mar;5(3):37-50. [PubMed:22468178]
5. Millington K, Liu E, Chan YM: The Utility of Potassium Monitoring in Gender-Diverse Adolescents Taking Spironolactone. J Endocr Soc. 2019 Apr 4;3(5):1031-1038. doi: 10.1210/js.2019-00030. eCollection 2019 May 1. [PubMed:31065620]
6. Karim A: Spironolactone: disposition, metabolism, pharmacodynamics, and bioavailability. Drug Metab Rev. 1978;8(1):151-88. doi: 10.3109/03602537808993782. [PubMed:363379]
7. Carone L, Oxberry SG, Twycross R, Charlesworth S, Mihalyo M, Wilcock A: Spironolactone. J Pain Symptom Manage. 2017 Feb;53(2):288-292. doi: 10.1016/j.jpainsymman.2016.12.320. Epub 2016 Dec 23. [PubMed:28024992]
8. Sica DA: Pharmacokinetics and pharmacodynamics of mineralocorticoid blocking agents and their effects on potassium homeostasis. Heart Fail Rev. 2005 Jan;10(1):23-9. doi: 10.1007/s10741-005-2345-1. [PubMed:15947888]
9. Gardiner P, Schrode K, Quinlan D, Martin BK, Boreham DR, Rogers MS, Stubbs K, Smith M, Karim A: Spironolactone metabolism: steady-state serum levels of the sulfur-containing metabolites. J Clin Pharmacol. 1989 Apr;29(4):342-7. [PubMed:2723123]
10. Menard J: The 45-year story of the development of an anti-aldosterone more specific than spironolactone. Mol Cell Endocrinol. 2004 Mar 31;217(1-2):45-52. doi: 10.1016/j.mce.2003.10.008. [PubMed:15134800]
11. BOLTE E, VERDY M, MARC-AURELE J, BROUILLET J, BEAUREGARD P, GENEST J: Studies on new diuretic compounds: spirolactone and chlorothiazide. Can Med Assoc J. 1958 Dec 1;79(11):881-8. [PubMed:13608362]
12. FDA Approved Drug Products: Spironolactone [Link]
13. FDA Approved Drug Products: Aldactone (spironolactone) tablets [Link]

External Links

Human Metabolome Database

HMDB0014565

KEGG Drug

D00443

KEGG Compound

C07310

PubChem Compound

5833

PubChem Substance

46508525

ChemSpider

5628

BindingDB

50228080

RxNav

9997

ChEBI

9241

ChEMBL

CHEMBL1393

ZINC

ZINC000003861599

Therapeutic Targets Database

DAP000297

PharmGKB

PA451483

Guide to Pharmacology

GtP Drug Page

PDBe Ligand

SNL

RxList

RxList Drug Page

Drugs.com

Drugs.com Drug Page

PDRhealth

PDRhealth Drug Page

Wikipedia

Spironolactone

AHFS Codes

• 24:32.20 — Mineralocorticoid (Aldosterone) Receptor Antagonists

PDB Entries

2ab2 / 2oax / 3vhu

FDA label

Download (204 KB)

MSDS

Download (72.6 KB)

Clinical Trials

Clinical Trials

Phase	Status	Purpose	Conditions	Count
4	Active Not Recruiting	Basic Science	Healthy Volunteers / Hypoglycemia	1
4	Active Not Recruiting	Prevention	Disorder Related to Renal Transplantation	1
4	Active Not Recruiting	Treatment	Atrial Fibrillation (AF)	1
4	Completed	Diagnostic	Heart Failure	1
4	Completed	Diagnostic	Heart Failure / Nonischemic Dilated Cardiomyopathy	1
4	Completed	Prevention	Anthracycline Induced Cardiotoxicity	1
4	Completed	Prevention	Chronic Renal Failure (CRF) / End-stage Renal Failure (ESRF)	1
4	Completed	Prevention	Liver Cirrhosis / Portal Hypertension	1
4	Completed	Treatment	Arrhythmia of ventricular origin	1
4	Completed	Treatment	Arterial Elasticity / Arterial Stiffness	1

Pharmacoeconomics

Manufacturers

• Gd searle llc
• Actavis elizabeth llc
• Amneal pharmaceuticals
• Ascot hosp pharmaceuticals inc div travenol laboratories inc
• Ivax pharmaceuticals inc
• Lederle laboratories div american cyanamid co
• Mutual pharmaceutical co inc
• Mylan pharmaceuticals inc
• Purepac pharmaceutical co
• Sandoz inc
• Superpharm corp
• Upsher smith laboratories inc
• Vangard laboratories inc div midway medical co
• Vintage pharmaceuticals llc
• Warner chilcott div warner lambert co
• Watson laboratories inc

Packagers

• Actavis Group
• Advanced Pharmaceutical Services Inc.
• Amerisource Health Services Corp.
• A-S Medication Solutions LLC
• Cardinal Health
• Caremark LLC
• Comprehensive Consultant Services Inc.
• Dept Health Central Pharmacy
• DHHS Program Support Center Supply Service Center
• Direct Dispensing Inc.
• Dispensing Solutions
• Diversified Healthcare Services Inc.
• GD Searle LLC
• Greenstone LLC
• Guna Inc.
• H and H Laboratories
• Heartland Repack Services LLC
• Innoviant Pharmacy Inc.
• Lake Erie Medical and Surgical Supply
• Liberty Pharmaceuticals
• Major Pharmaceuticals
• Mckesson Corp.
• Medisca Inc.
• Murfreesboro Pharmaceutical Nursing Supply
• Mutual Pharmaceutical Co.
• Mylan
• Neighborcare Repackaging Inc.
• Neuman Distributors Inc.
• Nucare Pharmaceuticals Inc.
• Palmetto Pharmaceuticals Inc.
• PD-Rx Pharmaceuticals Inc.
• Pfizer Inc.
• Pharmaceutical Utilization Management Program VA Inc.
• Pharmacia Inc.
• Pharmedix
• Physicians Total Care Inc.
• Preferred Pharmaceuticals Inc.
• Prepackage Specialists
• Prepak Systems Inc.
• Professional Co.
• Qualitest
• Rebel Distributors Corp.
• Remedy Repack
• Resource Optimization and Innovation LLC
• Richmond Pharmacy
• Sandhills Packaging Inc.
• Sandoz
• Southwood Pharmaceuticals
• UDL Laboratories
• Vangard Labs Inc.
• Vintage Pharmaceuticals Inc.

Dosage Forms

Form	Route	Strength
Tablet	Oral	50 mg
Capsule		25 MG
Pill		100 MG
Capsule	Oral	100 mg
Tablet, coated	Oral	25 mg
Tablet	Oral
Tablet, coated	Oral	50 mg
Tablet		25 mg
Suspension	Oral	25 mg/5mL
Tablet, film coated	Oral
Tablet	Oral	100 mg
Tablet, coated	Oral	100 mg
Tablet	Oral	25 mg
Tablet	Oral	20 mg
Gel	Topical
Capsule	Oral	20 mg
Tablet, film coated		100 mg
Tablet, film coated		50 mg
Tablet
Tablet, film coated	Oral	20 mg
Tablet		20 mg
Capsule	Oral	25 MG
Capsule	Oral	50 MG
Tablet		100 MG
Tablet		50 MG
Tablet, film coated	Oral	100 MG
Tablet, film coated	Oral	25 MG
Tablet, film coated	Oral	50 MG
Suspension	Oral	10 mg/1mL
Suspension	Oral	2 mg/1mL
Suspension	Oral	5 mg/1mL
Tablet	Oral	100 mg/1
Tablet	Oral	25 mg/1
Tablet	Oral	50 mg/1
Tablet, film coated	Oral	100 mg/1
Tablet, film coated	Oral	25 mg/1
Tablet, film coated	Oral	50 mg/1
Tablet	Oral
Tablet, film coated	Oral
Tablet, film coated		25 mg

Prices

Unit description	Cost	Unit
Spironolactone powder	12.56USD	g
Aldactone 100 mg tablet	2.14USD	tablet
Aldactazide 50-50 mg tablet	2.02USD	tablet
Aldactazide 50-50 tablet	1.92USD	tablet
Aldactone 50 mg tablet	1.84USD	tablet
Spironolactone 100 mg tablet	1.45USD	tablet
Aldactazide 25-25 mg tablet	1.26USD	tablet
Aldactazide 25-25 tablet	1.04USD	tablet
Spironolactone 50 mg tablet	0.83USD	tablet
Aldactone 25 mg tablet	0.8USD	tablet
Spironolactone-HCTZ 25-25 mg tablet	0.57USD	tablet
Spironolactone 25 mg tablet	0.5USD	tablet
Novo-Spiroton 100 mg Tablet	0.25USD	tablet
Novo-Spiroton 25 mg Tablet	0.11USD	tablet

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)	Region
Unlock Additional Data
US9757394	No	2017-09-12	2036-10-28
US10493083	No	2019-12-03	2036-10-28
US10624906	No	2016-10-28	2036-10-28
US10660907	No	2016-10-28	2036-10-28

Additional Data Available

Filed On
Filed On
The date on which a patent was filed with the relevant government.
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Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	134.5 °C	[MSDS]
boiling point (°C)	201	[MSDS]
logP	2.78	https://www.ncbi.nlm.nih.gov/pubmed/26642673

Predicted Properties

Property	Value	Source
Water Solubility	0.00198 mg/mL	ALOGPS
logP	3.1	ALOGPS
logP	3.64	ChemAxon
logS	-5.3	ALOGPS
pKa (Strongest Acidic)	18.01	ChemAxon
pKa (Strongest Basic)	-4.9	ChemAxon
Physiological Charge	0	ChemAxon
Hydrogen Acceptor Count	3	ChemAxon
Hydrogen Donor Count	0	ChemAxon
Polar Surface Area	60.44 Å2	ChemAxon
Rotatable Bond Count	2	ChemAxon
Refractivity	113.5 m3·mol-1	ChemAxon
Polarizability	46.03 Å3	ChemAxon
Number of Rings	5	ChemAxon
Bioavailability	1	ChemAxon
Rule of Five	Yes	ChemAxon
Ghose Filter	Yes	ChemAxon
Veber's Rule	No	ChemAxon
MDDR-like Rule	No	ChemAxon

Predicted ADMET Features

Property	Value	Probability
Human Intestinal Absorption	+	0.9912
Blood Brain Barrier	+	0.932
Caco-2 permeable	+	0.5432
P-glycoprotein substrate	Substrate	0.5691
P-glycoprotein inhibitor I	Inhibitor	0.6807
P-glycoprotein inhibitor II	Inhibitor	0.8388
Renal organic cation transporter	Non-inhibitor	0.727
CYP450 2C9 substrate	Non-substrate	0.7897
CYP450 2D6 substrate	Non-substrate	0.9116
CYP450 3A4 substrate	Substrate	0.6638
CYP450 1A2 substrate	Non-inhibitor	0.9045
CYP450 2C9 inhibitor	Non-inhibitor	0.9071
CYP450 2D6 inhibitor	Non-inhibitor	0.9276
CYP450 2C19 inhibitor	Non-inhibitor	0.9025
CYP450 3A4 inhibitor	Non-inhibitor	0.8309
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.8681
Ames test	Non AMES toxic	0.9158
Carcinogenicity	Non-carcinogens	0.9288
Biodegradation	Not ready biodegradable	0.9696
Rat acute toxicity	2.0150 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.9427
hERG inhibition (predictor II)	Non-inhibitor	0.7002

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum	Spectrum Type	Splash Key
Predicted GC-MS Spectrum - GC-MS	Predicted GC-MS	Not Available
Mass Spectrum (Electron Ionization)	MS	splash10-0006-9836000000-9f600bd39c3b914c0b17
Predicted MS/MS Spectrum - 10V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
LC-MS/MS Spectrum - LC-ESI-ITFT , positive	LC-MS/MS	splash10-014i-0000900000-5e2e1944e45fcef225d1
LC-MS/MS Spectrum - LC-ESI-ITFT , positive	LC-MS/MS	splash10-014i-0000900000-406c100eed5b6cdc3286

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Drug created on June 13, 2005 07:24 / Updated on October 25, 2020 09:16