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Hyponatremia is an uncommon, but serious, complication of diuretic therapy. Thiazide diuretics are more likely than loop diuretics to cause hyponatremia. Loop diuretics inhibit sodium (Na+) transport in the renal medulla and prevent the generation of a maximal osmotic gradient.
Spironolactone also treats fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. This medication is also used to treat or prevent hypokalemia (low potassium levels in the blood).
Low potassium (hypokalemia) refers to a lower than normal potassium level in your bloodstream. Potassium is a chemical (electrolyte) that is critical to the proper functioning of nerve and muscles cells, particularly heart muscle cells. Normally, your blood potassium level is 3.6 to 5.2 millimoles per liter (mmol/L).
The pump acts to re-absorb sodium and water in exchange for potassium, which is then eliminated in the urine. Consequently, aldosterone antagonism can cause hyperkalemia. Hyperkalemia is an established adverse effect of both spironolactone and eplerenone. The symptoms of hyperkalemia begin with muscle weakness.
Time to peak plasma concentration is approximately one hour. Distribution – Although the plasma half life of spironolactone itself is short (1.3 hours) the half lives of the active metabolites are longer (ranging from 2.8 to 11.2 hours). Spironolactone is estimated to be 90% protein bound.
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