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For heart failure, at eGFR 30-50 consider starting at 25 mg every other day because of hyperkalemia risk. At eGFR >50 and potassium <=5 mEq/L, the initial dose is 25 mg daily.
Limits and monitoring
Check potassium within one week of starting or titrating and regularly thereafter. Verify baseline potassium, volume status and interacting drugs.
Before use
Apply only to the stated formulation, indication and renal population.
DailyMed SPL version 25, effective 2025-11-28; posted Dec 01, 2025 | Selected sections checked 2026-11-07. Independent clinical review pending.
Spironolactone (Aldactone), adult oral tablets for heart failure
Renal measure
Indexed GFR/eGFR, mL/min/1.73 m2
Source revision
DailyMed SPL version 25, effective 2025-11-28; posted Dec 01, 2025
Retrieved
2026-11-07 (not the revision date)
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Renal guidance: 2.2 and 5.1
For heart failure, at eGFR 30-50 consider starting at 25 mg every other day because of hyperkalemia risk. At eGFR >50 and potassium <=5 mEq/L, the initial dose is 25 mg daily. Check potassium within one week of starting or titrating and regularly thereafter. Verify baseline potassium, volume status and interacting drugs.
Source revision: DailyMed SPL version 25, effective 2025-11-28; posted Dec 01, 2025 | Retrieved: 2026-11-07. Retrieval date is not the revision date.
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Source scope / renal recommendation differences
Aldactone - product and source limitations
Check potassium within one week of starting or titrating and regularly thereafter. Verify baseline potassium, volume status and interacting drugs.
How to use this: Apply only to the stated formulation, indication and renal population.
Choose a source, then jump to its renal or dialysis section. These links locate stored text; they do not merge regimens or certify that sources agree.
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Official source
Aldactone - labeled renal guidance
Spironolactone (Aldactone), adult oral tablets for heart failure
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Important source distinctions
The qualitative contraindications and alternative interval table are distinct original statements. The alternative does not override a contraindication or potassium monitoring.
Edema from CHF, cirrhosis or nephrotic syndrome: initially 100 mg/day once or divided; source range 25-200 mg/day. As sole diuretic continue the starting dose for at least 5 days before optimizing. Hypertension: start 50-100 mg/day once or divided; may combine with more proximally acting diuretics or other antihypertensives. Allow at least 2 weeks because maximal response may be delayed. Diuretic-induced hypokalemia: 25-100 mg/day when potassium supplementation or other potassium-sparing approaches are inappropriate.
GRPH-spironolactone-01 · Source section: Usual Dosing (Adults)Renal section finder
Renal Dosing
The original contraindications are anuria, acute renal insufficiency, significant impairment of renal excretory function or hyperkalemia. It also lists an alternative: CrCl above 50 mL/min no change; 10-50, every 12-24 hours; below 10, avoid.
For heart failure, at eGFR 30-50 consider starting at 25 mg every other day because of hyperkalemia risk. At eGFR >50 and potassium <=5 mEq/L, the initial dose is 25 mg daily. Check potassium within one week of starting or titrating and regularly thereafter. Verify baseline potassium, volume status and interacting drugs.
RDM73-aldactone-official-1 · Source locator: Renal guidance: 2.2 and 5.1
GlobalRPh RX List / product-label mirror · Spironolactone (Aldactone), adult oral tablets for heart failure
Renal method: Use the renal measure explicitly present in the RX passage. Source date: Mirror revision not established in the reviewed passage. Retrieved: 2026-11-07
Label mirror, not independent corroboration. This is selected locally stored RX List content. Full monograph import and current official-label review are not implied.
Renal toxicity or monitoring. On-treatment injury and monitoring instructions are not a baseline renal-dose schedule.
Additional summaries stored on this page: 1 official-label, 1 RX List, 0 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.
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The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.
