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Spironolactone 100mg Tablets

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Package Leaflet: Information for the User Spironolactone 25mg and 100mg Tablets

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you:

-    Keep this leaflet. You may need to read it again.

-    If you have any further questions, ask your doctor or pharmacist.

-    This medicine has been prescribed for you only. Do not pass it on to others. It may harm them even if their signs of illness are the same as yours.

-    If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

In this leaflet

1.    What Spironolactone Tablets are and what they are used for

2.    What you need to know before you take Spironolactone Tablets

3.    How to take Spironolactone Tablets

4.    Possible side effects

5.    How to store Spironolactone Tablets

6.    Contents of the pack and other information

1. What Spironolactone Tablets are and what they are used for

Spironolactone belongs to a group of medicines called potassium-sparing diuretics (‘water tablets’). They are used to help reduce the build up of too much fluid in the body (oedema) in the following conditions:

•    Nephrotic syndrome — a kidney disorder that causes too much fluid in your body

•    Heart failure

•    Ascites — too much fluid in your abdomen, for example caused by cirrhosis of the liver

•    Primary aldosteronism - extra fluid in your body caused by too much of a hormone called ‘aldosterone’.

If you have these illnesses Spironolactone Tablets will help your body to get rid of the extra fluid.

2. What you need to know before you take Spironolactone Tablets

Do not take Spironolactone Tablets if:

•    you are allergic to spironolactone, other diuretics or to any of the other ingredients in this medicine (listed in section 6)

•    you have Addison’s disease; (a hormone deficiency characterised by extreme weakness, loss of weight and low blood pressure)

•    you have hyperkalaemia (raised blood potassium levels)


•    you cannot pass urine

•    you have severe kidney disease

•    you are breast-feeding

•    you are taking water tablets (potassium sparing diuretics) or any potassium supplements

•    you are taking eplerenone (a medicine for high blood pressure).


Warnings and precautions

Talk to your doctor or pharmacist before taking Spironolactone Tablets if

you are taking any other water tablets (diuretics) in combination with Spironolactone Tablets which may cause low sodium levels (hyponatraemia) in the blood you have a diet rich in potassium or salt substitutes containing potassium.

severe increases in the levels of potassium in your blood. This can affect


•    you suffer from kidney or liver disease. Your doctor will    •

routinely assess you

•    you are pregnant

If you experience reduced kidney function or kidney failure you may have the way your heart functions and in extreme cases this can be fatal.

Other medicines and Spironolactone TabletsTell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Your doctor may wish to alter your dose of Spironolactone Tablets if you are taking any of the following:

•    digoxin or carbenoxolone

•    medicines for high blood pressure especially ACE inhibitors

•    other diuretics


• non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofem


•    potassium supplements

•    heparin or low molecular weight heparin (medicines used to prevent blood clots)


•    antipyrine

•    noradrenaline.


If you are going to have an operation where you will be given an anaesthetic, tell your doctor or surgeon that you are taking Spironolactone Tablets.

Taking Spironolactone Tablets with food or drink

This medicine should be taken with food (see section 3 ‘How to take Spironolactone Tablets).

Pregnancy and breast-feeding

Tell your doctor if you are pregnant, think you may be pregnant or are planning to become pregnant as your doctor will need to judge whether you should be prescribed Spironolactone Tablets.

Spironolactone Tablets should not be used if you are breast-feeding. You should discuss the use of Spironolactone Tablets with your doctor, who will advise you to consider an alternative method of feeding your baby while taking this medicine.

Driving and using machines

Take care if you drive or operate machinery. Drowsiness and dizziness have been associated with spironolactone treatment and may affect your ability to drive or operate machinery safely.

3. How to take Spironolactone tablets

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

You will be prescribed the lowest dose needed to control your symptoms. Do not stop taking the medicine or change the dose unless your doctor tells you to.

Swallow the tablets with a glass of water.

Adults:

Adults over 60 years:

Your doctor will start you on a low starting dose and gradually increase the dosage as needed to obtain the desired effect, which may be less than the recommended adult dose.


Congestive heart failure: The usual dose is 100 mg per day. In severe cases, your doctor may increase the dose gradually to 400mg per day. When swelling and puffiness of the legs is controlled then a maintenance dose of 75mg to 200mg per day may be prescribed.

Cirrhosis of the liver: The usual dose is between 100mg and 400mg per day.

Children:

If you are giving Spironolactone Tablets to a child, the number of tablets you give will depend on the child’s weight. Your doctor will work out the number of tablets you should give,


Nephrotic syndrome: The usual dose is 100mg to 200mg per day. Use of spironolactone is only advised if other medicines by themselves are not effective.

Primary aldosteronism: Your doctor may use spironolactone to diagnose this condition. If a diagnosis is made, then the doctor may decide to treat the condition by surgery, in which case the usual dose is from 100mg to 400mg daily. For patients who are unsuitable for surgery, spironolactone may be used for long term treatment at the lowest effective dose.

If you take more Spironolactone Tablets than you should

If you accidentally take more tablets than prescribed or somebody else takes any tablets, contact a doctor or go to your nearest hospital casualty department at once. Take any remaining tablets with you and the container or packaging, so they can be identified. Some signs of overdose are drowsiness, confusion, nausea, vomiting, dizziness and diarrhoea.

If you forget to take Spironolactone Tablets

If you miss a dose, skip it and go back to your regular schedule. Do not take a double dose to make up for a forgotten dose.

4. Possible side effects

Like all medicines, spironolactone can cause side effects, although not everybody gets them.

Contact your doctor at once if you develop any of the following effects after taking this medicine:

Itchiness and blistering of the skin around the lips and rest of the body (Stevens-Johnson syndrome)

Detachment of the top layer of skin from the lower layers of skin, all over the body (toxic epidermal necrolysis)

Skin rash, fever and swelling (which could be symptoms of something more serious, drug rash and eosinophilia and systemic symptoms)

Yellow skin and eyes, itching, abnormal pain and/or tenderness (jaundice), Spironolactone Tablets can cause impairment of liver function


Other side effects of Spironolactone Tablets

•    nausea, stomach upset

•    headache

•    confusion, dizziness

•    menstrual problems in women

•    change in sex drive for both men and women (libido)

•    disturbances in body electrolytes

•    reduced number of cells that fight infection - white cells (leukopenia), reduced number of cells that help with clotting (thrombocytop enia)


Blood disorders signs of which are bruising easily, bleeding, sore throat, fever

Irregular heartbeat, tingling sensation, paralysis or difficulty in breathing; which may be symptoms of raised potassium levels in your blood. Your doctor will conduct regular blood tests to monitor potassium and other electrolyte levels. He or she may stop your treatment if necessary

Signs of bone problems such as bone pain, backache and muscle weakness.


•    excessive growth of breast tissue in men (gynaecomastia), this goes away when treatment is stopped, breast lumps, breast pain

•    skin rashes, generalised itchiness

•    skin allergy with development of itchiness and weals (urticaria), excessive hair growth (hypertrichosis)

•    hair loss

•    general weakness, muscle cramps, tiredness

•    bone softening

•    sudden kidney failure


Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Spironolactone Tablets

Keep this medicine out of the sight and reach of children Do not store above 25°C. Keep the container tightly closed (for containers). Store in the original package (for blisters). Do not use this medicine after the expiry date which is stated on the packaging after EXP. The expiry date refers to the last day of that month.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Spironolactone Tablets contain

The active ingredient (which makes the tablets work) is spironolactone. The 25mg tablets contain 25mg of spironolactone. The 100mg tablets contain 100mg of spironolactone. The tablets also contain: calcium sulphate dihydrate, povidone, maize starch, crospovidone, pregelatinised maize starch, magnesium stearate, peppermint flavour and quinoline yellow E104.

What Spironolactone Tablets look like and contents of the pack

Spironolactone 25mg Tablets are pale yellow, bi-convex tablets engraved with SPR25. Spironolactone 100mg Tablets are pale yellow, bi-convex tablets engraved with SPR100. Both 25mg and 100mg strengths are available in pack sizes of 28, 30, 50, 56, 60, 84, 100, 250, 500 and 1000 tablets. Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

6 Riverview Road, Beverley, HU17 0LD, U.K    Spironolactone 100mg Tablets PL 08553/0118

© Dr. Reddy's Laboratories (UK) Limited    Spironolactone 25mg Tablets PL 08553/0119

Leaflet last revised Febraury 2014    SL0102