Espironolactona
Spironolactone
También conocido como: Aldactone · Aldactazide · Cardalis · Prilactone · espironolactona · SC-9420 · spirolactone · spironolactonum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation) | 1-2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| As a diuretic in CHF (with other diuretics when hypokalemia is an issue) | 2-4 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| As a diuretic in CHF (to allow further reduction of furosemide dose) | 0.5 mg/kg PO once daily to 2 mg/kg twice daily | PO | q24h to q12h | — | 🌎 NA |
| For treating ascites (using fixed dose combination with hydrochlorothiazide) | 0.5-1 mg/kg PO twice daily | PO | q12h | — | 🌎 NA |
| For treating ascites (caused by right-sided heart failure) | 1-2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| For adjunctive treatment of hypertension | 1-2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| For adjunctive treatment of hypertension (Step 4 drug) | 1-2 mg/kg twice daily | PO | q12h | — | 🌎 NA |
| Congestive heart failure, ascites, hyperaldosteronism | 2-4 mg/kg | PO | q24h | Continuous | 🌍 EU |
- As a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation): Refractory CHF
- As a diuretic in CHF (to allow further reduction of furosemide dose): 0.5 mg/kg once daily for aldosterone blockage (weak diuretic effect); 2 mg/kg twice daily for stronger diuretic effect.
- For treating ascites (using fixed dose combination with hydrochlorothiazide): Empirical dosage based on the spironolactone component of Aldactazide.
- For treating ascites (caused by right-sided heart failure): Added to optimized furosemide and ACE inhibitor therapy.
- For adjunctive treatment of hypertension (Step 4 drug): For systolic >160 mmHg, diastolic >120 mmHg after enalapril/benazepril and amlodipine.
- Congestive heart failure, ascites, hyperaldosteronism: Licensed for use in combination with standard therapy for treatment of CHF caused by valvular regurgitation in dogs.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation) | 1-2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| As a diuretic in CHF (when serum potassium is low) | 1 mg/kg q12h PO | PO | q12h | — | 🌎 NA |
| For adjunctive treatment of hypertension | 1-2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| For adjunctive treatment of hypertension (Step 3 drug) | 1-2 mg/kg twice daily | PO | q12h | — | 🌎 NA |
| For adjunctive treatment of primary hyperaldosteronism | 1-2 mg/kg PO twice daily | PO | q12h | — | 🌎 NA |
| Congestive heart failure, ascites, hyperaldosteronism | 2-4 mg/kg | PO | q24h | Continuous | 🌍 EU |
- As a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation): Refractory CHF
- For adjunctive treatment of hypertension (Step 3 drug): When systolic BP >160 mmHg, diastolic >120 mmHg after amlodipine and ACE inhibitor.
- For adjunctive treatment of primary hyperaldosteronism: If potassium supplementation alone does not control clinical signs.
- Congestive heart failure, ascites, hyperaldosteronism: Severe ulcerative facial dermatitis has been reported in Maine Coon cats.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La espironolactona es un antagonista de la aldosterona sintético y un diurético ahorrador de potasio. En medicina veterinaria, se utiliza principalmente como tratamiento coadyuvante para la insuficiencia cardíaca congestiva (ICC), ascitis, hipertensión sistémica e hiperaldosteronismo primario (especialmente en gatos).
Perlas clínicas y contexto farmacológico:
- Escape de aldosterona: Aunque su efecto diurético directo es relativamente débil en comparación con los diuréticos de asa como la furosemida, la espironolactona desempeña un papel crucial en el bloqueo del sistema renina-angiotensina-aldosterona (SRAA). Incluso cuando los pacientes reciben inhibidores de la ECA, los niveles de aldosterona pueden aumentar nuevamente (un fenómeno conocido como "escape de aldosterona"). La espironolactona mitiga este efecto.
- Cardioprotección: En medicina humana, la espironolactona es altamente valorada por sus efectos antifibróticos en el miocardio, ayudando a prevenir el remodelado cardíaco perjudicial. Si bien el alcance de este beneficio en pacientes veterinarios (como perros con enfermedad valvular mitral mixomatosa) ha sido objeto de debate, se incorpora cada vez más en los protocolos estándar de tratamiento multifármaco para la ICC.
- Biodisponibilidad: La absorción aumenta significativamente cuando se administra con alimentos.
Mecanismo de acción
Spironolactone acts as a competitive antagonist at the mineralocorticoid receptor.
- Mechanism: It competitively inhibits aldosterone binding in the distal renal tubules and collecting ducts.
- Pathway: Blockade of the receptor → prevents the synthesis of aldosterone-induced proteins (such as Na+/K+ ATPase and epithelial sodium channels) → decreases sodium and chloride reabsorption while decreasing potassium, ammonium, and phosphate excretion.
- Result: Mild diuresis with potassium retention. It does not affect carbonic anhydrase or proximal renal transport mechanisms.
Seguridad y advertencias
Contraindicaciones
- Hyperkalemia
- Addison's disease (hypoadrenocorticism)
- Anuria
- Acute renal failure
- Significant renal impairment
- Hyperkalaemia
- Hyponatraemia
- Concurrent use with NSAIDs in animals with renal insufficiency
- Pregnancy
- Lactation
- Animals intended for breeding
Efectos adversos
- Facial dermatitis (notably reported in Maine Coon cats)
- Hyperkalemia
- Hyponatremia
- Dehydration
- Increased BUN and mild acidosis (in patients with renal impairment)
- Gastrointestinal distress (vomiting, anorexia)
- CNS effects (lethargy, ataxia)
- Endocrine changes (anti-androgenic effects, e.g., gynecomastia in humans, feminization of male fetuses)
- Hyponatraemia
- Hyperkalaemia
- Reversible prostatic atrophy (in entire male dogs)
- Severe ulcerative facial dermatitis (in Maine Coon cats)
- Hepatotoxicity (reported in humans)
Precauciones
Hepatic & Renal Caution: Use cautiously in patients with hepatic disease (though often used to treat ascites). Use in patients with renal impairment may lead to hyperkalemia.
Reproductive Safety: FDA Category D for pregnancy. Spironolactone and its active metabolites cross the placenta and can cause feminization of male fetuses. Canrenone (active metabolite) is excreted in breast milk; use with caution in nursing animals.
Interacciones farmacológicas
Spironolactone may increase the half-life of digoxin; enhanced monitoring of digoxin serum levels is warranted. May also cause falsely elevated digoxin values if using a radioimmune assay (RIA).
Spironolactone may mute the effects of mitotane if given concurrently; monitor carefully.
Possible increase in neuromuscular blockade effects.
Increased risk of hyperkalemia.
Increased risk of hyperkalemia.
Spironolactone's diuretic effects may be decreased if administered concomitantly.
Potentiates diuretic effects
Potentiates diuretic effects
Increased risk of hyperkalaemia (though generally safe to use concurrently in practice; monitor potassium)
Increased risk of hyperkalaemia and nephrotoxicity
Increased risk of hyperkalaemia
Monitorización
- Serum electrolytes (especially potassium and sodium)
- BUN and creatinine
- Hydration status
- Blood pressure (if indicated)
- Clinical signs of edema/ascites
- Patient weight
- Serum potassium
- Serum sodium
- Renal function (BUN, Creatinine)
- Digoxin levels (if used concurrently)
Farmacocinética
Vida media
Absorción
In fasted dogs, oral bioavailability is approximately 50%, but increases up to 90% when given with food. In humans, it is >90% bioavailable with peak levels reached within 1-2 hours.
Distribución
Spironolactone and its active metabolite, canrenone, are both about 98% bound to plasma proteins. Both cross the placenta, and canrenone is detected in breast milk.
Metabolismo
Rapidly metabolized to several metabolites, including the active metabolite canrenone, which possesses diuretic activity.
Eliminación
About 70% of a dose is found in the feces and 18% in the urine.
Sobredosis
Information on acute overdosage of spironolactone in veterinary patients is limited.
- Management: Should an acute overdose occur, follow general guidelines for diuretic overdose (e.g., furosemide or chlorothiazide).
- Treatment: Empty the stomach if ingestion was recent. Provide supportive care, monitor hydration status, and closely evaluate serum electrolytes (especially potassium and sodium).
- Contact an animal poison control center for further guidance.
Productos disponibles
Formulaciones
- Oral tablets
- Oral suspension (compounded)
- 10 mg tablet
- 40 mg tablet
- 50 mg tablet
- 80 mg tablet
- 100 mg tablet
- Compound preparations with benazepril (e.g., 2.5mg/20mg, 5mg/40mg, 10mg/80mg)
Veterinario
- Cardalis (compound with benazepril)
- Prilactone
Etiquetado para humanos
- Spironolactone Oral Tablets: 25 mg, 50 mg & 100 mg; Aldactone® (Searle); generic
- Spironolactone/Hydrochlorothiazide Oral Tablets: 25 mg/25 mg & 50 mg/50 mg; Aldactazide® (Searle); generic
- Spironolactone generics
Estado regulador
POM-V / POM
POM-V / POM
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store tablets at room temperature in tight, light-resistant containers. An extemporaneously prepared oral suspension using pulverized tablets and cherry syrup is reportedly stable for at least one month when refrigerated.
Información para el cliente
- Administración: Administre este medicamento con comida, ya que esto aumenta significativamente la absorción del fármaco en el cuerpo.
- Advertencia sobre el potasio: Debido a que este medicamento ayuda al cuerpo a retener potasio, no le dé a su mascota suplementos de potasio ni cambie a una dieta alta en potasio a menos que su veterinario se lo indique específicamente.
- Cuándo llamar al veterinario: Notifique a su veterinario si su mascota presenta vómitos graves o persistentes, diarrea, pérdida de apetito o letargo/debilidad extrema.
- Para dueños de gatos: Un pequeño porcentaje de gatos (especialmente los Maine Coon) puede desarrollar picazón facial severa, costras o dermatitis mientras toma este medicamento. Si nota que su gato se rasca la cara excesivamente, comuníquese con su veterinario.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.