Знаков). due to the nonosmotic release of antidiuretic hormone (ADH)

due to the nonosmotic release of antidiuretic hormone (ADH). Electrolyte disturbances have been reported postmarketing.[Ref]

Endocrine

Endocrinologic side effects have been due to the antiandrogenic properties of spironolactone (the active ingredient contained in Aldactone) Five percent to 30% of male patients complained of gynecomastia, impotence or diminished libido. Female patients reported hirsutism, oligomenorrhea, amenorrhea, menorrhagia, and breast tenderness. These side effects appeared to be dose-related, and were more likely during long-term therapy. Gynecomastia may be more likely in some male patients with liver disease due to the increased conversion of androgens to estrogens in severe liver disease.[Ref]

Spironolactone interferes with 17-hydroxylase activity, which causes a decrease in testosterone synthesis. It also inhibits the intracellular binding of dihydrotestosterone to its receptor.

Rare cases of young women with liver disease who developed menarche only after spironolactone was discontinued are reported. Since estradiol synthesis is partially dependent on testosterone synthesis, spironolactone may cause primary or secondary amenorrhea in adolescents.[Ref]

Renal

Results of a case-controlled study indicate that heart failure patients who developed renal insufficiency while receiving spironolactone (the active ingredient contained in Aldactone) tended to have a lower baseline body weight, a higher baseline serum creatinine, required higher doses of loop diuretics, and were also likely to be receiving a thiazide diuretic. In this study, the incidence of renal insufficiency requiring discontinuation of therapy was 3.7%. In contrast, another study reported that 25% of their heart failure patients developed renal insufficiency while receiving spironolactone.[Ref]

Renal side effects have included renal insufficiency, manifested by increased BUN and serum creatinine.[Ref]

Cardiovascular

Cardiovascular side effects have included mainly hypovolemia, although the risk of hyperkalemia associated spironolactone (the active ingredient contained in Aldactone) has been important, especially in some patients with heart disease.[Ref]

Cases of hyperkalemia associated with fatal and refractory ventricular fibrillation are reported during spironolactone therapy.[Ref]

Dermatologic

In one case, histology of an associated lupoid eruption was consistent with lupus erythematosus, including immune deposits at the dermal-epidermal junction. There