OVERDOSE
The oral LD50 of spironolactone is greater than 1,000
mg/kg in mice, rats, and rabbits.
Acute overdosage of spironolactone may be manifested
by drowsiness, mental confusion, maculopapular or erythematous
rash, nausea, vomiting, dizziness, or diarrhea. Rarely,
instances of hyponatremia, hyperkalemia, or hepatic coma
may occur in patients with severe liver disease, but these
are unlikely due to acute overdosage. Hyperkalemia may
occur, especially in patients with impaired renal function.
Treatment
Induce vomiting or evacuate the stomach by lavage. There
is no specific antidote. Treatment is supportive to maintain
hydration, electrolyte balance, and vital functions.
Patients who have renal impairment may develop spironolactone-induced
hyperkalemia. In such cases, Aldactone should be discontinued
immediately. With severe hyperkalemia, the clinical situation
dictates the procedures to be employed. These include
the intravenous administration of calcium chloride solution,
sodium bicarbonate solution and/or the oral or parenteral
administration of glucose with a rapid-acting insulin
preparation. These are temporary measures to be repeated
as required. Cationic exchange resins such as sodium polystyrene
sulfonate may be orally or rectally administered. Persistent
hyperkalemia may require dialysis.
CONTRAINDICATIONS
Aldactone is contraindicated for patients with anuria,
acute renal insufficiency, significant impairment of renal
excretory function, or hyperkalemia.
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