NSTK · 01.2026Independent supplement reference
NutriStack
Edition 1.0Updated July 13, 2026

Spironolactone

Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026

Spironolactone is a non-selective mineralocorticoid receptor antagonist with landmark evidence from the RALES trial demonstrating a 30% mortality reduction in severe heart failure. It is also used for resistant hypertension, primary hyperaldosteronism, and ascites due to cirrhosis.

Evidence tier
Strong
Indexed sources
10 2016–2025
Interactions
0
Category
Prescription
Read the sources → Compare profiles
Publication status

Exploratory record, not a reviewed medical publication.

See the editorial and medical-review policies for the publication gate.

This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.

In short

What the research says.

A quick, data-only summary. The full evidence, dosing, and sources are below.

Spironolactone is a non-selective mineralocorticoid receptor antagonist with landmark evidence from the RALES trial demonstrating a 30% mortality reduction in severe heart failure. NutriStack rates the supporting evidence as strong. Common adult dosing is 12.5–100 mg daily (heart failure: 12.5–50 mg; hypertension: 25–100 mg) (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 10 sources.

What it's good for
  • 30% mortality reduction in severe heart failure (RALES trial)6,2
  • Effective for resistant hypertension2,5
  • Potassium-sparing diuresis
  • Reduces cardiac fibrosis and remodeling
  • Effective for primary aldosteronism2,10
What to watch for
  • Hyperkalemia (potentially life-threatening)
  • Gynecomastia and breast tenderness (anti-androgenic effect)
  • Menstrual irregularities
  • Hyperkalemia (serum K+ >5.0 mEq/L)7
  • Acute renal insufficiency or significant renal impairment (eGFR <30 mL/min)9

The bottom line

Evidence rating strong. Most-documented uses: 30% mortality reduction in severe heart failure (rales trial), effective for resistant hypertension, potassium-sparing diuresis. 10 sources indexed (2016–2025), with 0 interaction records on file.

The science

How it works, mechanistically.

Core mechanism

Competitively binds to aldosterone receptors (mineralocorticoid receptors) in the distal tubule and collecting duct. Blocks aldosterone-mediated sodium reabsorption and potassium excretion, resulting in mild diuresis and potassium retention. In heart failure, it blocks the harmful effects of aldosterone on cardiac fibrosis, hypertrophy, and vascular inflammation. Also has anti-androgenic and progesterone receptor activity.8

Class
Potassium-Sparing Diuretic / Mineralocorticoid Receptor Antagonist
Absorption
Fat-soluble; take with food
Dosing

Dosing & protocol.

Common range
12.5–100 mg daily (heart failure: 12.5–50 mg; hypertension: 25–100 mg) (as prescribed by your physician)
Recommended form
Oral tablet

Food increases bioavailability by ~100%; take with meals for optimal absorption

Safety

Full safety detail.

Side effects

  • Hyperkalemia (potentially life-threatening)
  • Gynecomastia and breast tenderness (anti-androgenic effect)
  • Menstrual irregularities
  • Dizziness
  • GI disturbances (nausea, diarrhea)
  • Sexual dysfunction
  • Hyponatremia

Contraindications

  • Hyperkalemia (serum K+ >5.0 mEq/L)7
  • Acute renal insufficiency or significant renal impairment (eGFR <30 mL/min)9
  • Addison's disease
  • Concurrent use of potassium supplements or other K+-sparing agents (use with caution)
  • Anuria
Sources

Sources, by evidence tier.

Numbered references. Citations throughout the page link here.

Meta-analyses & systematic reviews

5

Reference material

5
FAQ

Common questions.

Quick answers about Spironolactone, drawn from the data on this page.

What is Spironolactone?

Spironolactone is a non-selective mineralocorticoid receptor antagonist with landmark evidence from the RALES trial demonstrating a 30% mortality reduction in severe heart failure. It is also used for resistant hypertension, primary hyperaldosteronism, and ascites due to cirrhosis.

What is Spironolactone used for?

Commonly cited benefits of Spironolactone include: 30% mortality reduction in severe heart failure (RALES trial); Effective for resistant hypertension; Potassium-sparing diuresis; Reduces cardiac fibrosis and remodeling; Effective for primary aldosteronism. NutriStack rates the overall evidence as strong.

What is a typical dose of Spironolactone?

A typical adult dose of Spironolactone is 12.5–100 mg daily (heart failure: 12.5–50 mg; hypertension: 25–100 mg) (as prescribed by your physician). The commonly recommended form is Oral tablet. These are general ranges, not personalized advice; confirm the right dose with a clinician.

What are the side effects of Spironolactone?

Reported side effects include hyperkalemia (potentially life-threatening), gynecomastia and breast tenderness (anti-androgenic effect), menstrual irregularities, dizziness, gi disturbances (nausea, diarrhea), sexual dysfunction. This is educational information; check with a healthcare professional before use.

How strong is the evidence for Spironolactone?

NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.

Use this with your stack

Spironolactone in NutriStack.

Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.

Download on the App Store → Read the methodology

NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.