*Welcome to the OutUK series looking at gay men and their health brought to you in association with the NHS* website.**
	Each week we'll tackle a different topic in our A to Z of Gay Health. We'll have features and advice on everything from relationships, sexual health, mental and physical conditions and how to stay fit. You can follow any of links provided below for more information direct from the NHS website, or see this week's feature L: Laxatives.

How And When To Take Spironolactone

NHS medicines information on dosage for spironolactone, how to take it and what to do if you miss a dose or take too much.

Dosage and strength

Spironolactone tablets come in strengths of 12.5mg, 25mg, 50mg and 100mg.

How much spironolactone you need to take depends on why you're taking it. Your dose may need to be changed a few times before you find the dose that's right for you.

The usual dose for adults is:

heart failure - 25mg once a day as a starting dose. Depending on how well it works for you, the dose can be from 25mg every other day to 50mg once a day
build-up of fluid caused by liver disease (ascites) - between 100mg and 400mg a day
oedema caused by heart failure - 100mg a day as a starting dose. Depending on well it works for you, the dose can be between 25mg and 200mg a day
nephrotic syndrome (a condition caused by kidney disease) - between 100mg and 200mg a day
high aldosterone levels - 400mg a day as a starting dose, for a few days to a few weeks, to check if high aldosterone levels are the cause of your symptoms. Once confirmed, the long-term dose can be between 100mg and 400mg a day
high blood pressure (hypertension) - 25mg a day

Doses are usually lower for people over 65 years as they may be more likely to get side effects.

For babies and children, your child's doctor will use your child's weight or age to work out the right dose.

How to take it

You'll usually take spironolactone once a day in the morning.

If you're taking a high dose you might need to take spironolactone twice a day. If you're taking it twice a day, make sure you take the second dose no later than 4pm. Taking it later than this may mean you have to wake up in the night to pee.

Some people only need to take it once every 2 days.

Take spironolactone with a meal to help reduce side effects such as feeling sick.

Swallow the tablets whole with a drink of water. Do not chew them.

How long to take it for

Depending on the reason why you're taking spironolactone, you may have to take it for a long time, even for the rest of your life.

Talk to your doctor if you want to stop taking spironolactone. If you stop it too soon, your condition may get worse.

If you're bothered by side effects, your doctor may be able to prescribe you a different medicine.

If you forget to take it

If you forget to take a dose of spironolactone, take it as soon as you remember, unless it's after 6pm. In this case, skip the missed dose and take your next dose at the usual time the next day.

Do not take 2 doses to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You can also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much spironolactone can make you pee more than usual and feel thirsty. It can also cause symptoms including feeling or being sick, diarrhoea, and feeling confused or dizzy.

Too much spironolactone can cause the potassium levels in your blood to become too high. Signs of high potassium levels include:

a slow or irregular heartbeat
a tingling feeling
muscle weakness
shortness of breath

Contact 111 for advice now if:

you take more than your prescribed dose of spironolactone and you:

feel unwell
are over 65 (even if you feel well)
have kidney, liver or heart failure (even if you feel well)

Go to 111.nhs.uk or call 111. Call 111 if you're asking about a child under 5 years.

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the spironolactone packet, or the leaflet inside it, plus any remaining medicine with you.

OutUK's A to Z of Gay Health continues and you can read this week's feature L: Laxatives. We have covered many subjects in this series and you can catch up with all of our Previous A to Z Features. If you want to find out more about this particular topic you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.
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