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Aldactone is a potassium – and magnesium-sparing diuretic. It is a competitive aldosterone antagonist in terms of its effect on the distal nephron (competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permease carrier proteins in the aldosterone-dependent region of the collecting ducts and distal tubules), increases the excretion of sodium, chlorine and water ions and reduces the excretion of ions potassium and urea, reduces the titratable acidity of urine. Increased diuresis causes a hypotensive effect, which is unstable. The hypotensive effect does not depend on the level of renin in the blood plasma and does not appear at normal blood pressure (BP). The diuretic effect is manifested on the 2nd-5th day of treatment.


high blood pressure; edema in chronic heart failure; fibrosis and cirrhosis of the liver (especially with the simultaneous presence of hypokalemia and hyperaldosteronism); nephrotic syndrome; swelling in the 2nd and 3rd trimesters of pregnancy; arterial hypertension, including with aldosterone-producing adrenal adenoma (as part of combination therapy); primary hyperaldosteronism; aldosterone-producing adrenal adenoma (long-term maintenance therapy in case of contraindication to surgical treatment or in case of refusal of it); other benign neoplasms of the adrenal glands; diagnosis of hyperaldosteronism; hypokalemia and its prevention in the treatment of saluretics; polycystic ovary syndrome; premenstrual syndrome; essential (primary) hypertension; secondary hypertension; portal hypertension; ascites; preeclampsia, unspecified.

Instructions for use and dosing regimen

Adults with primary hyperaldosteronism in the period of preparation for surgery – 100-400 mg per day, if the operation is refused, the minimum effective dose is selected. With edema (cardiac, hepatic and renal origin) in the initial dose – 100 mg per day in divided doses. After 5 days, depending on the clinical effect, the dose is reduced to 25 mg or increased to 200 mg. With arterial hypertension – in the initial dose of 50-100 mg per day in divided doses, after 2 weeks it is possible to increase or decrease the dose (depending on the effect). With hypokalemia caused by diuretics – 25-100 mg per day.

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