Balancing the Benefits and Risks: Understanding Spironolactone – A Potassium-Sparing Diuretic for Hypertension, Edema, and Heart Failure Treatment

What diuretic causes hyperkalemia and more rarely, gynecomastia?

SpironolactoneSpironolactone is the most commonly used potassium-sparing diuretic, but it can cause hyperkalemia, especially when supplementing potassium or using an ACE inhibitor. Additionally, it has neurohormonal effects that can result in gynecomastia.

The diuretic drug that can cause hyperkalemia (high levels of potassium in the blood) and, more rarely, gynecomastia (enlargement of breast tissue in males) is spironolactone. Spironolactone is a potassium-sparing diuretic that acts on the aldosterone receptor in the distal tubules of the kidneys. It works by blocking the actions of aldosterone, a hormone that promotes sodium and water retention while increasing the excretion of potassium.

Spironolactone is commonly used to treat hypertension, edema (fluid retention), and congestive heart failure. However, due to its potential side effects, it is important to monitor serum potassium levels, especially in patients with renal impairment or those taking other potassium-raising medications. Gynecomastia is a rare but possible side effect, especially with long-term use or at high doses, and may be due to the estrogenic effect of spironolactone. If gynecomastia occurs, discontinuing the drug is usually sufficient to reverse the condition.

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