Spironolactone
Dosing in kidney impairment
Use in Renal Impairment Spironolactone oral suspension is substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Patients with renal impairment are at increased risk of hyperkalemia. Monitor potassium closely.
Dosing in liver impairment
Treatment of Edema Associated with Hepatic Cirrhosis In patients with cirrhosis, initiate therapy in a hospital setting and titrate slowly [see Use in Specific Populations and Clinical Pharmacology] . The recommended initial daily dose is 75 mg (15 mL) administered in either single or divided doses. In patients requiring titration above 100 mg, use another formulation [see Dosage and Administration] .
When given as the sole agent for diuresis, administer for at least five days before increasing dose to obtain desired effect.