# Spironolactone in Nigeria

Spironolactone has 7 active NAFDAC registrations in our October 2026 copy of the register, from 6 registration holders; 11 further listings have lapsed.

- Source: https://ogbogwu.com/drugs/spironolactone/
- Drug class: Aldosterone antagonist (potassium-sparing diuretic) (Hypertension)
- Also known as: Aldactone, Spinotone, Zoractone, Water pill for heart failure, Potassium-sparing diuretic
- Prescription required: yes
- On the WHO Model List of Essential Medicines
- Last updated: October 2026

## Price in Nigeria

Our sampled online pharmacies held no spironolactone listing this cycle, so we quote no price. The 25 mg tablets are inexpensive generics, mostly Indian-made and sold in strips of ten; the original Aldactone commands a premium where old stock is still on shelves, but its Nigerian registration lapsed in 2024. Ask a licensed pharmacy and check the NAFDAC number on the strip.

## What is Spironolactone?

Spironolactone is a diuretic — a water tablet — that works differently from the familiar ones. Furosemide and the thiazides push the kidney to lose salt, water and potassium; spironolactone blocks aldosterone, the hormone that tells the kidney to hold on to salt and dump potassium, so it sheds fluid gently while keeping potassium in the body. That is why it is the diuretic chosen when potassium is already low, and why it is dangerous when potassium is already high. Beyond the kidney, blocking aldosterone protects a failing heart, which is where most of its use in Nigeria now lies.

Nigerians have known it as Aldactone, the Pfizer original, for forty years. The name is still what pharmacists are asked for, but the brand's Nigerian registration (04-4304) expired in February 2024 in our October 2026 copy of the register, and the market today is Indian-made generics — Spinotone (La-Lid), Zoractone (ZMC), AG Spironolactone (AnnyGod), Alpadactone (Dony-Triumph), Bedex and a plain 100 mg tablet from Chez Resources — all recorded Active. A pack sold as Aldactone should be checked by its printed number rather than taken on the name.

Two things decide whether spironolactone is safe for a given person: the potassium level and the kidneys. It is almost always prescribed alongside an ACE inhibitor or ARB (lisinopril, losartan) in heart failure, and that pairing raises potassium twice over, so blood tests before starting and in the first weeks are not optional. Taken as prescribed and monitored, it is one of the few medicines shown to help people with heart failure live longer.

## What is Spironolactone used for?

- Heart failure with reduced pumping function, in addition to standard treatment
- High blood pressure that has not responded to three other medicines
- Fluid retention from liver cirrhosis (ascites), nephrotic syndrome and heart failure
- Primary hyperaldosteronism (Conn's syndrome)
- Low potassium caused by other diuretics
- Hormonal acne, hirsutism and PCOS in women (off-label)

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: Heart failure: 25 mg once a day, sometimes raised to 50 mg if potassium stays normal, or lowered to 25 mg on alternate days if it climbs. Resistant hypertension: 25 to 50 mg once a day. Ascites in cirrhosis: 100 mg a day to start, increased under supervision up to 400 mg, often with furosemide in a 100:40 ratio. Oedema from other causes: 25 to 100 mg a day. Take it in the morning, with food, which improves absorption. Blood potassium and kidney function are checked before starting, within the first week, at a month, and then every three to six months.
- Children: Used in paediatric heart failure, nephrotic syndrome and ascites at 1 to 3 mg per kg a day in one or two doses, prescribed and monitored by a paediatrician; tablets are halved or crushed for small children.
- Elderly: Start at 25 mg or lower. Older kidneys clear potassium more slowly, so the monitoring matters more, not less.

Never take potassium supplements or 'low-sodium' salt substitutes (which are potassium chloride) with spironolactone unless a doctor has prescribed them. Stop and seek help for muscle weakness, an irregular heartbeat or a slow pulse — the signs of high potassium. The full effect on fluid takes two to three days, and on blood pressure two to four weeks; it is not a tablet to judge by the next morning.

## Side effects

Common: Raised potassium, which is why the blood tests exist; Breast tenderness and enlargement in men (gynaecomastia) — dose-related and reversible, and the commonest reason men stop; Irregular periods and breast tenderness in women; Dizziness on standing, tiredness, headache; Stomach upset, nausea, diarrhoea; Passing more urine in the first days.

Serious (seek medical help immediately): Dangerous high potassium: muscle weakness, numbness, a slow or irregular heartbeat — a medical emergency; Worsening kidney function, especially when dehydrated or when also taking an ACE inhibitor, ARB or NSAID; Low sodium: confusion, severe weakness, seizures; Severe allergic skin reactions (rare).

When to see a doctor: Go to a clinic the same day for muscle weakness, a slow or irregular pulse, confusion, fainting, or very little urine. See a doctor within days for breast changes in a man, a missed period, or persistent dizziness. Any vomiting or diarrhoea lasting more than a day while on spironolactone needs advice, because dehydration pushes potassium and kidney function the wrong way.

## Warnings

Do not take if: High blood potassium (hyperkalaemia) from any cause; Addison's disease or other adrenal insufficiency; Severe kidney failure or no urine output (anuria); Known allergy to spironolactone.

Interactions: ACE inhibitors (lisinopril, ramipril) and ARBs (losartan, valsartan) — the usual partners in heart failure, but together they raise potassium; blood tests are essential; Potassium supplements and potassium-containing salt substitutes — avoid; NSAIDs (ibuprofen, diclofenac) — blunt the diuretic, raise potassium and strain the kidneys; Trimethoprim (in co-trimoxazole) — raises potassium sharply, particularly in the elderly; Lithium — levels rise; Digoxin — spironolactone can raise digoxin levels and interferes with some digoxin blood tests; Other antihypertensives — additive drop in blood pressure.

Pregnancy & breastfeeding: Avoid in pregnancy: spironolactone blocks male hormones and could affect a male baby's development, and the fluid and potassium effects are unwelcome in pregnancy. Treat hypertension in pregnancy with the medicines meant for it. Small amounts of its active metabolite pass into breast milk; most authorities consider short courses compatible with breastfeeding, but ask the prescriber.

## Brands in Nigeria

Well-known NAFDAC-registered brands: Aldactone (Pfizer Specialties Ltd, made in United Kingdom); Spinotone-25 (La-Lid Pharmaceutical Company Limited, made in India); Spinotone-50 (La-Lid Pharmaceutical Company Limited, made in India); Zoractone (ZMC International Limited, made in India); AG Spironolactone (AnnyGod Pharmaceutical Company Ltd, made in India); Alpadactone (Dony-Triumph and Company Nigeria Limited, made in India).
Full searchable brand list: https://ogbogwu.com/drugs/spironolactone/brands/

## How to verify it is genuine

1. Check the strip for its NAFDAC number and look it up. In our October 2026 copy of the register the current single-ingredient products include Spinotone-25 (A4-7782) and Spinotone-50 (B4-5201), Zoractone 25 mg (B4-9859), AG Spironolactone 25 mg (A4-100160), Alpadactone 50 mg (A4-1472), Bedex Spironolactone 25 mg (C4-0947) and Spironolactone 100 (C4-0435)
2. Aldactone (04-4304, Pfizer) is recorded Expired since February 2024. A strip still on sale under that name should be checked by its printed number and expiry date, and a renewal confirmed on the official Greenbook before you rely on it
3. Confirm the strength on the strip matches the register entry — 25 mg and 50 mg strips look alike and the dose matters for potassium
4. Enter the number in our free NAFDAC checker and confirm the product name, strength and manufacturer match the pack

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### Is Aldactone still registered in Nigeria?

Not in our October 2026 copy of the NAFDAC register: Aldactone Tablets 25 mg (04-4304, Pfizer Specialties, made in the UK) is recorded Expired since 27 February 2024. Spironolactone itself is well covered by current registrations — Spinotone, Zoractone, AG Spironolactone, Alpadactone, Bedex and a Chez Resources 100 mg tablet are all Active. Listings can lag renewals, so if you hold a recent Aldactone pack, confirm its status on the official Greenbook.

### What is spironolactone used for in Nigeria?

Mostly for heart failure, where a low dose added to the other heart medicines reduces admissions and deaths; for high blood pressure that three other drugs have not controlled; and for the swollen abdomen of liver cirrhosis, where it is the main diuretic. Doctors also prescribe it off-label to women for hormonal acne, excess hair and PCOS.

### Can I take spironolactone with lisinopril or losartan?

Yes — that combination is standard heart-failure treatment — but only with blood tests, because both medicines raise potassium and together they raise it more. Expect a test before starting, in the first week or two, at about a month, and every few months after. Avoid potassium supplements and salt substitutes, and tell the prescriber before taking ibuprofen or diclofenac, which add to the risk.

### Why does spironolactone cause breast enlargement in men?

Because it also blocks male hormone receptors. Gynaecomastia is dose-related — uncommon at 25 mg, more likely at 100 mg and above — and reverses when the medicine is stopped. Men who need the heart benefit but cannot tolerate it are sometimes switched to eplerenone, a related medicine without the hormonal effect, where it can be found.

### Is spironolactone a water pill like Lasix?

Both are diuretics, but they work differently. Furosemide (Lasix) is powerful and fast and lowers potassium; spironolactone is gentler and keeps potassium up. They are often used together in cirrhosis and heart failure precisely because the potassium effects cancel. Spironolactone on its own takes two to three days to show its effect on fluid.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- WHO Model List of Essential Medicines
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)