spironolactone indications/contra

Stem definitionDrug idCAS RN
aldosterone antagonists, spironolactone derivates 2475 52-01-7

Description:

MoleculeDescription

Molfile Inchi Smiles

Synonyms:

  • spironolactone
  • abbolactone
  • aldactone
  • aldopur
  • berlactone
  • euteberol
  • quimolactona
  • spirolactone
A potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827)
  • Molecular weight: 416.58
  • Formula: C24H32O4S
  • CLOGP: 2.84
  • LIPINSKI: 0
  • HAC: 4
  • HDO: 0
  • TPSA: 60.44
  • ALOGS: -5.32
  • ROTB: 2

Drug dosage:

DoseUnitRoute
75 mg O

Approvals:

DateAgencyCompanyOrphan
Jan. 21, 1960 FDA GD SEARLE LLC

FDA Adverse Event Reporting System

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MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Hyperkalaemia 7365.37 41.72 1398 4656 9896 3369909
Acute kidney injury 4670.66 41.72 1268 4786 48415 3331390
Hyponatraemia 2015.19 41.72 537 5517 17822 3361983
Drug interaction 1469.54 41.72 524 5530 46288 3333517
Dehydration 1285.99 41.72 437 5617 33212 3346593
Hypotension 1153.37 41.72 446 5608 49068 3330737
Renal failure 932.57 41.72 343 5711 32597 3347208
Bradycardia 775.32 41.72 252 5802 16417 3363388
Blood creatinine increased 739.42 41.72 260 5794 21558 3358247
Fall 610.79 41.72 301 5753 58582 3321223
Blood potassium increased 578.79 41.72 147 5907 3889 3375916
Gynaecomastia 577.14 41.72 126 5928 1683 3378122
Cardiac failure 449.95 41.72 177 5877 19928 3359877
Hepatic encephalopathy 439.95 41.72 114 5940 3263 3376542
Asthenia 399.58 41.72 236 5818 65429 3314376
Confusional state 394.84 41.72 195 5859 37803 3342002
Renal impairment 381.31 41.72 153 5901 18108 3361697
Syncope 325.08 41.72 151 5903 25482 3354323
Blood urea increased 325.01 41.72 108 5946 7452 3372353
Malaise 299.09 41.72 196 5858 64981 3314824
Orthostatic hypotension 286.32 41.72 89 5965 4947 3374858
Diarrhoea 285.10 41.72 229 5825 104119 3275686
Oedema peripheral 283.10 41.72 151 5903 34210 3345595
Drug hypersensitivity 280.55 41.72 152 5902 35528 3344277
Dyspnoea 268.64 41.72 220 5834 102714 3277091
Metabolic acidosis 267.43 41.72 97 5957 8681 3371124
Hypokalaemia 261.61 41.72 108 5946 13697 3366108
Vomiting 251.75 41.72 200 5854 89331 3290474
International normalised ratio increased 242.38 41.72 104 5950 14511 3365294
Condition aggravated 232.52 41.72 139 5915 39094 3340711

Pharmacologic Action:

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SourceCodeDescription
ATC C03DA01 CARDIOVASCULAR SYSTEM
DIURETICS
POTASSIUM-SPARING AGENTS
Aldosterone antagonists
FDA EPC N0000175557 Aldosterone Antagonist
FDA MoA N0000011310 Aldosterone Antagonists
MeSH PA D004232 Diuretics
MeSH PA D006727 Hormone Antagonists
MeSH PA D006730 Hormones, Hormone Substitutes, and Hormone Antagonists
MeSH PA D000451 Mineralocorticoid Receptor Antagonists
MeSH PA D045283 Natriuretic Agents
CHEBI has role CHEBI:35498 diuretic
CHEBI has role CHEBI:35674 antihypertensive agent

Drug Use (View source of the data)

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DiseaseRelationSNOMED_IDDOID
Hypertensive disorder indication 38341003 DOID:10763
Chronic heart failure indication 48447003
Aldosteronism indication 88213004 DOID:446
Edema indication 267038008
Ascites indication 389026000
Peripheral Edema due to Chronic Heart Failure indication
Hypokalemia Prevention indication
Pulmonary Edema due to Chronic Heart Failure indication
Diagnostic Test for Primary Aldosteronism indication
Edema due to Nephrotic Syndrome indication
Edema due to Hepatic Cirrhosis indication
Anuria contraindication 2472002 DOID:2983
Hypercholesterolemia contraindication 13644009
Hyperkalemia contraindication 14140009
Metabolic acidosis, normal anion gap, acidifying salts contraindication 18104000
Secondary angle-closure glaucoma contraindication 21571006
Hypovolemia contraindication 28560003
Dehydration contraindication 34095006
Hyperuricemia contraindication 35885006 DOID:1920
Hypokalemia contraindication 43339004
Systemic lupus erythematosus contraindication 55464009 DOID:9074
Sympathectomy contraindication 57071006
Acute nephropathy contraindication 58574008
Hypercalcemia contraindication 66931009 DOID:12678
Hyperparathyroidism contraindication 66999008 DOID:13543
Hypochloremic alkalosis contraindication 70134007
Hepatic coma contraindication 72836002 DOID:12550
Diabetes mellitus contraindication 73211009 DOID:9351
Hyponatremia contraindication 89627008
Gout contraindication 90560007 DOID:13189
Kidney disease contraindication 90708001 DOID:2527
Hypomagnesemia contraindication 190855004
Acute pancreatitis contraindication 197456007 DOID:2913
Neonatal hyperbilirubinemia contraindication 281610001
Azotemia contraindication 445009001
Polycystic ovaries off-label use 69878008 DOID:11612

Acid dissociation constants calculated using MoKa v3.0.0

None

Orange Book patent data (new drug applications)

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Formulation strengthTrade nameApplicantApplication numberApproval dateTypeDose formRoutePatent numberPatent expiration datePatent use
25MG/5ML CAROSPIR CMP DEV LLC N209478 Aug. 4, 2017 RX SUSPENSION ORAL 9757394 Oct. 28, 2036 CAROSPIR IS INDICATED FOR TREATMENT OF NYHA CLASS III-IV HEART FAILURE AND REDUCED EJECTION FRACTION TO INCREASE SURVIVAL, MANAGE EDEMA, AND TO REDUCE THE NEED FOR HOSPITALIZATION FOR HEART FAILURE

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

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TargetClassPharosUniProtActionTypeActivity value
(-log[M])
Mechanism
action
Bioact sourceMoA source
Mineralocorticoid receptor Nuclear hormone receptor ANTAGONIST IC50 9.88 WOMBAT-PK CHEMBL
Cytochrome P450 2C19 Enzyme IC50 5.52 DRUG MATRIX
Nuclear receptor subfamily 1 group I member 2 Nuclear hormone receptor WOMBAT-PK
Progesterone receptor Nuclear hormone receptor EC50 6.03 WOMBAT-PK
Glucocorticoid receptor Nuclear hormone receptor IC50 6.23 WOMBAT-PK
Androgen receptor Nuclear hormone receptor Ki 7.40 CHEMBL
Estrogen receptor beta Nuclear hormone receptor EC50 5.48 CHEMBL
Multidrug and toxin extrusion protein 1 Transporter IC50 4.73 CHEMBL
Progesterone receptor Transcription factor Ki 6.66 DRUG MATRIX
Androgen receptor Transcription factor IC50 6.17 CHEMBL

External reference:

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IDSource
DB00421 DRUGBANK_ID
2875 IUPHAR_LIGAND_ID
4017881 VUID
N0000146234 NUI
C0037982 UMLSCUI
D00443 KEGG_DRUG
27O7W4T232 UNII
987 INN_ID
4017881 VANDF
1587 MMSL
9997 RXNORM
13929005 SNOMEDCT_US
387078006 SNOMEDCT_US
5506 MMSL
d00373 MMSL
N0000005900 NDFRT
N0000146234 NDFRT
002211 NDDF
CHEMBL1393 ChEMBL_ID
5833 PUBCHEM_CID
D013148 MESH_DESCRIPTOR_UI
CHEBI:9241 CHEBI
SNL PDB_CHEM_ID

Pharmaceutical products:

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ProductCategoryIngredientsNDCFormQuantityRoute MarketingLabel
Aldactone HUMAN PRESCRIPTION DRUG LABEL 1 0025-1001 TABLET, FILM COATED 25 mg ORAL NDA 14 sections
ALDACTAZIDE HUMAN PRESCRIPTION DRUG LABEL 2 0025-1011 TABLET, FILM COATED 25 mg ORAL NDA 13 sections
ALDACTAZIDE HUMAN PRESCRIPTION DRUG LABEL 2 0025-1021 TABLET, FILM COATED 50 mg ORAL NDA 13 sections
Aldactone HUMAN PRESCRIPTION DRUG LABEL 1 0025-1031 TABLET, FILM COATED 100 mg ORAL NDA 14 sections
Aldactone HUMAN PRESCRIPTION DRUG LABEL 1 0025-1041 TABLET, FILM COATED 50 mg ORAL NDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0228-2672 TABLET, FILM COATED 50 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0228-2673 TABLET, FILM COATED 100 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0228-2803 TABLET, FILM COATED 25 mg ORAL ANDA 14 sections
Spironolactone and Hydrochlorothiazide HUMAN PRESCRIPTION DRUG LABEL 2 0378-0141 TABLET 25 mg ORAL ANDA 12 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0378-0243 TABLET, FILM COATED 50 mg ORAL ANDA 13 sections
Spironolactone and Hydrochlorothiazide HUMAN PRESCRIPTION DRUG LABEL 2 0378-0403 TABLET 25 mg ORAL ANDA 12 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0378-0437 TABLET, FILM COATED 100 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0378-2146 TABLET, FILM COATED 25 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0603-5763 TABLET, FILM COATED 25 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0603-5764 TABLET, FILM COATED 50 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0603-5765 TABLET, FILM COATED 100 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0615-1535 TABLET, FILM COATED 25 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0615-5592 TABLET, FILM COATED 50 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0615-6591 TABLET, FILM COATED 100 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0615-8031 TABLET, FILM COATED 25 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0615-8178 TABLET, FILM COATED 25 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0781-1599 TABLET, FILM COATED 25 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 0904-5951 TABLET, FILM COATED 25 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 10544-499 TABLET 25 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 10544-523 TABLET 25 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 16729-225 TABLET, FILM COATED 25 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 16729-226 TABLET, FILM COATED 50 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 16729-227 TABLET, FILM COATED 100 mg ORAL ANDA 13 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 21695-766 TABLET 25 mg ORAL ANDA 14 sections
Spironolactone HUMAN PRESCRIPTION DRUG LABEL 1 21695-960 TABLET, FILM COATED 50 mg ORAL ANDA 15 sections