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Spironolactone can cause hyperkalemia, or high blood potassium levels. [111] Rarely, this can be fatal. [111] Of people with heart disease prescribed typical dosages of spironolactone, 10 to 15% develop some degree of hyperkalemia, and 6% develop severe hyperkalemia. [111] At a higher dosage, a rate of hyperkalemia of 24% has been observed. [119]
[1] [2] Hyperkalemia can cause an abnormal heart rhythm which can result in cardiac arrest and death. [1] [3] Common causes of hyperkalemia include kidney failure, hypoaldosteronism, and rhabdomyolysis. [1] A number of medications can also cause high blood potassium including spironolactone, NSAIDs, and angiotensin converting enzyme inhibitors. [1]
[12] [13] Due to its activity as an androgen receptor antagonist and progesterone receptor agonist, spironolactone causes adverse effects, including gynecomastia or decreased libido in males and menstrual abnormalities in females. [14] Spironolactone also causes hyperkalemia [15] and renal insufficiency. [16]
The pharmacodynamics of spironolactone are characterized by high antimineralocorticoid activity, moderate antiandrogenic activity, and weak steroidogenesis inhibition. In addition, spironolactone has sometimes been found to increase estradiol and cortisol levels and hence could have slight indirect estrogenic and glucocorticoid effects.
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The same year, 1959, spironolactone was launched as a potassium-sparing diuretic. It became clear years later that aldosterone antagonists inhibit a specific receptor protein. This protein has high affinity for aldosterone but also for cortisol in humans and corticosterone in mice and rats. For this reason, aldosterone antagonists were called ...
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Calcipotriene causes a rapid rise in calcium ion levels. [31] Calcium ion levels can remain high for weeks if untreated and lead to an array of medical issues. [31] There are also cases of hypercalcemia reported due to dogs ingesting rodenticides containing a chemical similar to calcipotriene found in psoriasis cream. [31]