Potassium-Sparing Diuretics / Aldosterone Antagonists
Common brand names: Spironolactone (Aldactone), Eplerenone (Inspra), Amiloride
Two nutrients listed against this medication. The most severe is marked moderate.
At a glance
One of the two is marked well documented. The other one carries its own evidence level.
At a glance
- Magnesium (Retention, Monitor)Moderate · Well documented
- ZincModerate · Traditionally cited, limited evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Unlike loop/thiazide diuretics, potassium-sparing diuretics RETAIN potassium and magnesium. This means supplementing potassium or magnesium while on these drugs can cause dangerously high levels (hyperkalemia, hypermagnesemia). This is the opposite pattern from most diuretics.
Common signs, If supplementing K+ or Mg2+: dangerous cardiac arrhythmia risk from electrolyte excess
Soberman & Weber (Curr Hypertens Rep, 2000): review of spironolactone in heart failure. Aldosterone antagonism retains potassium and magnesium rather than wasting them, which is why this row is a monitoring note and not a depletion.
Caution: potassium and magnesium are not supplemented here without physician approval and electrolyte monitoring. The general pattern of magnesium repletion with diuretics does not apply to this drug class.
Mechanism, Spironolactone is an anti-androgen: it blocks androgen receptors and raises sex hormone-binding globulin. Because testosterone influences zinc handling, an indirect effect on zinc status has been proposed. The controlled measurement below did not find one.
Common signs, Reduced libido, fatigue, immune effects, delayed wound healing
Tubek (Biol Trace Elem Res, 2006): 23 hypertensive patients on spironolactone 100 mg/day with serum and lymphocyte zinc measured before and after treatment. Spironolactone's anti-androgen effect is sometimes linked to zinc signalling, but this study did not establish zinc depletion. Theoretical.
Zinc picolinate was used at 15–25 mg daily, discussed with the prescriber. Electrolytes are monitored, and potassium is not self-supplemented.
For your next appointment
It prints or saves as a single page. Whether to add a supplement for a nutrient this medication may lower is a decision for your prescriber.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
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