Dangers of Spironolactone?

[Persephone]

I was looking at the drug info on spiro on RxList (http://www.rxlist.com/aldactone-drug.htm#) when I came across the following bold, highlighted "WARNING":

"Aldactone (spironolactone) has been shown to be a tumorigen in chronic toxicity studies in rats (see PRECAUTIONS). Aldactone (spironolactone) should be used only in those conditions described under INDICATIONS. Unnecessary use of this drug should be avoided."

What's this all about? How significant is it?

Hugs,
Persephone.

[Frances]

Do you know any drug that does not come some serious warnings? I have taken stuff that came with the warning "may cause death". You either want to transition or you don't. There are risks to everything.

[Jorja]

It has been years since I took Spironolactone so I had to go look up the info on it here http://www.webmd.com/drugs/drug-6671-Aldactone+Oral.aspx?drugid=6671&drugname=Aldactone+Oral The biggest warning is about high levels of potassium and slow/irregular heart beat.

Spironolactone is known as a "water pill" (potassium-sparing diuretic).
This medication may lead to high levels of potassium, especially in patients with kidney problems. If not treated, very high potassium levels can be fatal. Tell your doctor immediately if you notice any of the following unlikely but serious side effects: slow/irregular heartbeat, muscle weakness.

It is one thing to transition, it is another do it as safely as possible.

[RADER]

My wife has been taking this pill for 3 years. Yes it is a water pill, to keep the water away from the hart and out of the legs.
She also takes a Potassium pill with that, as not to drain all the Potassium out of her.
Rader

[Bree-asaurus]

Do you know any drug that does not come some serious warnings? I have taken stuff that came with the warning "may cause death". You either want to transition or you don't. There are risks to everything.

*like*

I was about to post this myself :P

Did you know that a risk of not transitioning when you need to is death? ;)

[ameliabee]

I was looking at the drug info on spiro on RxList (http://www.rxlist.com/aldactone-drug.htm#) when I came across the following bold, highlighted "WARNING":

"Aldactone (spironolactone) has been shown to be a tumorigen in chronic toxicity studies in rats (see PRECAUTIONS). Aldactone (spironolactone) should be used only in those conditions described under INDICATIONS. Unnecessary use of this drug should be avoided."

What's this all about? How significant is it?

Hugs,
Persephone.

Congratulations - somebody demonstrated that spironolactone can theoretically cause cancer with doses considerably greater than those given to humans. Along with - what? - ten thousand other substances we're exposed to everyday? If you're seriously worried about the cancer risk, increase antioxidant and omega-3 oil intake.

[Aprilrain]

do you know any drug that does not come some serious warnings? I have taken stuff that came with the warning "may cause death". You either want to transition or you don't. There are risks to everything.

exactly!!!!!!!!!!!!!!!!!!!!!!!!!!

[Phyliss]

Medical study:

Having been born ... results in death

[crystalann]

:^5:Well Said.................
Do you know any drug that does not come some serious warnings? I have taken stuff that came with the warning "may cause death". You either want to transition or you don't. There are risks to everything.

[Inna]

Before HRT I have come to self prescribe suicide for my condition, death wasn't something scary but means to switching the unbearable pain off. After surviving and living for another day I promised that I will do absolutely everything to allow being a "true self" even if it kills me. Then came HRT including Spiro, if this one kills me, it will be the sweetest death I could hope for :) Death doesn't scare me, but lies, guilt and psychological torment does!!!!!!

[Melody Moore]

You do realise that if you drink too much water as well then you might end up drowning? :daydreaming:

[Stephenie S]

I have to interject here because spiro IS a very dangerous drug, although no one seems to be mentioning exactly what that danger is.
Spironolactone is NOT a transition hormone drug. Spiro is a diuretic. This has been mentioned already. Spiro has an interesting side effect, however. In very high doses, spiro can lower testosterone. But spiro is really a diuretic blood pressure medication. A diuretic makes you pee. It REMOVES fluid from your body. Why do we want a drug that makes you pee? Because when you lower fluid volume in the body (peeing) it LOWERS blood pressure.

So? What difference does this make to a transwoman who is using spiro to lower testosterone in her body? Well, the normal dose for lowering blood pressure with spiro is 25mg to 50mg per day. OK. But the normal dose for lowering testosterone is 150mg to 400mg per day and sometimes higher. What do you think that high a dose of spiro does to your blood pressure? Right. Your BP can drop drastically. Now, no blood pressure means you are dead. Low blood pressure can cause dizziness, fainting, weakness, black outs, among other more serious effects.

Until you get used to taking spiro, you should be prepared for this occurrence. Sometime you may be unable to even move. If this should happen while you are driving you are in trouble. After a couple of weeks, your body should be used to this high a dose of Spiro and you should be fine. But those first few weeks of spiro can be a bit scary and DEFINITELY dangerous if you are not prepared for the possible symptoms of extremely low BP.

Stephie

PS. I am aware that I am skating on thin ice by mentioning dosage in this post. But I only mention a RANGE of dosage. I think the seriousness of this subject warrants the inclusion of my VERY loose dosage parameters. I am not sure I could communicate the importance of this idea without doing this.

S

[Melody Moore]

If you are so worried about a drug like Spironolactone, then why not
look for some other alternative for an anti-androgen like Androcur?

My point was that all medications usually come with some risks & this is why you should be fully aware
of the correct dosages & any possible side affects of any sort of medication that you take. Noone is
saying that you should be complacent about this - education & awareness is the key to taking any sort
of drug safely. So research your meds so you fully understand the risks & know what to look for if things
do start to go wrong.

[sandra-leigh]

I am on a relatively low dose of spiro as the blood pressure (or some other side effect) makes me tired.

How tired? Tired enough that some weeks, 3 days out of 5 I pretty much had to leave work several hours early because I was too tired to do anything.

For me I did not get any muscle exhaustion or any dizziness (as such). I have, though, taken a lot of naps, slept long hours, and had long long long dreams that leave my mind very foggy in the morning because I did not get the right kind of sleep.

Two weeks ago, I remember I was at work and feeling wide awake, but started to feel that my eyes were getting a bit tired from all of the computer work. So I closed my eyes for a moment to rest the eyes themselves, and my body jerked. Which, I then realized, was because I had fallen asleep in seconds and didn't even "know" I was asleep, and my head started to drop forward after a couple of minutes. The incident was harmless because I was just sitting at my desk that time. It was easy to picture that it could have happened while I was driving, in that I had no idea I was going to fall asleep, with my intent being to just close my eyes and open them again a couple of seconds later.

There are, of course, the usual dangers about mixing medications and alcohol. I don't know, but it seems intuitive to me that blood pressure lowering medication would be especially bad with alcohol.

Spiro can damage your liver, and it is important to have your liver function checked while you are on it, especially if you happen to be on anything else that is potentially damaging to your liver (e.g., the anti-depressant I am taking.)

The warnings about Spiro are not just pro forma "If you eat 17 pounds of this an hour, you may get acid reflux" warnings: chances are that you will experience side effects that could be dangerous. You have to learn your limits, and if you operate heavy machinery (e.g., drive), you better have a plan in place for when (not if!) you suddenly realize that you could really use a nap.

For me, those plans include ensuring I always have enough cash on me to take a cab home, as some days I realize I am too tired to walk the 6 blocks to catch my bus.

[Nicole Erin]

Well, everything can kill you. Everything carries risks.
It is not much different than the fact that each time you drive your car, you are trusting not only your car but the skills of other drivers to NOT kill you.

Now to keep BP from dropping too bad, one would do well to smoke 15 to 20 cigarettes a day.

[Persephone]

Thank y'all for your suggestions and information. Out of fourteen replies so far, though, no-one seemed to address the content of the warning which was tumorigen. Not the side effects or the other things but that it was shown to cause turmors (i.e. potential cancers) to develop.

I understand that the warning is based upon higher-than-normal doses administered to rats and that they are not actually reporting on tumors in humans, but that still seems like a greater than normal cause for concern.

I did check a couple of other unrelated medications and they did not carry such a warning.

Hugs,
Persephone.

[Gerrijerry]

Wait just a minute. Asking a question should not be treated with such -------. Well you should all know that Transitioning should never be taken lightly and looking into what meds can do is something to be considered also. May I suggest Persephone that you talk over what you are asking with the correct person. A doctor. Take your time think about what is correct for you and then deside. Don't be afraid to ask any questions.

[Aprilrain]

Ask all the questions you want! Spiro does what Spiro does, Are you willing to assume this risk or not THAT is the question!
There are alternatives but they carry risks as well.

[Frances]

Wait just a minute. Asking a question should not be treated with such -------. Well you should all know that Transitioning should never be taken lightly and looking into what meds can do is something to be considered also.

Maybe I am turning into Kate (comes with SRS?), but this kind of question comes up all the time in this forum section, usually asked by cross-dressers with feminizing fantasies, but with a ton of reasons not to go forward. The actual transitioners in this forum (a relatively small number) are commited to transition. That means possibly losing everything, and assuming all sorts of risks that may shorten their lives in the long run.

Questions about drug dangers should be asked to a doctor, but then again, if someone gets to the point of being in front of an endo with the firm commitment of transitioning, you really think risks matter? One last year alive as woman outweighs dying as a man. Besides, Androcur is very dangerous and has not been approved in the States. I have two friends who had embolisms from HRT. They did not regret anything, and went on with their transition.


Ask all the questions you want! Spiro does what Spiro does, Are you willing to assume this risk or not THAT is the question!
There are alternatives but they carry risks as well.

Exactly!

[Stephenie S]

Tumorigen isn't a thing. Tumorigen means that a substance has been shown to cause tumors. SMOKING is tumorigenic. So are TONS of other things we are exposed to on a daily basis.

Extreme blood pressure drops are real, nearly universal, and need to be accounted for.

Doctors don't explain. That's the nurses job. Doctor's function is to diagnose and prescribe. Nurses then educate and dispense. The last thing I ALWAYS say to a patient is, "Is there anything else you would like to know?"

It would be nice if doctors explained things. They used to. They used to come to your house too. As a small child, I never went to the doctor. The doctor always came to my house.

Now a days, doctors don't have time to teach. Insurance companies used to give doctors 15 minutes to see a patient. Now it's 10 minutes. That means that when they HAVE to take 1/2 an hour with a patient, somebody else gets taken advantage of. It's not the doctors fault. If they want to participate in the pool of insurance company customers, then they better follow the insurance company rules. And that means 10 minutes per patient, thank you very much.

So don't blame the doc. But he, or his nurse, will explain things if you insist. Always ask questions and never leave until you are satisfied.

[sandra-leigh]

Tumorigen isn't a thing. Tumorigen means that a substance has been shown to cause tumors.

For example, with Spiro (especially in the doses used for HRT), you might well have breast enlargement. Breast enlargement increases the risk of breast cancer. If you take Spiro and end up with breast cancer as a result, then as far as science is concerned, the Spiro has "caused" the breast cancer.

[Frances]

Breast enlargement increases the risk of breast cancer.

Doctors were pretty convinced that it killed my mother.

[Stephenie S]

Oh, Frances. I'm so sorry.

Stephie

[Nicole Erin]

Somehow I don;t believe that a TS person is going to halt transition because there might be risks. They may seek safer alternatives to certain meds or whatever but really, what are you gonna do? Give up?

[stacie]

The HRT we take for our transition are hard on our body. This is why we go through blood testing on a regular base's. The estrogan alone is link to cancer. For myself I would rather take this risk then the risk of putting a bullet into my head beause of being suicidal for have the wrong body. But it is good to know the risk we can run it to from HRT and how important it is to not self medicate.

[Jessinthesprings]

I was looking at the drug info on spiro on RxList (http://www.rxlist.com/aldactone-drug.htm#) when I came across the following bold, highlighted "WARNING":

"Aldactone (spironolactone) has been shown to be a tumorigen in chronic toxicity studies in rats (see PRECAUTIONS). Aldactone (spironolactone) should be used only in those conditions described under INDICATIONS. Unnecessary use of this drug should be avoided."

What's this all about? How significant is it?

Hugs,
Persephone.


I belive that is why self-medicating is poo-pooed so much. Sure, we may find the dosages but without doctor suporvision you are chanceing too much.

I have to agree with many of the ladies that it's a risk we have to take if we want to transition. Everything has risks. If you never want to risk anything a bubble is in your future.

[Eryn]

For example, with Spiro (especially in the doses used for HRT), you might well have breast enlargement. Breast enlargement increases the risk of breast cancer. If you take Spiro and end up with breast cancer as a result, then as far as science is concerned, the Spiro has "caused" the breast cancer.

Replace the word "science" with "tort attorneys" and you would be correct.

This link will take you to the FDA's info with information regarding the rat study:

http://www.drugs.com/pro/spironolactone.html

Note the dosages given the rats, between 10 and 500 mg/kg/day. A normal human dose is on the order of 0.25mg/kg/day.

Along with the increased risk of developing benign tumors comes a significant risk of _not_ dying from a heart attack, which is the usual reason that the drug is prescribed. Obviously the benefit often outweighs the risk.

It might be nice to talk to the doctor about this, but considering the condescending attitude that some doctors have toward their patients sometimes it is better to get the information unedited.