Manufacturers recommend spironolactone be taken at the same time every day, with or without food.1,2 Because food increases the bioavailability of spironolactone, a consistent pattern related to meals and drug dosing should be followed.3–5
Spironolactone has a short half-life of only two hours and is broken down into three major metabolites that contribute to its clinical effect.6 The blood level of the drug and its metabolites reach their peak in 2.6 to 4.3 hours.1,2
While studies of some antihypertensive medications have indicated that bedtime dosing may improve 24-hour blood pressure control,7 studies on bedtime dosing have not included spironolactone.
References
- Aldactone (spironolactone) [package insert].New York, NY: Pfizer Labs; 2018.
- Spironolactone [package insert]. Morgantown, WV: Mylan Pharmaceuticals; 2015.
- Karim A. Spironolactone: disposition, metabolism, pharmacodynamics, and bioavailability. Drug Metab Rev 1978; 8 (1): 151-188.
- Melander A, Danielson K, Schersten B, Thulin T, Wahlin E. Enhancement by food of canrenone bioavailability from spironolactone. Clin Pharmacol Ther 1977; 22 (1): 100-103.
- Overdiek HW, Merkus FW. Influence of food on the bioavailability of spironolactone. Clin Pharmacol Ther 1986; 40 (5): 531-536.
- Kolkhof P, Barfacker L. 30 years of the mineralocorticoid receptor: mineralocorticoid receptor antagonists: 60 years of research and development. J Endocrinol 2017; 234 (1): T125-T140.
- Zhao P, Xu P, Wan C, Wang Z. Evening versus morning dosing regimen drug therapy for hypertension. Cochrane Database Syst Rev 2011;(10): CD004184.
