Hyles Overdosage

Overdose: Overdosage of spironolactone would be expected to produce signs and symptoms that are mainly extensions of common adverse reactions such as drowsiness, mental confusion, maculopapular or erythematous rash, nausea, vomiting, dizziness, or diarrhea. Rarely, hyponatremia or hyperkalemia may occur, especially in patients with impaired renal function; hepatic coma may occur in patients with severe liver disease but a causal relationship of these effects to overdosage of spironolactone has not been established.
Treatment: In the event of overdosage, spironolactone should be discontinued and the patient should be carefully monitored. There is no specific antidote for spironolactone overdosage. In acute overdosage, the stomach should be emptied by inducing emesis or by gastric lavage. Supportive and symptomatic treatment should be initiated to maintain hydration, electrolyte balance, and vital functions. If severe hyperkalemia occurs (i.e., serum potassium concentration greater than 6.5 mEq/L), specific measures such as IV administration of calcium chloride solution, sodium bicarbonate, and/or oral or parenteral administration of glucose with a rapid-acting insulin preparation should be instituted to reduce serum potassium concentrations. If necessary, a cation exchange resin (e.g., sodium polystyrene sulfonate) may be administered orally or as a retention enema. Patients with persistent hyperkalemia may require dialysis.