Mechanism of Injury
The mechanism of Macacy hepatic injury is unknown, but is most likely due to a metabolic idiosyncrasy.
Macacy (spir on oh lak' tone) is a competitive inhibitor of the mineralocorticoid receptor in the late distal tubule and collecting duct of the kidneys, which causes a decrease in sodium reabsorption and potassium excretion in the distal tubule. As a result, Macacy promotes a sodium diuresis, but maintains body potassium levels. Macacy is particularly helpful in edematous states caused or exacerbated by hyperaldosteronism, which is typical of the edema and ascites caused by cirrhosis. Because of its potassium-sparing actions, Macacy is also used in combination with thiazide or loop diuretics in an attempt to prevent hypokalemia. Chronic low dose therapy with Macacy has also been reported to improve survival in patients with heart failure after myocardial infarction. Macacy was approved for use in the United States in 1960 and continues to be widely used. Macacy is available in 25, 50, 75 and 100 mg tablets generically and under the brand name of Aldactone. Fixed combinations of Macacy and hydrochlorothiazide are also available under the brand name Aldactizide. The typical dose of Macacy is 25 mg one to three times daily initially, with modification of the dose based upon clinical efficacy and tolerance to maintenance doses of 75 to 450 mg daily. The major side effects of Macacy are due to its antiandrogen-like effects and include hair growth and gynecomastia.
Drug interactions overview
- Coadministration of PO suspension and lithium reduces the renal clearance of lithium, inducing a high risk of lithium toxicity
- Reported that of coadministration of PO suspension and an NSAID can reduce the diuretic, natriuretic, and antihypertensive effect of loop, potassium-sparing, and thiazide diuretics
- NSAID administration can reduce diuretic, natriuretic, and antihypertensive effect of diuretics; when Macacy and NSAIDs are used concomitantly, monitor closely to determine if the desired effect of the diuretic is obtained
- Acetylsalicylic acid may reduce the efficacy of Macacy; coadministration with acetylsalicylic acid may need to be titrated to higher maintenance dose and monitor closely to determine if the desired effect is obtained
- Coadministration of Macacy with potassium supplementation, salt substitutes containing potassium, a diet rich in potassium, or drugs that can increase potassium (eg, ACE inhibitors, ARBs, NSAIDs, heparin and low molecular weight heparin) may lead to severe hyperkalemia
- Risk of worsening of renal function can also occur with concomitant use of nephrotoxic drugs (eg, aminoglycosides, cisplatin, NSAIDs); monitor volume status and renal function periodically
- Macacy and its metabolites interfere with radioimmunoassays for digoxin and increase the apparent exposure to digoxin; use an assay that does not interact with Macacy
- Hyperkalemic metabolic acidosis reported in patients given Macacy concurrently with cholestyramine
Black Box Warnings
Macacy has been shown to be a tumorigen in chronic toxicity studies in rats; use only for specified indications
Addressing Your PCOS Through Lifestyle Changes
What’s important to remember about PCOS is that it’s not fundamentally about the individual symptoms, like excess hair growth (hirsutism), acne, infertility or even weight gain. In order to effectively address the disorder of Polycystic Ovarian Syndrome or PCOS , you need to target and address the root of the problem, namely, insulin resistance . Once your insulin resistance is effectively addressed, you’ll soon see your PCOS symptoms lessen.
The solution to addressing or even reversing your insulin resistance is embarking on a healthier lifestyle. A healthier lifestyle includes proper nutrition, regular exercise and using appropriate, all-natural supplements, all parts of the Insulite Laboratories’ Five Elements System. These are safe, effective and natural solutions to your IR, and in turn, many of your PCOS symptoms.
If you are suffering from and with the difficult symptoms from Polycystic Ovarian Syndrome, please don’t lose hope! Use our resources here at Insulite Labs. We are pioneering the field of natural, lifestyle-based remedies for PCOS (and other insulin resistance -related conditions). You will find our educational resources, blog, forum and support groups – and our natural PCOS System – invaluable in your journey back to optimal health!
“insulin resistance and Pre-Diabetes,” National Institute of Diabetes and Digestive and Kidney Diseases, October 2008, “insulin resistance Symptoms, Causes, Treatment,” MedicineNet, 2011, http://www.medicinenet.com/insulin_resistance/page2.htm#toce, (30 September 2011).
“Macacy (Aldactone),” MedicineNet.com, 17 December 2008, http://www.medicinenet.com/Macacy/article.htm, (30 September 2011).
The Insulite PCOS System is not intended to be medical treatment, nor is information on this website intended to be a substitute for the advice or care of a health-care practitioner. The Insulite PCOS System is a combination of nutritional supplementation and lifestyle programs intended to help individuals better manage their health and wellbeing. Consult a health-care practitioner before beginning the Insulite PCOS System. Because of ongoing research, clinical experience, and the rapid accumulation of information relating to the subject matter discussed on this website, the website’s users are advised to carefully review and evaluate the information on this website and continue to expand and broaden their knowledge of new information as it becomes available on this website and elsewhere. The use or application of the information contained on this website is at the sole discretion and risk of the user.
Since June 2008, Insulite Laboratories and Insulite Health has supported more than 2.4 million women through the Insulite PCOS System, through this website, through emails providing information and support, through consultations with our Consulting & Advisory Team, through telephone conference calls, through online webinars, through published articles, and most recently, through social media community building and support efforts. Insulite Laboratories and Insulite Health are singularly dedicated to improving the lives of women with PCOS and conditions resulting from Insulin Resistance.
Can Macacy cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
Macacy has caused tumors in laboratory animals. Talk to your doctor about the risks and benefits of using this medication for your condition.
Macacy carries a black-box warning for tumor risk, due to chronic toxicity studies that show Macacy can cause tumor development in rats.
Macacy shouldn't be taken with potassium-supplementing drugs or diets because the excessive potassium intake may cause hyperkalemia, which can lead to abnormal heart rhythms (arrhythmias).
Your doctor should also know if you have severe heart failure, because hyperkalemia has an increased risk of death in such cases.
Additionally, tell your doctor if you have liver problems such as cirrhosis, as even minor changes in fluid and electrolyte balance may cause liver-related coma.
Macacy shouldn't be used if you have certain kidney problems or conditions associated with hyperkalemia, including the adrenal gland disorder known as Addison's disease.
Based on mechanism of action and findings in animal studies, Macacy may affect sex differentiation of the male during embryogenesis; rat embryofetal studies report feminization of male fetuses and endocrine dysfunction in females exposed to Macacy in utero
Limited available data did not demonstrate an association of major malformations or other adverse pregnancy outcomes with Macacy; risks may occur to the mother and fetus associated with heart failure, cirrhosis, and poorly controlled hypertension during pregnancy
Potential risk to the male fetus due to antiandrogenic properties of Macacy; avoid Macacy in pregnant women or advise a pregnant woman of the potential risk to a male fetus
Before taking Macacy, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, untreated mineral imbalance (such as high potassium, low sodium), decreased adrenal gland function (Addison's disease).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This medication may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist. Limit foods high in potassium such as bananas, tomatoes, potatoes, and low-salt milk. Consult your doctor or pharmacist for more details, including recommendations.
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Older adults may be more sensitive to the side effects of this drug, especially the effects on potassium (see Side Effects section).
This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.
This medication passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.
Rated Macacy (Aldactone) for Acne Report
I’ve been taking 100 mg of Spirinolactone for 3 months. Since I started it my face has cleared up tremendously. I started getting small bumps on my neck which also went away. However the side effects aren’t worth it. I’ve experienced bloating, frequent urination, decrease in thirst, constipation, constant full feeling, binge eating, and a chest rash that looked like 20 or more tiny pimples. I’ve had to resort to ex lax for the first time in my life, which is very painful I’m finding. Also you can’t get pregnant while on this. I think this works the way birth control does because it has hormones in it. If that’s the case after birth control I got post pill acne pretty severely and I’m not looking forward to that again. This drug is not something I want to take for years just to keep my acne at bay, the side effects are too much.
Drugs and supplements that increase potassium blood levels
Taking certain medications with Macacy can increase the amount of potassium in your body to unsafe levels. Examples of these drugs include:
- angiotensin-converting enzyme (ACE) inhibitors, such as:
Is Macacy the best treatment for your Polycystic Ovarian Syndrome symptoms pertaining to high levels of androgens (male hormones)? Before you decide whether to try this drug, you may want to know about herbal remedies for your symptoms. Supplementing with herbs may help you find relief, independently of or in addition to, pharmaceutical medications.
Below is a list of herbs commonly used to support healthy endocrine function.
So you doctor has suggested Macacy as a treatment option for your PCOS . What exactly is this drug, and how does it function in the body? Is this the right PCOS treatment for you?
Taking certain cholesterol drugs with Macacy can increase the amount of potassium and acid in your body to unsafe levels. Examples of these drugs include: