Aldosterone Receptor Antagonists: Diuretics for Heart Failure

Gives info on diuretics to remove extra water (fluid) from body. Explains medicines are used for people with congestive heart failure.

Aldosterone Receptor Antagonists: Diuretics for Heart Failure


Generic Name Brand Name
eplerenone Inspra
spironolactone Aldactone

How It Works

Aldosterone receptor antagonists are
medicines that help the body get rid of extra water (diuretics). They
also have other properties that can prevent
heart failure from becoming worse, along with
improving symptoms of heart failure.

These medicines cause the
kidneys to get rid of extra water and they help hold on to (retain)
potassium by inhibiting the action of the hormone aldosterone. Because of this,
they are called potassium-sparing diuretics.

Why It Is Used

Aldosterone receptor antagonist
medicines may be used if you have heart failure and you are
already taking other medicines (such as angiotensin-converting enzyme [ACE]
inhibitors and beta-blockers).footnote 1

How Well It Works

Aldosterone receptor antagonists are
the only diuretics that improve survival for people with heart failure. They
lower the risk of death and hospitalization and improve symptoms of heart
.footnote 2

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.
  • Confusion.
  • Irregular heartbeat.
  • Numbness or tingling in your hands, feet, or lips.

Call your doctor if you have:

  • Hives.

Common side effects of this medicine include:

  • Nausea and vomiting.
  • Stomach cramps.
  • Diarrhea.

See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)

What To Think About

You may feel more tired or need to urinate more often when you start taking this medicine. These effects typically occur less after you have taken the medicine for a while. If the increase in urine interferes with your sleep or daily activities, ask your doctor to help you plan a schedule for taking the medicine.

Your doctor may monitor the potassium in your blood with regular blood tests. Your doctor will let you know when you need to have the tests.

This diuretic does not make you lose potassium from your body like some other diuretics do. So you do not need to get extra potassium in your diet. Talk with your doctor or a dietitian before eating salt substitutes, because some salt substitutes contain potassium.

For information on other types of diuretics for heart failure, see Diuretics for Heart Failure.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

For tips on taking medicine for heart failure, see:

Heart Failure: Taking Medicines Properly.

Advice for women

If you are pregnant, breast-feeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) ( What is a PDF document? ) to help you understand this medication.



  1. Yancy CW, et al. (2013). 2013 ACCF/AHA Guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 62(16): e147–e239.
  2. Drugs for treatment of chronic heart failure (2009). Treatment Guidelines From The Medical Letter, 7(83): 53–56.


ByHealthwise StaffPrimary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology Adam Husney, MD - Family Medicine Specialist Medical Reviewer Margaret Hetherington, PHM, BsC - Pharmacy

Current as ofOctober 5, 2017