How Much Water Should I Drink When Taking Spironolactone?

By Robynn Lowe
Medically reviewed checkmarkMedically reviewed
July 25, 2022

Spironolactone is a diuretic, also known as a “water pill’, which causes the kidneys to eliminate excess fluid.

Unfortunately, there’s always a possibility of dehydration during this process.

To avoid dehydration, it’s vital to know how much fluid intake you need and the signs that your body needs more fluid.

In this article, I’ll discuss spironolactone and its common uses. Then, I’ll explain how spironolactone works and the possible side effects.

Next, I’ll talk about how much water you should drink when taking spironolactone, signs of dehydration, and tips for staying hydrated. Finally, I’ll explore when to see a medical professional.

What is Spironolactone? 

Spironolactone is a generic medicine with the brand names Aldactone and CaroSpir. It is a potassium-sparing diuretic.

This means that it aids the retention of potassium in the body while causing the kidney to eliminate excess fluids and sodium.

It is not sold over-the-counter. Rather, it is a prescription medicine, meaning you can only purchase it with a medical professional’s prescription. 

Common Uses 

Some of the common conditions for which medical providers prescribe spironolactone include:

  • High blood pressure
  • Heart failure
  • Swelling or edema caused by various conditions like heart failure or a liver problem
  • Hyperaldosteronism (excessive production of the hormone aldosterone)

Sometimes, spironolactone is used off-label.

This means that a medical provider prescribes it in ways that the U.S. Food and Drug Administration (FDA) has not approved: either for a condition the drug is not approved to be used for, or as a different dosage amount than is common.

Some of the off-label uses include the treatment of:

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How Spironolactone Works 

Spironolactone belongs to a class of medications known as aldosterone antagonists.

Aldosterone is a hormone the adrenal glands produce that aids water and sodium retention while causing the release of potassium.

It can also affect blood pressure. Spironolactone works by inhibiting the activity of aldosterone.

This causes the kidney to eliminate excess fluid and sodium from the body through the urine while reducing the loss of potassium from the body. 

Side Effects of Spironolactone

Spironolactone has various side effects that range from mild to severe, and some are more common than others.

Common Side Effects of Spironolactone

Some common side effects of spironolactone include:

  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal cramping 
  • Headache
  • Itching
  • Dizziness
  • Lightheadedness
  • Menstrual bleeding after menopause
  • Irregular menstrual bleeding
  • Inability to have an erection
  • Loss of sex drive
  • Growth of breast tissue

Some side effects, such as dizziness and lightheadedness, can be made worse by consuming alcohol.

Speak to your healthcare provider about consuming alcohol while taking spironolactone.

Less Common Side Effects of Spironolactone

Some less common side effects include:

  • Hives
  • Difficulty breathing or swallowing
  • Gastric bleeding
  • Mental confusion
  • Lethargy
  • Renal dysfunction

How Much Water Should I Drink When Taking Spironolactone? 

Since spironolactone causes the kidney to eliminate excess fluid, it is common to experience dehydration while on it. 

The recommended amount of fluid you should consume to stay hydrated is 1.5 to 2 liters per day.

However, every case is specific, and people’s hydration needs can differ based on their age, medical conditions, the climate in which they live, physical activity level, weight, diet, and gender. 

Follow your healthcare provider’s instructions on the amount or type of liquid to consume.

They may ask you to increase or lower your fluid intake depending on your medical condition or other factors.

When to Drink Water 

There is no particular recommended time of day to drink water while taking spironolactone.

Instead, consistency is most important.

Maintain your fluid intake throughout the day, don’t go long periods without drinking water or other fluids, and pay attention to potential signs of dehydration to avoid more serious complications. 

The first symptoms of dehydration can feel mild, but it’s important to not ignore the signs, and to have a plan for rehydration if you start experiencing any of these.

Signs of Dehydration 

  • Dry mouth
  • Thirst
  • Headache
  • Dizziness
  • Unsteadiness
  • Muscle cramps
  • Dry skin
  • Infrequent urination

Other Tips for Staying Hydrated 

Hydration is critical to many of the body’s daily functions, including regulating body temperature, lubricating the joints, delivering nutrients to cells, clearing waste and toxins from the body, and maintaining proper organ function. 

Staying on top of your water intake is even more important when taking a medication like spironolactone, which can quicken the process of dehydration.

But remembering to maintain or increase your hydration can be difficult.

It’s common to hear people say they forget to drink water, but with these tips, staying hydrated should be easier.

They include:

  • Drink a glass of water first thing in the morning.
  • Carry a reusable water bottle everywhere.
  • Set reminders.
  • Flavor your water.
  • Eat food high in water, such as watermelon, lettuce, celery, and cucumbers.
  • Take water breaks.
  • Drink water before meals.
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When to See a Medical Professional 

See a medical professional immediately if you notice symptoms of an allergic reaction to spironolactone. Symptoms include:

  • Difficulty breathing
  • Hives
  • Swelling of your face, lips, tongue, or throat.

You should also see a medical professional if you observe symptoms such as:

  • Slow heart rate
  • Confusion
  • Little or no urination
  • Muscle weakness
  • Irregular heartbeat
  • Lightheadedness
  • Loss of movement

When taking spironolactone, you will need to take regular blood tests so your healthcare provider can monitor your electrolyte levels and kidney function.

The frequency of these tests will be based on your health condition, the dosage of spironolactone, and the stability of your electrolyte levels.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and, if needed, text with a healthcare provider in minutes.

K Health’s AI-powered app is HIPAA compliant and is based on 20 years of clinical data.

Frequently Asked Questions

How much water should I drink on diuretics?
Typically, medical professionals recommend 1.5 to 2 liters of fluid per day, but it may vary based on your specific condition. They may ask you to increase or lower your fluid intake depending on your medical conditions or other factors like activity level. Note that your fluid intake can include water, other drinks (like fruit juice), and food that contains water, like watermelon and celery.
Does spironolactone cause water retention?
No, spironolactone does not cause water retention. Instead, it causes your kidneys to eliminate excess fluid and sodium in the body through urine while retaining potassium.
What should I avoid while taking spironolactone?
While taking spironolactone, avoid taking potassium supplements or following a diet rich in potassium(containing foods like bananas, spinach, and potatoes). High potassium levels in the body can cause hyperkalemia. Also, avoid eating foods that are high in salts, such as salted meat, pickles, and pizza. Inform your healthcare provider of all medicines you take, including over-the-counter medications and herbal supplements. Spironolactone can interact with alcohol which may worsen side effects such as dizziness, so you should lessen or avoid consuming alcohol.
What is the best time of day to take spironolactone?
Although there’s no particular time to take spironolactone, it is better to take it earlier in the day, so you don’t have to wake up at night to pee. If you need to take it twice a day, it is best to take the second pill before 6 p.m.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Robynn Lowe

Robynn Lowe is a board certified Family Nurse Practitioner with over 15 years in the medical field. Robynn received her Bachelor's and Master's degrees from Florida Atlantic University and has been practicing in rural family medicine since. Robynn is married to her college sweetheart, Raymond and they have three awesome children. When Robynn isn't with patients you can find her shopping, coaching her kids sports teams, or spending time on the water.

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