Aldosterone Antagonists

Reviewed by: HU Medical Review Board | Last reviewed: June 2023

Aldosterone antagonists are a type of drug prescribed for people with heart failure and high blood pressure. Aldosterone antagonists can lower the risk of sudden cardiac death by about 20 percent in people who have heart failure or a problem with the left ventricle of their heart.1,2

Treatment goals of aldosterone antagonists include:1,2

  • Improved heart function or delayed progression of heart failure
  • Symptom relief
  • Reduced risk of hospitalization for heart failure
  • Reduced risk of death from heart failure

Aldosterone antagonists are sometimes called aldosterone receptor blockers.1,2

How do aldosterone antagonists work?

Aldosterone antagonists work by blocking the effects of the hormone aldosterone. Aldosterone makes your kidneys retain salt and water, which raises your blood pressure. By blocking aldosterone, these drugs allow your kidneys to release excess water and salt from your blood. This helps lower your blood pressure and reduce fluid buildup around your heart.1


Aldosterone antagonists used to treat heart failure include:1,2

  • Aldactone®, CaroSpir® (spironolactone)
  • Inspra® (eplerenone)

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. The most common side effects of aldosterone antagonists include:1,2

  • High potassium levels (hyperkalemia)
  • Kidney problems
  • Tiredness
  • Dizziness or lightheadedness
  • Diarrhea, nausea, or vomiting
  • Headache
  • Breast enlargement or tenderness (gynecomastia)

These are not all the possible side effects of aldosterone antagonists. Talk to your doctor about what to expect when taking an aldosterone antagonist. You also should call your doctor if you have any changes that concern you when taking an aldosterone antagonist.

Other things to know

Before taking an aldosterone antagonist, tell your doctor if you have:1,2

  • Liver problems, including cirrhosis and ascites
  • High potassium levels
  • Addison's disease
  • Diabetes

Aldosterone antagonists can raise potassium levels. Do not take potassium supplements or potassium-sparing diuretics (water pills) while taking an aldosterone antagonist. If you are taking an aldosterone antagonist and following a low-sodium diet, you should also avoid salt substitutes that contain potassium chloride.1,2

Before beginning treatment for heart failure, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

By providing your email address, you are agreeing to our privacy policy.