Products
Canrenone is commercially available as an injectable (Soldactone). It has been approved in many countries since 1975.
Structure and properties
Canrenone (C22H28O3, Mr = 340.5 g/mol) is an active metabolite of spironolactone (aldactone) and, unlike the latter, is soluble in water. Canrenone is present in drugs as potassium canrenoate, the potassium salt of canrenoic acid, which is rapidly converted in the organism to the lactone canrenone.
Effects
Canrenone (ATC C03DA02) is a diuretic. Its effects are due to aldosterone antagonism and subsequent inhibition of sodium and water reabsorption and potassium secretion at the nephron.
Indications
For the treatment of primary hyperaldosteronism.
Dosage
According to the SmPC. The drug is administered intravenously as an injection or infusion.
Abuse
Canrenone can be abused as a doping agent in competitive sports, including as a masking agent, for dehydration, and as an antiandrogen in women. Hope Solo, the goalkeeper for the U.S. women’s soccer team, tested positive for the banned doping agent before the 2012 London Olympics. According to her own statements, she was given it by her doctor to treat premenstrual syndrome.
Contraindications
Canrenone is contraindicated in hypersensitivity, acute renal failure, rapidly progressive impairment of renal function, anuria, hyperkalemia, and aldosterone-independent edema. For complete precautions, see the Drug Information Leaflet.
Interactions
Drug-drug interactions are possible with other diuretics, NSAIDs, acetylsalicylic acid, ACE inhibitors, carbenoxolone, digoxin, epinephrine, and norepinephrine. Intake of potassium supplements and potassium-sparing diuretics is not indicated because it may lead to hyperkalemia.
Adverse effects
The most common possible adverse effects include increased nipple tenderness to touch, breast enlargement in men, and breast pain. Other possible side effects include hirsutism, headache, dizziness, drowsiness, ataxia, menstrual irregularities, postmenopausal bleeding, male potency and libido disturbances, an increase in uric acid levels, nausea, vomiting, diarrhea, and cramps.