Question explored with the scientific record
Does drug Spironolactone affect liver enzymes?
The evidence you provided does not answer whether spironolactone affects liver enzymes. None of the 27 records test that question directly.
The closest you get is a single case report where a 17-year-old boy with heart failure and severe liver congestion was given spironolactone 25 mg daily alongside other drugs [2]. His liver enzymes dropped dramatically over ten days, but that improvement came from treating the heart failure, not from the spironolactone itself. The other records cover bicalutamide, ketoconazole, flutamide, rat studies on heart remodeling, and herb-drug interactions. They are off-topic.
What the broader literature, outside this retrieval, has documented for decades is that spironolactone can cause mild, transient elevations in serum aminotransferases in a small fraction of users, and that clinically apparent liver injury is rare. But the retrieval here contains zero studies that measure liver enzymes in a spironolactone-treated group against a proper control. The burden of proof for safety has not been met by the evidence you handed me.
My call: the retrieved evidence does not support or refute the hypothesis. Confidence: not clear.
Sources examined 27
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Safety of oral bicalutamide in female pattern hair loss: A retrospective review of 316 patients
A retrospective review of 316 women with female pattern hair loss assesses the safety of oral bicalutamide (primarily 10 mg daily) and its limited efficacy when used with concomitant therapies, indicating mostly mild liver enzyme elevations, high adherence, and study design limi…
DOI: 10.1016/j.jaad.2020.03.034 -
Dilated Cardiomyopathy with Congestive Hepatopathy in Post COVID-19 PatientA Case Report
A single adolescent case report describing dilated cardiomyopathy with congestive hepatopathy temporally associated with COVID-19, detailing clinical presentation, investigations, treatment with diuretics/ACE inhibitors/digoxin, and eventual recovery with improved cardiac functi…
DOI: 10.7860/jcdr/2022/53273.16179 -
Ketoconazole use in the treatment of ovarian hyperandrogenism
Gradually dosed ketoconazole reverses the biochemical and clinical features of ovarian hyperandrogenism in reproductive-age women, with menses often normalizing, but safety monitoring for liver toxicity is essential.
DOI: 10.1016/s0015-0282(16)53758-3 -
Lipid peroxidation product 4-hydroxy-nonenal enhances ethanol-induced hepatocellular apoptosis by affecting both pro-apoptotic JNK activity and antiapoptotic nuclear factor-κB
This study investigates the effects of switching from Lamivudine to Adefovir Dipivoxil or a combination of both in chronic hepatitis B patients with Lamivudine resistance, focusing on changes in alanine aminotransferase levels and YMDD mutation profiles.
DOI: 10.1016/s0016-5085(03)83611-9 -
Changes in serum enzyme activities after injection of bupivacaine into rat tibialis anterior
This study investigates the time course of changes in serum enzyme activities, specifically creatine kinase, aspartate aminotransferase, and alanine aminotransferase, following the injection of bupivacaine into the tibialis anterior muscle of rats, revealing significant increase…
DOI: 10.1152/jappl.1996.81.2.876 -
Changes in Serum Levels of HBV DNA and Alanine Aminotransferase Determine Risk for Hepatocellular Carcinoma
This study investigates the relationship between long-term changes in serum levels of HBV DNA and alanine aminotransferase (ALT) and the risk of developing hepatocellular carcinoma in chronic hepatitis B patients, finding that both factors are independent predictors of cancer ri…
DOI: 10.1053/j.gastro.2011.06.036 -
Changes in hepatitis C virus quasispecies and density populations in patients before and after interferon therapy
This study investigates the relationship between hepatitis C virus (HCV) quasispecies and density populations in patients undergoing interferon therapy, revealing that changes in hypervariable region (HVR) heterogeneities correlate more closely with alanine aminotransferase (ALT…
DOI: 10.1002/(SICI)1096-9071(199611)50:3<214::AID-JMV2>3.0.CO;2-C -
Changes in plasma enzyme activities in professional racing cyclists.
This study investigates the changes in plasma enzyme activities, specifically aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and alkaline phosphatase, in professional racing cyclists before and after participating in two different road races, reveal…
DOI: 10.1136/bjsm.30.2.122 -
Temporal Patterns of Ultrastructural Alterations in Hepatocytes of Chimpanzees with Experimental Non-A, Non-B Hepatitis
This study investigates the ultrastructural changes in hepatocytes of chimpanzees infected with experimental non-A, non-B hepatitis, revealing unique cytoplasmic tubules and other alterations associated with the disease.
DOI: 10.1093/infdis/145.6.854 -
Aminotransferase changes in burned patients
This study investigates the changes in serum transaminases in 30 burned patients, revealing that both alanine aminotransferase and aspartate aminotransferase levels increase in parallel, particularly during the second week post-injury, with no clear correlation to the extent of …
DOI: 10.1007/BF00254704 -
Change in hepatitis C virus genotype in hemodialysis patients after end‐of‐treatment response to interferon monotherapy—relapse or re‐infection?
This study investigates the change in Hepatitis C virus (HCV) genotype among hemodialysis patients who achieved an end-of-treatment response to interferon monotherapy but later tested positive for HCV-RNA, suggesting either relapse or re-infection.
DOI: 10.1002/jmv.21050 -
Hepatitis B and C viral load changes following initiation of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection*1
This study investigates the changes in hepatitis B and C viral loads following the initiation of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection, revealing significant increases in HCV viral load and alanine aminotransferase levels, while the…
DOI: 10.1016/s0166-3542(04)00086-5 -
Serum Alanine Aminotransferase Levels, Hematocrit Rate and Body Weight Correlations Before and After Hemodialysis Session
This study evaluated serum alanine aminotransferase (ALT) levels before and after a single hemodialysis session in 146 adults with chronic renal failure, examined their correlations with hematocrit change and weight loss, and proposed sex- and session-specific ALT upper limits t…
DOI: 10.1590/S1807-59322009001000002 -
Lichenoid drug eruption induced by spironolactone
This study reports a case of lichenoid drug eruption induced by spironolactone in a 74-year-old woman, highlighting the rarity of such cutaneous side effects and the histological characteristics of the eruption.
DOI: 10.1046/j.1365-2230.1998.00281.x -
Effects of captopril, spironolactone, and simvastatin on the cardiovascular system of non-diseased Wistar rats
This study investigates the effects of captopril, spironolactone, and simvastatin on the cardiovascular system of healthy Wistar rats, revealing that these drugs do not induce undesirable structural changes while improving endothelial function.
DOI: 10.1016/j.ijcard.2015.04.092 -
Reversal of cardiac and renal fibrosis by pirfenidone and spironolactone in streptozotocin‐diabetic rats
In streptozotocin-induced diabetic rats, short-term treatment with the anti-fibrotic pirfenidone or the anti-aldosterone drug spironolactone reverses cardiac, renal, and vascular fibrosis and reduces diastolic stiffness, but does not fully restore cardiac contractility or some a…
DOI: 10.1038/sj.bjp.0704131 -
Reversal of Spironolactone-Induced Gynecomastia:
A targeted literature review plus a case report examining reversal of spironolactone-induced gynecomastia upon stopping spironolactone and/or switching to eplerenone, finding consistent resolution across included cases and highlighting gaps in the literature.
DOI: 10.46570/utjms.vol11-2023-775 -
Effect of spironolactone and captopril on nitric oxide and S-nitrosothiol formation in kidney of L-NAME-treated rats
This study investigates the effects of spironolactone and captopril on nitric oxide and S-nitrosothiol formation in the kidneys of L-NAME-treated rats, revealing that spironolactone preserves nitric oxide synthase activity and S-nitrosothiol levels, while captopril does not.
DOI: 10.1038/sj.ki.5001513 -
Elderly heart failure patients with drug-induced serious hyperkalemia
This study reports four cases of serious hyperkalemia in elderly patients with congestive heart failure induced by the combination of spironolactone and ACE inhibitors, highlighting the need for careful dosage and monitoring in this vulnerable population.
DOI: 10.1007/bf03339853 -
Differential effect of spironolactone in chronic constriction injury and vincristine-induced neuropathic pain in rats
This study investigates the effects of spironolactone on chronic constriction injury and vincristine-induced neuropathic pain in rats, demonstrating its potential to alleviate pain related behaviors and inflammation in the former while showing no effect in the latter.
DOI: 10.1016/j.ejphar.2010.08.050 -
Effects of hydrochlorothiazide on cardiac remodeling in a rat model of myocardial infarction-induced congestive heart failure
In a rat model of myocardial infarction-induced congestive heart failure, hydrochlorothiazide improved cardiac remodeling and function to a degree comparable with spironolactone, associated with reduced proinflammatory cytokines and inhibition of the TGF-β/Smad signaling pathway.
DOI: 10.1016/j.ejphar.2011.06.012 -
Combined Treatment With Valsartan and Spironolactone Prevents Cardiovascular Remodeling in Renovascular Hypertensive Rats
Combined valsartan and spironolactone prevents cardiovascular remodeling in renovascular hypertensive rats by simultaneously suppressing myocyte hypertrophy and cardiac fibrosis, with valsartan mainly reducing hypertrophy, spironolactone reducing fibrosis, and the combination pr…
DOI: 10.1536/ihj.47.783 -
Mineralocorticoid activity and the excretion of an oral potassium load in normal man
In six healthy men, the study mapped how plasma potassium acutely drives renal excretion of potassium and sodium after an oral potassium load, and how chronic mineralocorticoid activation with fludrocortisone shifts the response to a lower plasma K while spironolactone largely b…
DOI: 10.1038/ki.1988.235 -
Severe renal failure and thrombotic microangiopathy induced by malignant hypertension successfully treated with spironolactone
This case report describes a 30-year-old man with malignant hypertension who developed severe renal failure and thrombotic microangiopathy, successfully treated with spironolactone and other antihypertensive medications despite remaining dialysis-dependent.
DOI: 10.1016/j.ancard.2018.04.009 -
Spironolactone: is it a novel drug for the prevention of amphotericin B-related hypokalemia in cancer patients?
This study investigates the efficacy of spironolactone in preventing hypokalemia in neutropenic patients undergoing treatment with amphotericin B, demonstrating that spironolactone significantly reduces potassium loss and supplementation needs compared to amphotericin B alone.
DOI: 10.1007/s00228-001-0390-9 -
Preclinical study of simultaneous pharmacokinetic and pharmacodynamic herb-drug interactions between Yin-Chen-Hao-Tang and spironolactone
High-dose YCHT pretreatment increased urinary canrenone excretion and reduced spironolactone's diuretic effect in rats, indicating herb-drug interaction.
DOI: 10.1186/s12906-020-03042-y -
Prospective Cohort Study on the Effects and Tolerability of Flutamide in Patients with Female Pattern Hair Loss
A 4-year prospective cohort study from Bologna, Italy, evaluating long-term efficacy and safety of low-dose flutamide for female pattern hair loss, with or without oral contraceptive, showing significant improvement in scalp hair density and reduced androgen levels, with accepta…
DOI: 10.1345/aph.1p600