Spironolactone (e.g., Aldactone generic, Pfizer), a diuretic and aldosterone antagonist, may nearly triple the risk of upper gastrointestinal (GI) events such as bleeding and ulcers, according to a study from Erasmus Medical Center in Rotterdam, The Netherlands. Researchers studied data from 306,645 patients, of whom 523 had definite gastric or duodenal ulcer or upper GI bleeding. Those patients were matched with 5,230 controls. Most patients used spironolactone for heart failure, but some used it for hypertension, and one used it for liver cirrhosis.
The current use of spironolactone was associated with a 2.7-fold increased risk of a GI event. Patients taking higher doses had a five-fold increased risk. The risk was most pronounced when spironolactone was combined with ulcerogenic drugs.