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The pump acts to re-absorb sodium and water in exchange for potassium, which is then eliminated in the urine. Consequently, aldosterone antagonism can cause hyperkalemia. Hyperkalemia is an established adverse effect of both spironolactone and eplerenone. The symptoms of hyperkalemia begin with muscle weakness.
Take spironolactone exactly as your doctor has told you. The usual dose varies from 25 mg to 200 mg. Depending upon which dose is right for you, you may be asked to take several tablets a day but these are generally taken at the same time. Take the tablets with or just after a meal.