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AMR Drug RepurposingSmart Screeningresearch prototype

Spironolactone

FDA-approved product (tablet, oral), marketed as Aldactone, Carospir, Spironolactone.

Registered studies
50+
Lab records
0
Pathogens at ≥40%
1 of 4

Chemical structure

Chemical structure of Spironolactone
A drawing shows what the molecule is, not what it does.

Existing / approved use

Documented · FDA, WHO, ChEMBL

Approved for

  • Ascites
  • Cardiovascular disease
  • Cirrhosis of liver
  • Congestive heart failure
  • Edema
  • Essential hypertension
  • Heart failure
  • Hepatic fibrosis
  • Hypertension
  • Myocardial infarction
  • Nephrotic syndrome
  • Preeclampsia
  • Primary hyperaldosteronism

Indications ChEMBL records as approved, from FDA and DailyMed labels. Label ↗

WHO therapeutic group
Aldosterone antagonists
FDA pharmacologic class
Aldosterone Antagonist FDA label ↗
Anti-infective classification
Not classified as an anti-infective.

Repurposing investigation

This medicine is being investigated here for AI-predicted antimicrobial activity against MRSA. It was surfaced computationally for further investigation; it is not an established treatment for this infection.

AI-predicted activity

AI prediction · nothing measured
  • MRSA55.0% AI-predicted activityAt or above the ≥40% mark this site uses to surface candidates.
  • E. coli35.3% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.
  • K. pneumoniae26.7% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.
  • M. tuberculosis33.0% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.

A model’s estimate of laboratory activity against each pathogen species. It is not clinical effectiveness.

Evidence

Clinical and experimental

Documented evidence

Clinical

50+registered studies name this medicine, for any condition. The registry search keeps the first 50, so there may be more. See them below.

Experimental

No evidence found

No laboratory measurement against the four pathogens in the ChEMBL records loaded here.

Open Spironolactone in ChEMBL Registered studies below

Docking

Computational · nothing measured

Dihydrofolate reductase ↗ (E. coli)

-7.8 kcal/mol

0better fit →-12

KPC-2 carbapenemase ↗ (K. pneumoniae)

-7.9 kcal/mol

0better fit →-12

Enoyl-ACP reductase (InhA) ↗ (M. tuberculosis)

-8.7 kcal/mol

0better fit →-12

Dihydrofolate reductase ↗ (MRSA)

-7.6 kcal/mol

0better fit →-12

AutoDock Vina, one experimentally solved protein per pathogen. This project’s screening target is -7.0 kcal/mol, its own mark rather than a universal cutoff. A docking score is a structural hypothesis, not proof of binding, and requires experimental validation.

Other medicines to investigate

AI prediction · nothing measured

Other repurposing candidates: approved medicines besides Spironolactone with AI-predicted activity ≥40% against the chosen pathogen, leaving out existing antimicrobials. They are computational candidates for further investigation, not alternatives and not recommendations.

Sorted by AI-predicted activity, high to low. The order is not a ranking of which medicine is better.

Registered studies

A registration describes a study; it does not establish a positive result.

  • Efficacy and Safety of Early Initiation of Midodrine for Control and Prevention of Ascites and Its Related Complications in Acute-on-chronic Liver Failure.

    NCT07422948 · start 2026-02-05

    Registered record
    Registry ID
    NCT07422948
    Conditions
    Acute on Chronic Liver Failure
    Interventions
    Midodrine; Standard Medical Treatment
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Not yet recruiting
    Start
    2026-02-05
    Completion
    2027-08-30
    Enrolment
    113

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute on Chronic Liver Failure
    InterventionMidodrine; Standard Medical Treatment
    PhaseNot applicable
    Registry statusNot yet recruiting

  • The Role of Skin Sodium Accumulation in Chronic Kidney Disease

    NCT07020104 · start 2025-01-07

    Registered record
    Registry ID
    NCT07020104
    Conditions
    Chronic Kidney Diseases
    Interventions
    Hydrochlorothiazide; Spironolactone; Lercanidipine; High sodium dietary intake (>200mmol/l); Low sodium dietary intake (<50mmol/l); High water intake; Habitual water intake
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Recruiting
    Start
    2025-01-07
    Completion
    2039-12-01
    Enrolment
    60

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionChronic Kidney Diseases
    InterventionHydrochlorothiazide; Spironolactone; Lercanidipine; High sodium dietary intake (>200mmol/l) +3 more
    PhaseNot applicable
    Registry statusRecruiting

  • Venous Congestion And Cognitive Dysfunction After Cardiac Surgery

    NCT07483151 · start 2024-11-01

    Registered record
    Registry ID
    NCT07483151
    Conditions
    Intraoperative Venous Congestion And Cognitive Dysfunction After Cardiac Surgery
    Interventions
    collection of demographic characteristics and comorbidities; surgery-related parameters; POCD assessments; collection of biological (laboratory) parameters; collection of hemodynamic parameters; collection of echocardiographic parameters and venous ultrasound assessments; collection of parameters monitoring on the central nervous system
    Study type
    OBSERVATIONAL
    Phase
    Not recorded
    Registry status
    Recruiting
    Start
    2024-11-01
    Completion
    2026-10-31
    Enrolment
    110

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionIntraoperative Venous Congestion And Cognitive Dysfunction After Cardiac Surgery
    Interventioncollection of demographic characteristics and comorbidities; surgery-related parameters; POCD assessments; collection of biological (laboratory) parameters +3 more
    PhaseNot recorded
    Registry statusRecruiting

  • Statin Combined with Amlodipine Treats Primary Aldosteronism

    NCT06523465 · start 2024-09-10

    Registered record
    Registry ID
    NCT06523465
    Conditions
    Primary Aldosteronism; Statin; Mineralocorticoid Receptor Antagonist; Hypertension
    Interventions
    Simvastatin combined with Amlodipine besylate; Simvastatin combined with Spironolactone and Amlodipine besylate.; Amlodipine besylate combined Spironolactone
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Recruiting
    Start
    2024-09-10
    Completion
    2026-09-30
    Enrolment
    180

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPrimary Aldosteronism; Statin; Mineralocorticoid Receptor Antagonist; Hypertension
    InterventionSimvastatin combined with Amlodipine besylate; Simvastatin combined with Spironolactone and Amlodipine besylate.; Amlodipine besylate combined Spironolactone
    PhasePhase 4
    Registry statusRecruiting

  • Optimal Medical Treatment of Difficult-to-treat Hypertension

    NCT06275763 · start 2023-10-20

    Registered record
    Registry ID
    NCT06275763
    Conditions
    Hypertension
    Interventions
    Phase C: Eplerenone; Phase C: Spironolactone; Phase C: Torasemide; Phase B: Triplixam / Elestar HCT; Phase A: Confirmation of uncontrolled hypertension
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Unknown
    Start
    2023-10-20
    Completion
    2025-12-31
    Enrolment
    2,500

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHypertension
    InterventionPhase C: Eplerenone; Phase C: Spironolactone; Phase C: Torasemide; Phase B: Triplixam / Elestar HCT +1 more
    PhasePhase 4
    Registry statusUnknown

  • Efficacy and Safety of Finerenone in Heart Failure With Reduced Ejection Fraction

    NCT05974566 · start 2023-08-01

    Registered record
    Registry ID
    NCT05974566
    Conditions
    Heart Failure With Reduced Ejection Fraction; Diabetes Mellitus; Diabetic Nephropathies
    Interventions
    Not recorded
    Study type
    OBSERVATIONAL
    Phase
    Not recorded
    Registry status
    Unknown
    Start
    2023-08-01
    Completion
    2023-10-30
    Enrolment
    60

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure With Reduced Ejection Fraction; Diabetes Mellitus; Diabetic Nephropathies
    InterventionNot recorded
    PhaseNot recorded
    Registry statusUnknown

  • Spironolactone Safety in African Americans With Mild Cognitive Impairment and Early Dementia

    NCT04522739 · start 2022-09-06

    Registered record
    Registry ID
    NCT04522739
    Conditions
    Mild Cognitive Impairment; Alzheimer Disease
    Interventions
    Spironolactone; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2022-09-06
    Completion
    2025-09-23
    Enrolment
    25

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionMild Cognitive Impairment; Alzheimer Disease
    InterventionSpironolactone; Placebo
    PhasePhase 4
    Registry statusCompleted

  • Evaluation of Spironolactone Efficacy in Patient with Rheumatoid Arthritis (RA)

    NCT05092984 · start 2022-06-22

    Registered record
    Registry ID
    NCT05092984
    Conditions
    Rheumatoid Arthritis
    Interventions
    Spironolactone; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Recruiting
    Start
    2022-06-22
    Completion
    2026-03
    Enrolment
    154

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionRheumatoid Arthritis
    InterventionSpironolactone; Placebo
    PhasePhase 3
    Registry statusRecruiting

  • Diuretic Treatment in Acute Heart Failure With Volume Overload Guided by Serial Spot Urine Sodium Assessment

    NCT05411991 · start 2022-06-12

    Registered record
    Registry ID
    NCT05411991
    Conditions
    Acute Heart Failure; Diuretics Drug Reactions
    Interventions
    UNa measurement after intravenous loop diuretic bolus; Intravenous acetazolamide 500 mg OD; Intravenous bumetanide TID; Oral chlorthalidone OD; Intravenous canrenoate 200 mg OD; Maintenance infusion; Oral potassium supplements; Intravenous hypertonic saline; Switch to oral diuretic therapy; Usual AHF care
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2022-06-12
    Completion
    2024-07-01
    Enrolment
    107

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Heart Failure; Diuretics Drug Reactions
    InterventionUNa measurement after intravenous loop diuretic bolus; Intravenous acetazolamide 500 mg OD; Intravenous bumetanide TID; Oral chlorthalidone OD +6 more
    PhasePhase 4
    Registry statusCompleted

  • Spironolactone in CKD Enabled by Chlorthalidone: PILOT

    NCT05222191 · start 2022-02-01

    Registered record
    Registry ID
    NCT05222191
    Conditions
    Renal Insufficiency; Chronic Hypertension
    Interventions
    Spironolactone; Chlorthalidone; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Unknown
    Start
    2022-02-01
    Completion
    2023-12-12
    Enrolment
    24

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionRenal Insufficiency; Chronic Hypertension
    InterventionSpironolactone; Chlorthalidone; Placebo
    PhasePhase 2
    Registry statusUnknown

  • Study of Drug Therapy for Pediatric Heart Failure

    NCT06039540 · start 2022-01-01

    Registered record
    Registry ID
    NCT06039540
    Conditions
    Heart Failure Congenital
    Interventions
    Captopril Tablets; Metoprolol Oral Tablet; Spironolactone Tablets; Torsemide Tablets; Potassium citrate powder
    Study type
    OBSERVATIONAL
    Phase
    Not recorded
    Registry status
    Unknown
    Start
    2022-01-01
    Completion
    2024-12-31
    Enrolment
    200

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure Congenital
    InterventionCaptopril Tablets; Metoprolol Oral Tablet; Spironolactone Tablets; Torsemide Tablets +1 more
    PhaseNot recorded
    Registry statusUnknown

  • Digoxin In Treatment of Alcohol Associated Hepatitis

    NCT05014087 · start 2021-10-08

    Registered record
    Registry ID
    NCT05014087
    Conditions
    Acute Alcoholic Hepatitis; Chemical and Drug Induced Liver Injury; Alcohol-Induced Disorders; Steatohepatitis Caused by Ingestible Alcohol
    Interventions
    Intravenous digoxin
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Terminated
    Start
    2021-10-08
    Completion
    2025-09-12
    Enrolment
    23

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Alcoholic Hepatitis; Chemical and Drug Induced Liver Injury; Alcohol-Induced Disorders; Steatohepatitis Caused by Ingestible Alcohol
    InterventionIntravenous digoxin
    PhasePhase 2
    Registry statusTerminated

  • Transgender Estradiol Affirming Therapy

    NCT05010707 · start 2021-08-02

    Registered record
    Registry ID
    NCT05010707
    Conditions
    Transgenderism
    Interventions
    Transdermal patch; Pro-thrombotic markers; Metabolic markers; Hormone Profile; Daily Sublingual Tablet; BID Sublingual Tablet; Spironolactone
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Completed
    Start
    2021-08-02
    Completion
    2024-01-01
    Enrolment
    39

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTransgenderism
    InterventionTransdermal patch; Pro-thrombotic markers; Metabolic markers; Hormone Profile +3 more
    PhasePhase 2
    Registry statusCompleted

  • The Effect of Sex Steroid Replacement Therapy in the Hypogonadism and Transgender Active-Duty Population

    NCT06247267 · start 2021-03-09

    Registered record
    Registry ID
    NCT06247267
    Conditions
    Hypogonadism; Gender Identity Dysphoria
    Interventions
    Fortesta; Estradiol; Fortesta
    Study type
    OBSERVATIONAL
    Phase
    Not recorded
    Registry status
    Recruiting
    Start
    2021-03-09
    Completion
    2025-08
    Enrolment
    75

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHypogonadism; Gender Identity Dysphoria
    InterventionFortesta; Estradiol; Fortesta
    PhaseNot recorded
    Registry statusRecruiting

  • Study to Assess Efficacy and Safety of SZC for the Management of High Potassium in Patients With Symptomatic HFrEF Receiving Spironolactone

    NCT04676646 · start 2021-03-08

    Registered record
    Registry ID
    NCT04676646
    Conditions
    Hyperkalaemia; Heart Failure With Reduced Ejection Fraction
    Interventions
    Sodium zirconium cyclosilicate; Placebo; Spironolactone
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2021-03-08
    Completion
    2024-07-15
    Enrolment
    366

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHyperkalaemia; Heart Failure With Reduced Ejection Fraction
    InterventionSodium zirconium cyclosilicate; Placebo; Spironolactone
    PhasePhase 4
    Registry statusCompleted