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Spironolactone is a potassium-sparing diuretic primarily used to treat conditions such as hypertension, heart failure, and hyperaldosteronism. The most significant adverse effects associated with spironolactone include hyperkalemia and galactorrhea.

Hyperkalemia occurs because spironolactone inhibits the action of aldosterone, leading to decreased potassium excretion in the kidneys. This can result in elevated potassium levels in the blood, which can have serious cardiovascular consequences.

Galactorrhea is another notable side effect of spironolactone due to its estrogenic effects. Spironolactone can stimulate prolactin secretion, leading to breast discharge in both men and women. This is particularly relevant in patients taking the drug long-term.

Together, these adverse effects highlight the importance of monitoring potassium levels and being aware of hormonal side effects in patients treated with spironolactone. Understanding these implications is critical for ensuring patient safety during treatment.