Should I discontinue spironolactone before my Breast revision surgery?

Question

I currently take 25 mg twice a day of spironolactone. I am having a Breast revision in a few weeks and want to know if I should discontinue. It was not listed in the meds to not take but Ive read to stop taking all meds two weeks before. I came across a site to not take it the day of surgery only. It is a blood pressure medication but I take it for acne. What is your opinion of this medication? Should I discontinue two weeks prior? The day of?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about discontinuing spironolactone before your breast revision surgery. Spironolactone is a diaretic. That means it makes you pee. This takes some of the strain off of the heart. Routine electrolytes and labs need to be taken before surgery. You can proceed with surgery if your labs are stable, especially potassium, BUN, and creatinine. It would be necessary to tell all medical personnel that you are on spironolactone so appropriate fluids can be given during surgery. Thank you for your question about discontinuing spironolactone before your breast revision surgery. 
Sincerely,
Dr. Katzen

Ronald J. Edelson, MD · Answer

As far as any medication you are taking, that question should be addressed to your surgeon only.  Don't take online advice about something like that.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

This is a question best discussed with your plastic surgeon as he/she is most familiar with your medical history.

The best way to assess and give
true advice would be an in-person exam.

Please see a board-certified
plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Gilbert Lee, MD · Answer

This is a really good question to ask your physician since he/she is aware of your entire medical history.

Lily Lee, MD · Answer

Taking spironolactone prior to any surgery *should* be ok, especially since you are young and presumably have normal kidney function. Because it is a potassium sparing diuretic, you just want to go into surgery with a normal level of potassium in your blood. I am sure the surgery center will require lab work prior to the surgery. Induction of anesthesia will cause intercellular potassium to leak extra cellular so it is important that your potassium levels going into surgery are low-normal to normal. You can help yourself by reducing intake of high potassium foods just prior to surgery (avocados, dark leafy greens, dried apricots/prunes, etc).

Lavinia K. Chong, MD · Answer

Great question, best fielded by your PS.  Spironolactone is a potassium sparing diuretic, which many of my patients use for acne but also for blood pressure control.  Personally, I would #prefer to have any acneic tendencies under control, especially if it affects your chest and back, as inflammatory blemishes can be associated with capsular contracture. I would only hold this on the day of surgery.  Be safe, ask your PS.  Good luck.

Should I discontinue spironolactone before my Breast revision surgery?

Answers (6)

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