Spironolactone in Alcohol Use Disorder (SAUD)

Exclusion Criteria

• •An individual who meets any of the following criteria will be excluded from participation in this study:
• •1. Most recent blood tests: potassium \> 5.2 mmol/L; creatinine \>= 2 mg/dL; eGFR \< 60 mL/min/1.73 m\^2, hemoglobin A1c (HbA1c) \> 6.5 %
• •2. Clinically significant and/or symptomatic hyponatremia, hypomagnesemia, hypocalcemia, and hyperuricemia based on Medical Advisory Investigators (MAI) or designee judgment.
• •3. Known history of clinically significant orthostatic hypotension
• •4. Known history of hypoaldosteronism, hyperaldosteronism, Addison s disease
• •5. Diagnosis of NYHA class III-IV heart failure, or unstable cardiovascular conditions (e.g., arrhythmias, clinically significant ECG abnormalities)
• •6. Current use of any diuretic, angiotensin receptor blocker (ARB), angiotensin converting enzyme inhibitor (ACEI), potassium supplementation, potassium containing salt substitute, heparin and low molecular weight heparin (LMWH), trimethoprim, lithium, digoxin, cholestyramine
• •7. Current use of MR antagonists
• •8. Current use of FDA-approved pharmacotherapy for AUD, or seeking treatment for AUD
• •9. Known history of prior hypersensitivity reaction to spironolactone or other MR antagonists, or any of the product components
• •10. Known history of alcohol withdrawal seizure and delirium tremens.
• •11. Physical and/or mental health conditions that are clinically unstable, as determined by the study clinicians, including (but not limited to) major depressive disorder or generalized anxiety disorder unstable during the past three months or other psychiatric conditions (e.g., schizophrenia, bipolar disorder) unstable during the past twelve months prior to screening.
• •12. Pregnancy, intention to become pregnant, or breastfeeding.
• •13. Any other reason or clinical condition that the Investigators judge would interfere with study participation and/or be unsafe for a participant.