Aldactone (spironolactone)

General information

Aldactone (Spironolactone) is potassium-sparing diuretic action is due to antagonism of aldosterone (ISS hormone of the adrenal cortex ) , contributing to reverse Na + absorption in the renal tubules and excretion of K +.

Indications

Aldactone (Spironolactone) is used to treat:

Edema : CHF, cirrhosis of the liver (especially in the simultaneous presence of hypokalemia and hyperaldosteronism ) , nephrotic syndrome , edema during pregnancy . Hypokalemia (prophylaxis in treating saluretikami ) . Primary hyperaldosteronism ( Conn’s syndrome ) – short-term preoperative treatment. Hypertension ( in combination therapy) . Aldosteronprodutsiruyuschaya adrenal adenoma ( long-term maintenance therapy with contraindications to surgery or in case of refusal from it) . Myasthenia gravis ( a subsidiary of drugs ) . Diagnosis of hyperaldosteronism . Hirsutism , polycystic ovary syndrome , premenstrual syndrome .

Contraindications

Aldactone (Spironolactone) is contraindicated in the following cases:

Hypersensitivity, Addison’s disease , hyperkalemia , hypercalcemia , hyponatremia , chronic renal failure , anuria , hepatic failure , diabetes mellitus (with confirmed or suspected chronic renal failure ) , diabetic nephropathy, pregnancy (I term ) , metabolic acidosis , menstrual disorders or increased dairy zhelez.C caution . AV block ( the possibility of strengthening due to the development of hyperkalemia ) , decompensated cirrhosis , surgery , taking drugs that cause gynecomastia , local and general anesthetics , old age.

Dosage and administration

Aldactone (Spironolactone) requires individual dosage. If not prescribed otherwise the drug is used in the mentioned below dosage.

In cirrhosis of the liver at a rate of Na + / K + less than 1 , the daily dose – 100 mg, if the ratio is greater than 1 – 200-400 mg / day . Nephrotic syndrome : 100-200 mg / day in combination with thiazide diuretics . When edema : 100-200 mg / day in 2-3 divided doses , in combination with a ” loop ” or thiazide diuretic . Assign daily for 5 days, then , depending on the effect to reduce the daily dose of 25-35 mg or gradually increased up to 200-400 mg in 2-4 doses. When hypertension : 50-100 mg / day , once or in 2-4 divided doses for 2 weeks in combination with antihypertensive drugs , and then gradually increase the dose every 2 weeks up to 200 mg / day. With hypokalemia : 25-100 mg once or in divided doses (maximum daily dose – 400 mg). In primary hyperaldosteronism : in preparation for surgery – 100-400 mg / day in 2-4 reception, with the inability ( or refusal ) of surgery – long-term treatment minimally effective doses. As a diagnostic agent : 400 mg / day in divided doses over four days ( short test ) or for 3-4 weeks (long test). Idiopathic hyperaldosteronism – 100 mg / day . Correction dosing regimen is carried out taking into account the K + concentration in the plasma. In marked hyperaldosteronism and a reduced content of K + in plasma administered in a daily dose of 300 mg in 2-3 doses (up to 400 mg / day) , while improving the state gradually reduce the dose to 25 mg / day. In polycystic ovary syndrome and hirsutism – 100 mg 2 times a day. Children with edema : 1-3.3 mg / kg or 30-90 mg / m per day, or once in 1-4 reception. After 5 days, and the dose adjusted , if necessary, a 3- fold increase from the initial dose.

Side effects

As all drugs, Aldactone (Spironolactone) has its side effects:

Nausea, vomiting , abdominal pain , gastritis, ulcers and bleeding in the gastrointestinal tract, intestinal colic, diarrhea or constipation , dizziness, drowsiness , lethargy , headache , lethargy , ataxia , muscle cramps , reduced potency , increasing concentrations of urea , hypercreatininemia , hyperuricemia, disruption of water -salt metabolism and CBS (metabolic acidosis or alkalosis gipohloremichesky ); megaloblastoz , agranulocytosis , thrombocytopenia. With prolonged use – gynecomastia , erectile dysfunction in men , women – dysmenorrhea, amenorrhea , metrorrhagia menopause , hirsutism , deepening of voice , breast tenderness , breast carcinoma , allergic reactions (urticaria, maculopapular and erythematous rash , drug fever , itching ) . Overdose . Symptoms: nausea , vomiting, dizziness, diarrhea , skin rash , hyperkalemia (paresthesia , myasthenia gravis, arrhythmias) , hyponatremia ( dry mouth , thirst, drowsiness) , hypercalcemia , dehydration, increasing concentrations of urea . Treatment: gastric lavage , symptomatic treatment of dehydration and blood pressure reduction . If hyperkalemia – rapid introduction of dextrose (5-20 % solution ), and the calculation of insulin 0.25-0.5 units per 1 g of dextrose and, if necessary repeated.

Special instructions

If necessary, the simultaneous administration of NSAIDs required monitoring of renal function and blood electrolytes . During treatment, avoid foods rich in K +.

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