Aldactone 25mg user’s manual
- International name: Spironolactone (Spironolactone)
- Group affiliation: Diuretic potassium-sparing agent
- Description of active ingredient (INN): Spironolactone
Dosage form: capsules, tablets, coated tablets.
A potassium-sparing diuretic, whose action is due to antagonism with aldosterone (MCN hormone of the adrenal cortex), which facilitates the inverse absorption of Na + in the renal tubules and the excretion of K +. Spironolactone, a competitive antagonist of aldosterone, influences the distal sections of the nephron (competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permeases in the aldosterone-dependent region of collecting ducts and distal tubules), increases the excretion of Na +, Cl- and water and reduces the excretion of K + and urea , reduces the titratable acidity of urine. Strengthening diuresis causes a hypotensive effect, which is unstable. Diuretic effect is manifested on the 2nd-5th day of treatment.
Aldactone 25mg contraindications:
Hypersensitivity, Addison’s disease, hyperkalemia, hypercalcemia, hyponatremia, chronic renal failure, anuria, hepatic insufficiency, diabetes mellitus (with confirmed or suspected chronic renal failure), diabetic nephropathy, pregnancy (I trimester), metabolic acidosis, menstrual irregularity or breast enlargement. . AV blockade (the possibility of amplification due to the development of hyperkalemia), decompensated liver cirrhosis, surgical interventions, drug use, gynecomastia, local and general anesthetics, and elderly age.
Nausea, vomiting, abdominal pain, gastritis, ulceration and bleeding in the gastrointestinal tract, intestinal colic, diarrhea or constipation, dizziness; drowsiness, lethargy, headache, inhibition, ataxia, muscle spasms, decreased potency, increased urea concentration, hypercreatininaemia, hyperuricemia, water-salt metabolism and CBS (metabolic hypochloraemic acidosis or alkalosis); megaloblastosis, agranulocytosis, thrombocytopenia.
With prolonged use – gynecomastia, erectile dysfunction in men; in women – dysmenorrhea, amenorrhea, metrorrhagia in menopause, hirsutism, voice coarsening, breast tenderness, breast carcinoma, allergic reactions (urticaria, maculopapular and erythematous rashes, drug fever, pruritus). Overdose. Symptoms: nausea, vomiting, dizziness, diarrhea, skin rash, hyperkalemia (paresthesia, myasthenia gravis, arrhythmia), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increased urea concentration. Treatment: gastric lavage, symptomatic therapy of dehydration and lowering blood pressure. With hyperkalemia – rapid administration of dextrose (5-20% solutions) and insulin at a rate of 0.25-0.5 ED per 1 g of dextrose; if necessary, repeat.
Aldactone 25mg instructions for use and dosage:
Inside. With cirrhosis of the liver with a coefficient Na + / K + less than 1, the daily dose is 100 mg, if the coefficient is more than 1 – 200-400 mg / day. With nephrotic syndrome: 100-200 mg / day in combination with thiazide diuretics. With edematic syndrome: 100-200 mg / day in 2-3 doses, in combination with a “loop” or thiazide diuretic. Assign daily, for 5 days, then, depending on the effect, the daily dose is reduced to 25-35 mg or gradually increased to 200-400 mg in 2-4 admission. With arterial hypertension: 50-100 mg / day, once, or in 2-4 doses for 2 weeks in combination with antihypertensive drugs, and then gradually increase the dose every 2 weeks to 200 mg / day.
At gipokaliemii: 25-100 mg, once, or in several receptions (the maximum daily dose – 400 mg). With primary hyperaldosteronism: in the period of preparation for the operation – 100-400 mg / day in 2-4 admission; if it is impossible (or refusal) to conduct an operative intervention – prolonged treatment with minimal effective doses. As a diagnostic tool: 400 mg / day in several doses for 4 days (short test) or for 3-4 weeks (long test). Idiopathic hyperaldosteronism – 100 mg / day. Correction of the dosing regimen is performed taking into account the concentration of K + in the plasma.
With pronounced hyperaldosteronism and reduced K + content in the plasma, 300 mg is prescribed in a daily dose in 2-3 doses (up to 400 mg / day), as the condition improves, the dose is gradually reduced to 25 mg / day. In the syndrome of polycystic ovaries and hirsutism – 100 mg 2 times a day. Children with oedematous syndrome: 1-3.3 mg / kg or 30-90 mg / sq. M per day, once or for 1-4 admission.
Dosing and Administration:
Inside. Adults with primary hyperaldosteronism during the preparation for the operation – 100-400 mg per day, in case of refusal of the operation, the minimum effective dose is selected; with edema (cardiac, hepatic and renal origin) in the initial dose of 100 mg per day in several doses, after 5 days, depending on the clinical effect, the dose is reduced to 25 mg or increased to 200 mg; with arterial hypertension – in an initial dose of 50-100 mg per day in several doses, after 2 weeks, it is possible to increase or decrease the dose (depending on the effect); with hypokalemia caused by diuretics, 25-100 mg per day. Children – 3.3 mg / kg body weight per day.
Indications for use Aldactone 25mg:
Hyperaldosteronism (primary and idiopathic), diagnosis of hyperaldosteronism, adrenal adrenal gland producing aldosterone; edematous syndrome with chronic heart failure, liver cirrhosis, nephrotic syndrome, nephropathy of pregnant women; arterial hypertension, hypokalemia, as an adjuvant for malignant hypertension, hypokalemia, prevention of hypokalemia in patients receiving cardiac glycosides.
During treatment should avoid excessive intake of potassium in the body. It is not recommended to combine with other potassium-sparing diuretics. With a simultaneous appointment with hypotensive and diuretics, you need to reduce the dose.
If it is necessary to simultaneously prescribe NSAIDs, control of kidney function and blood electrolytes is mandatory. During treatment avoid foods rich in K +.
Aldactone 25mg- weakens the effect of indirect anticoagulants. Reduces the sensitivity of blood vessels to norepinephrine, increases T1 / 2 digoxin. Enhances the toxic effects of Li +. Accelerates the metabolism and excretion of carbenoksolona. GCS and diuretics (benzothiadiazine derivatives, furosemide, ethacrynic acid) strengthen and accelerate, NSAIDs reduce diuretic and natriuretic effects. Reduces the effect of anticoagulants (heparin, coumarin derivatives, indandion), toxicity of cardiac glycosides. Strengthening the action of diuretics and antihypertensive drugs. ACE inhibitors, indomethacin, cyclosporine, other potassium-sparing diuretics, K + drugs and potassium supplements are the risk of developing hyperkalemia.