Spirocard 25

Spirocard 2525mg

Type:10 Tablets

Generic Name:Spironolactone

Manufacturer:Popular Pharmaceuticals Ltd.

Price:55.00

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Indication

Oedema, Hirsutism, Hypertension, Hepatic cirrhosis w/ ascites and oedema, Hyperaldosteronism, Severe CHF, Hypokalaemia

Administration

Should be taken with food.

Adult Dose

Oral Oedema Adult: Initially, 100 mg daily, may adjust dose according to response up to 400 mg daily. Hepatic cirrhosis with ascites and oedema Adult: Depending on urinary Na/K ratio: If >1: Initially, 100 mg daily; if <1: Initially, 200-400 mg daily. Diagnosis of primary hyperaldosteronism Adult: Long test: 400 mg daily for 3-4 wk. Short test: 400 mg daily for 4 days. Preoperative management of hyperaldosteronism Adult: 100-400 mg daily. Long-term maintenance in the absence of surgery: Admin the lowest effective dose. Hypertension Adult: As monotherapy: Initially, 50-100 mg in 1-2 divided doses, may adjust dose after 2 wk. Severe congestive heart failure Adult: As adjunct: Initially, 25 mg once daily to max 50 mg daily. May reduce to 25 mg every other day if 25 mg once daily dose is not tolerated. Diuretic-induced hypokalaemia Adult: 25-100 mg daily. Hirsutism Women with hirsutism Adult: 50-200 mg qDay or divided q12hr Elderly: Initiate w/ the lowest dose then titrate upward if needed.

Child Dose

Oral Hepatic cirrhosis with ascites and oedema Child: Initially, 3 mg/kg given in divided doses, may adjust according to response. Diagnosis of primary hyperaldosteronism Child: Initially, 3 mg/kg given in divided doses, may adjust according to response. Preoperative management of hyperaldosteronism Child: Initially, 3 mg/kg given in divided doses, may adjust according to response. Severe congestive heart failure Child: Initially, 3 mg/kg given in divided doses, may adjust according to response.

Renal Dose

Renal impairment CrCl >50 mL/min/1.73 m²: 12.5-25 mg qDay; use maintenance dose of 25 mg qDay or q12hr after 4 weeks of treatment with potassium <5 mEq/L CrCl 30-49 mL/min/1.73 m²: 12.5 mg qDay or every other day; use maintenance dose of 12.5-25 mg qDay after 4 weeks of treatment with potassium <5 mEq/L CrCl <30 mL/min/1.73 m²: Avoid use

Contraindication

Anuria, hyperkalaemia, acute or progressive renal insufficiency. Addison's disease.

Mode of Action

Spironolactone acts on the distal renal tubules as a competitive antagonist of aldosterone. It increases the excretion of sodium chloride and water while conserving potassium and hydrogen ions.

Precaution

Patient at risk of developing hyperkalaemia and acidosis, w/ DM. Renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness and somnolence, if affected do not drive or operate machinery. Monitoring Parameters Monitor serum electrolytes periodically; BP, renal function. Lactation: Metabolite excreted into breast milk; discontinue breastfeeding or do not use drug

Side Effect

Drowsiness, dizziness, headache, lethargy, leg cramps, GI disturbances (e.g. diarrhoea, cramps), ataxia, mental confusion, rashes, pruritus, alopecia, hyponatraemia, electrolyte disturbances, gynaecomastia, hirsutism, menstrual irregularities, breast pain, deepening of the voice, impotence, leucopenia (including agranulocytosis), thrombocytopenia, transient elevation in BUN concentration. Rarely, breast enlargement. Potentially Fatal: Hyperkalaemia.

Interaction

Increased risk of hyperkalaemia w/ other K-sparing diuretics or K supplements, ACE inhibitors, angiotensin II receptor antagonists, trilostane, heparin, LMWH. Increased risk of nephrotoxicity w/ ciclosporin, NSAIDs. Increased risk of lithium toxicity. May reduce ulcer-healing properties of carbenoxolone. May increase serum level of digoxin. May reduce vascular response to norepinephrine. Concurrent use w/ colestyramine may cause hyperkalaemic metabolic acidosis. Potentiation of orthostatic hypotension may occur w/ barbiturates or narcotics. Potentially Fatal: May enhance hyperkalaemic effect w/ eplerenone. Increased risk of lithium toxicity when used concurrently.

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