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Spironolactone - instructions for use, reviews, analogs and formulations (tablets 25 mg) of a diuretic for the treatment of hypertension, edema, hyperaldosteronism in adults, children and pregnancy. Composition

Spironolactone - instructions for use, reviews, analogs and formulations (tablets 25 mg) of a diuretic for the treatment of hypertension, edema, hyperaldosteronism in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Spironolactone. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of spironolactone in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Spironolactone in the presence of existing structural analogs. Use for the treatment of hypertension, edema and hyperaldosteronism in adults, children, as well as during pregnancy and lactation. Composition of a diuretic.

 

Spironolactone - potassium, magnesium-saving diuretic. It is a competitive antagonist of aldosterone on the effect on the distal 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 sodium, chlorine and water and reduces the excretion of potassium and urea, reduces titratuemoe acidity of urine. Strengthening diuresis causes a hypotensive effect, which is unstable. The hypotensive effect does not depend on the level of renin in the blood plasma and does not appear with normal blood pressure.

 

Diuretic effect is manifested on the 2nd-5th day of treatment.

 

Composition

 

Spironolactone + auxiliary substances.

 

Pharmacokinetics

 

After oral intake absorbed from the digestive tract, the absorption is 90%. Metabolized in the liver, the main active metabolite is canrenone. It is excreted mainly by the kidneys, a certain amount is excreted with bile.

 

Indications

  • edema in chronic heart failure, cirrhosis of the liver (especially with simultaneous presence of hypokalemia and hyperaldosteronism), with nephrotic syndrome;
  • edema in the 2nd and 3rd trimesters of pregnancy;
  • arterial hypertension, incl. with aldosteron-producing adrenal adrenal glands (as part of combination therapy);
  • primary hyperaldosteronism;
  • aldosterone-producing adrenal adrenal gland (prolonged maintenance therapy with contraindication to or in the event of withdrawal from surgical treatment);
  • diagnostics of hyperaldosteronism;
  • Hypokalaemia and its prevention in the treatment of saluretic;
  • polycystic ovarian syndrome;
  • premenstrual syndrome.

 

Forms of release

 

Tablets 25 mg.

 

Instructions for use and dosing regimen

 

Established individually, depending on the severity of violations of water-electrolyte metabolism and hormonal status.

 

With edematic syndrome, 100-200 mg per day (less often 300 mg per day) in 2-3 doses (usually in combination with a loop and / or thiazide diuretic) daily for 14-21 days. Correction of the dose should be carried out taking into account the values ​​of potassium concentration in the plasma. If necessary, the courses are repeated every 10-14 days.

 

With expressed hyperaldosteronism and reduced potassium content in plasma - 300 mg per day in 2-3 doses.

 

Cirrhosis of the liver: with a Na / K ratio of more than 1.0, the daily dose is 100 mg, if the coefficient is less than 1.0 - 200-400 mg per day.

 

Side effect

  • nausea, vomiting;
  • abdominal pain;
  • gastritis;
  • ulceration and bleeding in the gastrointestinal tract;
  • intestinal colic;
  • diarrhea or constipation;
  • dizziness;
  • drowsiness;
  • lethargy;
  • headache;
  • retardation;
  • ataxia;
  • increased urea concentration, hypercreatininaemia, hyperuricemia, water-salt metabolism and KCHR (metabolic hypochloraemic acidosis or alkalosis);
  • megaloblasticosis, agranulocytosis, thrombocytopenia;
  • gynecomastia;
  • erectile dysfunction in men;
  • dysmenorrhea, amenorrhea;
  • metrorrhagia in menopause;
  • hirsutism (excessive hair growth);
  • coarse voice;
  • tenderness of the mammary glands;
  • breast carcinoma;
  • hives;
  • maculopapular and erythematous rashes;
  • drug fever;
  • itching;
  • muscle spasms;
  • decreased potency.

 

Contraindications

  • Addison's disease;
  • hyperkalemia;
  • hypercalcemia;
  • hyponatremia;
  • chronic renal failure;
  • anuria;
  • liver failure;
  • diabetes mellitus with confirmed or suspected chronic renal failure;
  • diabetic nephropathy;
  • 1 trimester of pregnancy;
  • metabolic acidosis;
  • violation of the menstrual cycle or enlargement of the mammary glands;
  • hypersensitivity to spironolactone.

 

Application in pregnancy and lactation

 

Data on the negative effect of spironolactone on pregnancy and development of the fetus are absent. However, in the first trimester of pregnancy, the use is contraindicated, and in 2 and 3 trimesters it is possible to use it according to the indications.

 

If it is necessary to use during lactation, it should be borne in mind that a metabolite of spironolactone canrenone is released in small amounts with breast milk.

 

Use in children

 

Not studied.

 

Application in elderly patients

 

Use with caution in elderly patients.

 

special instructions

 

C use with caution in AV blockade (the possibility of amplification due to the development of hyperkalemia), decompensated liver cirrhosis, surgical interventions, the use of drugs that cause gynecomastia, with the administration of local and general anesthetics, in elderly patients.

 

Against the background of the use of spironolactone should not prescribe drugs containing potassium, as well as other diuretics that cause a delay in potassium in the body. Avoid the use of spironolactone with carbenoxolone, which causes sodium retention.

 

During the treatment period, the content of electrolytes and urea in the blood should be periodically determined.

 

When using spironolactone in combination with other diuretic or antihypertensive agents, the dose of the latter is recommended to be reduced. When using spironolactone simultaneously with digoxin, it may be necessary to reduce both the saturating and maintenance dose of the latter.

 

It was reported about the possibility of using spironolactone alone or as an additional tool in the treatment of hirsutism in women with polycystic ovary syndrome, with premenstrual syndrome, with family premature puberty in young men, with bronchopulmonary dysplasia in children; for the treatment of acne vulgaris (acne vulgaris) and alleviation of the manifestations of mountain sickness.

 

Drug Interactions

 

With simultaneous use with antihypertensive drugs, the hypotensive effect of spironolactone is potentiated.

 

With simultaneous use with ACE inhibitors, it is possible to develop hyperkalemia (especially in patients with impaired renal function) because ACE inhibitors reduce the content of aldosterone, which leads to a delay in potassium in the body against the background of the limitation of potassium excretion.

 

With simultaneous use with potassium preparations, other potassium-sparing diuretics, substitutes for table salt and dietary supplements for food containing potassium, it is possible to develop hyperkalemia.

 

With simultaneous application with salicylates, the diuretic effect of spironolactone is reduced due to blockade of canrenon excretion by the kidneys.

 

Indomethacin and mefenamic acid inhibit canrenone excretion by the kidneys.

 

With simultaneous use, the hypoprothrombinemic effect of oral anticoagulants is reduced.

 

With simultaneous use with digitoxin, both amplification and reduction in the effects of digitoxin are possible.

 

With simultaneous use of spironolactone inhibits the excretion of Digoxin by the kidneys and, probably, reduces its volume of distribution. This can cause an increase in the concentration of digoxin in the blood plasma.

 

With simultaneous use with candesartan, losartan, eprosartan, there is a risk of hyperkalemia.

 

With simultaneous application with colestyramine cases of hypochloremic alkalosis are described.

 

With simultaneous application of lithium carbonate, an increase in the concentration of lithium in the blood plasma is possible.

 

With the simultaneous use of norepinephrine, a decrease in the sensitivity of the vessels to norepinephrine may be possible.

 

With simultaneous use, the action of tryptorelin, buserelin, gonadorelin is enhanced.

 

Analogues of the drug Spironolactone

 

Structural analogs for the active substance:

  • Aldactone;
  • Verospilactone;
  • Veroshpiron;
  • Spiriks;
  • Spironaxan;
  • Spironol;
  • Spironolactone Darnitsa;
  • Spironolactone micronized;
  • Urakton.

 

Analogues for the pharmacological group (diuretics):

  • Adelphan Ezidrex;
  • Aquaphor;
  • Acrypamide;
  • Arifon;
  • Arifon retard;
  • Acetazolamide;
  • Brinerdin;
  • Britomar;
  • Brusniver;
  • Bufenox;
  • Hygroton;
  • Hydrochlorothiazide;
  • Hydrochlorothiazide;
  • Hypothiazide;
  • Diakarb;
  • Diver;
  • Zokardis plus;
  • Isobar;
  • Indap;
  • Indapamide;
  • Indapamide retard;
  • Indapamide Sandoz;
  • Inder;
  • Inverse;
  • Inspra;
  • Ionik;
  • Ipres Long;
  • Kanefron H;
  • Clopamid;
  • Cristepin;
  • Lasix;
  • Lauras;
  • Mannitol;
  • Mannitol;
  • Urea;
  • Niebelong H;
  • Pamid;
  • Retapres;
  • Sinepres;
  • Tenzar;
  • Torasemide;
  • Triamtel;
  • Trigrim;
  • Urological (diuretic) collection;
  • Uroflux;
  • Furosemide;
  • Fursemide;
  • Tsimalon;
  • Edarby Claw;
  • Eplerenone.

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Reviews (5):
Visitors
Lara
Hello! I have a question about taking specific medications. Tell me, please, after what time (no less than ...) can I take Tivortin after the course of taking the preparation Spironolactone? After all, in the instructions for the drug Tivortin it is written that the use of Tivortin after a course of treatment with Spironolactone or other potassium-sparing diuretics causes persistent hyperkalemia - an increase in the amount of potassium in the blood. So through how much all the same it is possible to accept Tivortinum after Spironolactonum not to do much harm and not cause dangerous hyperkalemia? And is it possible, Tivortin, to take it after taking Spironolactone earlier? Answer me, please, I very much ask you and thank you in advance for the answer! With respect to you!
P.S .: I did not find anything on the Tivortin product on the site, therefore I ask this question on the page of Spironolactone.
Administrators
admin
Lara, First time I hear about Tivortin. In Russia this drug is not registered. From open sources, I could not find anything about the period of removing this medicine from the human body. Although about the interaction with spironolactone and zamorochki with potassium read, apparently in the composition there is not only an amino acid arginine, because I have not heard that drugs based on this amino acid somehow reacted specifically with potassium-sparing diuretics. Contact for clarification of the matter to local doctors.
Guests
SNV68Z24
Hello. Can I drink Spironolactone and Carvedilol together?
Administrators
admin
SNV68Z24, Can. According to the instructions, additional side effects from the joint application of Spironolactone and Carvedilol should not be. A joint antihypertensive effect from this use can be strengthened and this plus this combination,although it may be necessary to correct the doses of medications taken, in terms of their reduction.
Guests
Tatyana
My husband was prescribed spironolactone. After a few doses, a strong dizziness began. Male insulin-dependent plus diagnosed diabetic nephropathy. The instructions say a contraindication for such a disease.

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