Aldactone - instructions for use, reviews, analogs and forms of release (tablets 25 mg and 100 mg, injections in ampoules for injection in solution) drug for the treatment of edema and high blood pressure in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Aldactone. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Aldactone 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 Aldacton in the presence of existing structural analogs.Use for the treatment of edema, hypertension, adrenal adrenal gland, liver cirrhosis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Aldactone - potassium and magnesium-saving diuretic. It is a competitive antagonist of aldosterone in influencing distal nephron sections (competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permease transfer proteins in the aldosterone-dependent region of collecting ducts and distal tubules), increases the excretion of sodium, chlorine and water ions and reduces the elimination of ions potassium and urea, reduces the titratable 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 at normal arterial pressure (BP). Diuretic effect is manifested on the 2nd-5th day of treatment.

Composition

Spironolactone + auxiliary substances.

Pharmacokinetics

After oral intake absorbed from the gastrointestinal tract (GIT), 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

• high blood pressure;
• edema in chronic heart failure;
• fibrosis and cirrhosis of the liver (especially with simultaneous presence of hypokalemia and hyperaldosteronism);
• nephrotic syndrome;
• edema in the 2nd and 3rd trimesters of pregnancy;
• arterial hypertension, including 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);
• other benign neoplasms of the adrenal glands;
• diagnostics of hyperaldosteronism;
• Hypokalaemia and its prevention in the treatment of saluretic;
• polycystic ovarian syndrome;
• premenstrual syndrome;
• Essential (primary) hypertension;
• secondary hypertension;
• portal hypertension;
• ascites;
• preeclampsia, unspecified.

Forms of release

Tablets coated with 25 mg and 100 mg.

Solution for injection 200 mg in 10 ml (injections in ampoules for injection).

Instructions for use and dosing regimen

Adults with primary hyperaldosteronism in the period of preparation for surgery - 100-400 mg per day, with a refusal of the operation, the minimum effective dose is selected.

With edema (cardiac, hepatic and renal origin) in the initial dose - 100 mg per day in several receptions. After 5 days, depending on the clinical effect, the dose is reduced to 25 mg or increased to 200 mg.

With arterial hypertension - in the initial dose of 50-100 mg per day in several doses, after 2 weeks, an increase or decrease in the dose (depending on the effect) is possible.

With hypokalemia caused by diuretics, 25-100 mg per day.

Children - 3.3 mg per 1 kg of body weight per day.

Side effect

• nausea, vomiting;
• abdominal pain;
• gastritis (inflammation of the gastric mucosa);
• ulceration and bleeding in the gastrointestinal tract;
• intestinal colic;
• diarrhea or constipation;
• dizziness;
• drowsiness, lethargy (a painful condition characterized by slowness, lethargy, fatigue);
• headache;
• retardation;
• ataxia (partial or complete loss of coordination of voluntary muscle movements);
• increased urea concentration in the blood, hypercreatininaemia, hyperuricemia;
• violation of water-salt metabolism and acid-base balance (KCHR) - metabolic hypochloraemic acidosis or alkalosis;
• megaloblasticosis, agranulocytosis, thrombocytopenia;
• gynecomastia (enlargement of the breast with hypertrophy of glands and adipose tissue);
• erectile dysfunction in men;
• women have dysmenorrhea (abdominal pain during menstruation), amenorrhea (absence of menstruation for several menstrual cycles), metrorrhagia (spotting from the vagina) in the menopause, hirsutism (excessive growth of hair on the body and face), coarsening of the voice, soreness mammary glands, breast carcinoma;
• hives;
• drug fever;
• rashes on the skin, itching;
• muscle spasms;
• decreased potency.

Contraindications

• Addison's disease;
• Hyperkalemia (high content of potassium in the blood);
• hypercalcemia (elevated calcium in the blood);
• hyponatremia (low sodium in the blood);
• chronic renal failure;
• anuria (discontinuation of urine output);
• 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 adverse effects of Aldactone on pregnancy and fetal development are not available. 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

When prescribing the drug, children and adolescents should strictly observe age-related doses.

Application in elderly patients

Use with caution in elderly patients.

special instructions

Cautiously apply Aldactone with atrioventricular 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 Aldactone should not be prescribed 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 Aldactone 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.

Drug Interactions

With simultaneous use with antihypertensive drugs, hypotensive action of Aldactone is potentiated.

When used simultaneously with angiotensin-converting enzyme (ACE) inhibitors, hyperkalemia (especially in patients with impaired renal function) is possible, since ACE inhibitors reduce the aldosterone content, which leads to a delay in potassium in the body against a background of potassium excretion.

With simultaneous use with potassium preparations, other potassium-sparing diuretics, substitutes for table salt and biologically active additives (BAA) for food containing potassium, it is possible to develop hyperkalemia.

With simultaneous application with salicylates, the diuretic effect of Aldactone 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 of 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 the simultaneous use of Aldactone with 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 Aldactone

Structural analogs for the active substance:

• Verospilactone;
• Veroshpiron;
• Spironolactone;
• Spiriks;
• Spironaxan;
• Spironol;
• Urakton.

Analogues of the drug Aldactone by pharmacological group (diuretics):

• Aquaphor;
• Acrypamide;
• Apo-Triazid;
• Arindap;
• Arifon;
• Acetazolamide;
• Brinaldiks;
• Brinerdin;
• Britomar;
• Brusniver;
• Bufenox;
• Verospilactone;
• Veroshpiron;
• Hygroton;
• Hydrochlorothiazide;
• Ginjaleling;
• Hypothiazide;
• Diazide;
• Diakarb;
• Diver;
• Zokardis plus;
• Isobar;
• Indapamide;
• Inder;
• Inverse;
• Indap;
• Indians;
• Indyur;
• Inspra;
• Clopamid;
• Cristepin;
• Lasix;
• Lespenefril;
• Lasersflain;
• Lauras;
• Mannitol;
• Mannitol;
• Marelin;
• Moderetik;
• Normatens;
• Oxodoline;
• Pamid;
• Ravell;
• Retapres;
• Sinepres;
• Spiriks;
• Spironaxan;
• Torasemide;
• Triompur compositum;
• Triamtel;
• Trigrim;
• Triplicksam;
• Triesid K;
• Tritenzine;
• Urakton;
• Uregit;
• Urflorin;
• Uroflux;
• Phytolysin;
• Furezis compositum;
• Furon;
• Furosemide;
• Tsimalon;
• Tzimycycle;
• Cystium Solidography;
• Eplerenone;
• Espiro.

Response of a therapist

Aldakton - inexpensive and quite effective in some diseases, a drug that has a diuretic effect. I assign it as part of a combination therapy for pronounced edema to patients suffering from chronic heart failure, patients with hypertension, nephrotic syndrome. As a rule, I start treatment with 100 mg per day. After a lapse of 5 days (in the treatment of edematous syndrome) or 14 days (in the treatment of arterial hypertension), depending on the effect achieved, I reduce or increase the daily dose. There were no serious adverse reactions to Aldakton in my practice.

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