Spironolactone, pills 25mg 20pcs

Composition

Pharmacological action

Potassium -, magnesium-sparing diuretic. It is a competitive aldosterone antagonist in terms of its effect on the distal nephron (it competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permeases in the aldosterone-dependent region of the collecting tubules and distal tubules), increases the excretion of Na+, Cl – and water and reduces the excretion of K+ and urea, reduces the titrated acidity of urine.

Increased diuresis causes a hypotensive effect, which is not constant.

The antihypertensive effect does not depend on the level of renin in the blood plasma and is not manifested in normal blood pressure.

The diuretic effect appears on the 2nd-5th day of treatment.

Indications

Edema in chronic heart failure, cirrhosis of the liver (especially in the simultaneous presence of hypokalemia and hyperaldosteronism), with nephrotic syndrome.

Edema in the second and third trimesters of pregnancy.

Arterial hypertension, including with aldosterone-producing adrenal adenoma (as part of combination therapy).

Primary hyperaldosteronism. Aldosterone-producing adrenal adenoma (long-term maintenance therapy in case of contraindication to surgical treatment or in case of refusal from it). Diagnosis of hyperaldosteronism.

Hypokalemia and its prevention in the treatment with saluretics.

Polycystic ovarian syndrome, premenstrual syndrome.

Recommendations for use

The method of use and dosage regimen of a particular drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and dosage regimen.

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

With edematous syndrome-100-200 mg / day (less often-300 mg/day) in 2-3 doses (usually in combination with a “loop” or/and a thiazide diuretic) daily for 14-21 days. Dose adjustment should be carried out taking into account the values of potassium concentration in plasma. If necessary, the courses are repeated every 10-14 days. With severe hyperaldosteronism and reduced potassium content in plasma-300 mg / day in 2-3 doses.

Contraindications

Addison’s disease, hyperkalemia, hypercalcemia, hyponatremia, chronic renal failure, anuria, liver failure, diabetes mellitus with confirmed or suspected chronic renal failure, diabetic nephropathy, First trimester of pregnancy, metabolic acidosis, menstrual irregularity or breast enlargement, hypersensitivity to spironolactone.

Side effects

From the digestive system:  nausea, vomiting, abdominal pain, gastritis, ulceration and bleeding in the gastrointestinal tract, intestinal colic, diarrhea or constipation.

From the central nervous system:  dizziness, drowsiness, lethargy, headache, lethargy, ataxia.

From the side of metabolism:  increased urea concentration, hypercreatininemia, hyperuricemia, impaired water-salt metabolism and KSHR (metabolic hypochloremic acidosis or alkalosis).

From the hematopoietic system:  megaloblastosis, agranulocytosis, thrombocytopenia.

From the endocrine system:  with prolonged use – gynecomastia, erectile dysfunction in men; in women-dysmenorrhea, amenorrhea, metrorrhagia in the menopausal period, hirsutism, coarsening of the voice, soreness of the mammary glands, breast carcinoma.

Allergic reactions:  urticaria, maculopapular and erythematous rashes, drug fever, pruritus.

Other services:  muscle spasms, decreased potency.

Interaction

When used concomitantly with antihypertensive drugs, the hypotensive effect of spironolactone is potentiated.

When used concomitantly with ACE inhibitors, hyperkalemia may develop (especially in patients with impaired renal function), since ACE inhibitors reduce the content of aldosterone, which leads to potassium retention in the body against the background of limited potassium excretion.

When used concomitantly with potassium supplements, other potassium-sparing diuretics, salt substitutes, and dietary supplements containing potassium, hyperkalemia may develop.

When used concomitantly with salicylates, the diuretic effect of spironolactone decreases due to blockade of canrenone excretion by the kidneys.

Indometacin and mefenamic acid inhibit renal excretion of canrenone.

Concomitant use reduces the hypoprothrombinemic effect of oral anticoagulants.

When used concomitantly with digitoxin, it is possible to both enhance and reduce the effects of digitoxin.

When used concomitantly, spironolactone inhibits the excretion of digoxin by the kidneys and probably reduces its volume of distribution. This may cause an increase in the concentration of digoxin in the blood plasma.

When used concomitantly with candesartan, losartan, and Eprosartan, there is a risk of hyperkalemia.

When used concomitantly with colestyramine, cases of hypochloremic alkalosis have been described.

When used concomitantly with lithium carbonate, it is possible to increase the concentration of lithium in blood plasma.

When used concomitantly with norepinephrine, it is possible to reduce the sensitivity of blood vessels to norepinephrine.

When used simultaneously, the effect of triptorelin, buserelin, and gonadorelin increases.

Special instructions

Use with caution in patients with AV blockage (possible increase due to the development of hyperkalemia), decompensated cirrhosis of the liver, surgical interventions, taking drugs that cause gynecomastia, when taking local and general anesthetics, in elderly patients.

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

During the treatment period, periodic determination of the content of electrolytes and urea in the blood should be carried out.

When using spironolactone in combination with other diuretics 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.

Active ingredient

Spironolactone

Conditions of release from pharmacies

By prescription

Dosage form

Tablets