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Aldactone |
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Aldactone, a trademark for a potassium-sparing diuretic (spironolactone). spironolactone [spi″rah-no-lak´tōn] one of the spirolactones, a competitive antagonist of aldosterone and a potassium-sparing diuretic; used in treatment of edema, hypokalemia, primary aldosteronism, and (usually in combination with other drugs) hypertension.
spironolactone Aldactone, Novo-spiroton (CA) Pharmacologic class: Aldosterone inhibitor Therapeutic class: Potassium-sparing diuretic Pregnancy risk category D FDA Boxed Warning• Drug induced tumors in chronic toxicity studies in rats. Use only in conditions listed under "Indications and dosages." Avoid unnecessary use. ActionInhibits aldosterone effects in distal renal tubule, promoting sodium and water excretion and potassium retention AvailabilityTablets: 25 mg, 50 mg, 100 mg ⊘Indications and dosages ➣ Edema caused by heart failure, hepatic cirrhosis, or nephrotic syndrome Adults: As sole diuretic, initially 100 mg/day P.O. (range of 25 to 200 mg) in single or divided doses, continued for 5 or more days and then adjusted to optimal therapeutic level Children: 1 to 3 mg/kg/day P.O. as a single dose or in divided doses ➣ Essential hypertension Adults: Initially, 50 to 100 mg/day P.O. as a single dose or in divided doses, continued for at least 2 weeks Children: 1 to 2 mg/kg P.O. b.i.d. ➣ Hypokalemia Adults: 25 to 100 mg/day P.O. ➣ Diagnosis and treatment of primary hyperaldosteronism Adults: For diagnosis, 400 mg/day P.O. for 4 days in short test or for 3 to 4 weeks in long test. Resolution of hypokalemia and hypertension confirm diagnosis of primary hyperaldosteronism. Dosages of 100 to 400 mg/day P.O. may be used as a bridge to surgical therapy; in patients unsuitable for this therapy, lowest effective dosage may be used for long-term maintenance. Off-label uses• Acne vulgaris Contraindications• Hypersensitivity to drug PrecautionsUse cautiously in: Administration• Give single daily dose with breakfast. If two daily doses are prescribed, give second dose with food in mid-afternoon.
Adverse reactionsCNS: headache, drowsiness, lethargy, ataxia, confusion GI: vomiting, diarrhea, cramping, gastritis, GI ulcers, GI bleeding GU: gynecomastia, irregular menses or amenorrhea, postmenopausal bleeding, erectile dysfunction, breast cancer Hematologic: agranulocytosis Metabolic: hyponatremia, hyperchloremic metabolic acidosis , hyperkalemia Skin: rash, pruritus, hirsutism Other: deepening of voice, drug fever InteractionsDrug-drug. Angiotensin-converting enzyme inhibitors, potassium-sparing diuretics, potassium supplements, other potassium-containing drugs: increased risk of hyperkalemia Anticoagulants, heparin: reduced hypoprothrombinemic effects of these drugs Digoxin: increased digoxin blood level Salicylates: decreased diuretic effect Drug-diagnostic tests. Blood urea nitrogen, potassium: increased levels Digoxin assays: false digoxin elevation Granulocytes: decreased count Drug-food. Potassium-containing salt substitutes: increased risk of hyperkalemia Drug-herbs. Licorice: potassium loss Patient monitoring☞ Monitor electrolyte levels (especially potassium). Watch for signs and symptoms of imbalances and metabolic acidosis. Patient teaching• Tell patient to take daily dose with breakfast. If two daily doses are prescribed, advise him to take second dose with food in mid-afternoon. Want to thank TFD for its existence? Tell a friend about us, add a link to this page, add the site to iGoogle, or visit the webmaster's page for free fun content. |
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