Spirolac 100

Spironolactone is a medicine known as a diuretic (water pill). It is mainly used in the treatment of heart failure and high blood pressure. It reduces the swelling (edema) caused by some other conditions. This medicine is also used to treat low potassium levels in the body (hypokalemia). Spironolactone should be taken with food at the same time each day to get the most benefit. Taking it early in the day can help prevent you from having to get up at night to go to the toilet frequently, You should keep using this medicine as it has been prescribed, even if you feel well. If you stop taking it, your condition may get worse. Follow your doctor's advice about the type and amount of liquids you should drink. If you are being treated for high blood pressure, lifestyle changes such as exercising regularly, and making changes to your diet like low-salt diet may increase the effectiveness of this medicine. The common side effects include nausea, vomiting, dizziness and swelling, or tenderness of your breasts (men and women). If these bother you, or appear serious, let your doctor know. There may be ways of reducing or preventing them. Drinking alcohol can increase certain side effects and should be avoided. You should be careful about using Spironolactone if you have kidney problems or are unable to urinate. Before taking it, tell your doctor if you have ever had kidney, liver or heart disease or are pregnant. Also let your healthcare team know about all other medications you are using as they may affect, or be affected by this medicine. Pregnant or breastfeeding women should consult their doctor before taking this medicine. While using this medicine, you may be advised to limit your intake of salt or salt substitutes, and you should have your blood pressure checked frequently. Some other tests like kidney function (e.g., creatinine) and potassium levels will be done to monitor your progress. Spironolactone is a potassium-sparing diuretic. It lowers blood pressure and swelling by removing the extra water and electrolytes from the body without loss of potassium.

• Hypertension (high blood pressure) • Edema

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.

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

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Spironolactone is to be taken with food.

If you miss a dose of Spironolactone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common: • Nausea • Vomiting • Leg cramps • Dizziness • Drowsiness • Confusion • Breast enlargement in male • Increased creatinine level in blood

[UNSAFE] Spironolactone may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur. It can make you feel dizzy for the first few days. Do not drive or do anything requiring concentration until you know how Spironolactone affects you. It may increase the level of potassium in your blood. Avoid taking potassium supplements and potassium-rich foods such as banana and broccoli. Your doctor will regularly check your kidney function and the amount of potassium in your blood while you are on this medicine. Notify your doctor if you experience dizziness, diarrhea, vomiting, fast or irregular heartbeat, swelling in feet, or difficulty breathing. Spironolactone may cause breast pain/swelling, irregular periods (women), or trouble with sexual performance. Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.

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

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.

[UNSAFE] It is unsafe to consume alcohol with Spironolactone.

[CONSULT YOUR DOCTOR] Spironolactone may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Spironolactone is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.

[CAUTION] Spironolactone should be used with caution in patients with kidney disease. Dose adjustment of Spironolactone may be needed. Please consult your doctor. Use of Spironolactone is not recommended in patients with severe kidney disease. [CONSULT YOUR DOCTOR] There is limited information available on the use of Spironolactone in patients with liver disease. Please consult your doctor.

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