Aldactonum

Aldactonum – kaliysberegayushchy diuretic means.

Form of release and structure

• Tablets, coated (on 10 pieces in blisters, 2 blisters in a cardboard box);
• Solution for injections (on 5 or 10 ml in ampoules, on 5 ampoules in blisters, 2 blisters in a cardboard box).

Active agent – Spironolactonum:

• 1 tablet – 25 or 100 mg;
• 1 ml of solution – 20 mg.

Indications to use

• Arterial hypertension;
• Primary and idiopathic hyper aldosteronism (treatment and diagnosis);
• The adenomas of adrenal glands producing Aldosteronum (as a part of a combination therapy);
• Hypopotassemia (treatment and prevention at use of saluretics);
• Hypostases at a nephrotic syndrome, cirrhosis (especially in case of the accompanying existence of a hypopotassemia and a hyper aldosteronism), chronic heart failure, a nephropathy of pregnant women;
• Hypostases in II and III trimesters of pregnancy;
• Malignant hypertension (as supportive application);
• Premenstrual syndrome;
• Syndrome of polycystic ovaries.

Contraindications

Absolute:

• Anury;
• Hyperpotassemia;
• Hyponatremia;
• Hypercalcemia;
• Addison's disease;
• Acute and chronic (with considerable depression of function of kidneys) a renal failure;
• Liver failure;
• Diabetes mellitus at patients with a chronic renal failure or at suspicion on its existence;
• Diabetic nephropathy;
• Metabolic acidosis;
• Increase in mammary glands or disturbance of a menstrual cycle;
• I trimester of pregnancy;
• Hypersensitivity to drug.

Relative:

• AV blockade;
• Dekompensirovanny cirrhosis;
• Surgical interventions;
• Advanced age;
• Use of local and general anesthetics;
• Concomitant use of drugs which can cause a gynecomastia.

Route of administration and dosage

The doctor establishes a drug dose individually depending on the hormonal status and expressiveness of disturbances of water and electrolytic exchange.

In the form of solution Aldactonum is entered intravenously on 100-200 mg (1-2 ampoules) a day within 3-5 days. The maximum daily dose – 800 mg.

In the form of tablets drug should be accepted inside. The recommended doses for adults:

• Primary hyper aldosteronism: in the period of a preparation for surgery – on 100-400 mg a day; at refusal of operation to the patient select a minimal effective dose;
• Hypostases (renal, hepatic and cordial origin): an initial daily dose – 100 mg in stages, 5 days later depending on the reached clinical effect and potassium concentration in a blood plasma increase a dose to 200 mg or reduce up to 25 mg. Treatment duration – 14-21 days. If necessary courses repeat bucketed 10-14 days;
• The hypopotassemia caused by diuretics: on 25-100 mg a day;
• Arterial hypertension: an initial daily dose – 50-100 mg in stages, 2 weeks later depending on effect decrease or increase in a dose is possible.

To children Aldactonum is appointed in the daily dose calculated taking into account weight – on 3,3 mg/kg.

Side effects

• From the central nervous system: dizziness, block, drowsiness, headache, lethargy, ataxy;
• From the alimentary system: diarrhea or locks, an abdominal pain, nausea, gastritis, vomiting, ulcerations and bleedings in digestive tract, intestinal colic;
• From system of a hemopoiesis: thrombocytopenia, мегалобластоз, agranulocytosis;
• From a metabolism: hyperuricemia, giperkreatininemiya, increase in concentration of urea, disturbance of a water salt metabolism and acid-base equilibrium (metabolic gipokhloremichesky acidosis, alkalosis);
• From endocrine system: women have a hirsutism, morbidity of mammary glands, voice coarsening, an amenorrhea, a dysmenorrhea, a metrorrhagia in a climacteric, a carcinoma of a mammary gland; men at prolonged use have a disturbance of an erection, a gynecomastia;
• Allergic reactions: itch, urticaria, medicinal fever, makulopapulezny and erythematic rashes;
• Others: muscular spasms, decrease in a potentiality.

Special instructions

During treatment it is necessary to determine periodically the content of urea and electrolytes in blood.

Along with Aldactonum it is not necessary to appoint the kaliysoderzhashchy drugs and other diuretics causing a potassium delay in an organism. It is recommended to refrain from use of a karbenoksolon since it causes a sodium delay.

In need of the combined use of Spironolactonum with anti-hypertensive means or other diuretics it is necessary to lower a dose of the last. The same concerns simultaneous use of digoxin.

Medicinal interaction

• Hypotensive drugs: anti-hypertensive action of Spironolactonum is exponentiated;
• The potassium drugs, other kaliysberegayushchy diuretics, substitutes of table salt containing potassium dietary supplements to food, and also лозартан, кандесартан and эпросартан: the risk of development of a hyperpotassemia increases;
• Mefenamovy acid, indometacin: excretion of a kanrenon (an active metabolite of Spironolactonum) is inhibited by kidneys;
• Salicylates: the diuretic effect of Aldactonum decreases;
• Digoxin: reduction or strengthening of its effects is possible;
• Peroral anticoagulants: its gipoprotrombinemichesky effect decreases;
• Lity carbonate: concentration of lithium in a blood plasma can increase;
• Colestyraminum: there is a risk of development of a gipokhloremichesky alkalosis;
• Triptorelin, гонадорелин, бусерелин: their action amplifies;
• Noradrenaline: sensitivity of vessels to its action can decrease;
• Angiotensin-converting enzyme inhibitors: the probability of development of a hyperpotassemia increases, especially at the accompanying renal failure.

Terms and storage conditions

To store in dry (tablets), protected from light and the place, unavailable to children, at a temperature: tablets – to 30 ºС, solution – to 25 ºС.

Period of validity – 5 years.