Domeever 25mg Domesco Treatment for congestive heart failure (2 blisters x 10 tablets)

Spironolacton is a mineralocorticoid antagonist, which is used by inhibiting competition with aldosteron and other mineralocorticoids, which are mainly in the distance, resulting in increased secretion of sodium and water.

Spironolacton reduces the excretion of potassium, ammonium ions (NH4+) and H+. Both diuretic and anti -hypertension effects evenly through that mechanism.

Spironolacton starts to work relatively slowly, it takes 2 or 3 days to achieve the maximum effect and the drug reduces the slow effect for 2-3 days when the drug is stopped. So do not use Spironolacton when it is necessary to cause fast cards.

Increased excretion of magnesium and potassium of thiazid diuretics and diuretics (Furosemid) will be reduced when used simultaneously with Spironolacton.

Spironolacton and its main metabolites (7 alpha - thiomethyl - spironolacton and canrenon) have anti -mineralocorticoid effects.

Spironolacton reduces both systolic and diastolic blood pressure, the maximum hypotension effect is achieved after 2 weeks of treatment. Because Spironolacton is an antagonist competing with aldosteron, the necessary dose is adjusted according to the treatment response. Increasing rare Aldosteron. Increased secondary aldosteron occurs in secondary edema caused by cirrhosis, kidney syndrome and prolonged congestive heart failure and after treatment with conventional diuretics.

Diuretic effects are enhanced when used in combination with Domeever 25mg with conventional diuretics, spironolacton does not cause hyperuricemia or hyperlem of blood glucose, as happened when using high -dose thiazid diuretics.

pharmacokinetics

Spironolacton is absorbed through the digestive tract, reaching the maximum concentration in the blood after drinking 1 hour, but still with the concentration can be measured at least 8 hours after drinking 1 dose.

Relatively 90 % of bioavailability of the bioavailability of Spironolacton solution in polyethylene glycol, the best absorption.

Spironolacton and its metabolites are excreted mainly through urine, partly through bile.

Precautions when using

Translation and electrolytes should be monitored regularly, especially in the elderly, people with kidney failure and severe liver failure.

Hyperbonemia can occur in patients with excessive impaired renal function or use potassium and may cause heart abnormalities that can be fatal. If hyperkalemia progresses, spironolacton should be stopped; And if it is necessary to take positive measures to reduce serum potassium back to normal.

Metabolic acidosis due to hypoglycemia can recover (often accompanied by hyperkalemia) can occur in unexpected cirrhosis despite normal kidney function.

Simultaneously used with other potassium diuretics, enzyme inhibitors, nonsteroidal anti -inflammatory drugs, Angiotensin II receptor resistant drugs, aldosteron blockers, heparin, low molecular weight heparin or other drugs or cases may increase potassium, potassium supplements, potassium -rich diets or replacement salts that can lead to potassium potassium hyperlemen.

Hypermathed hyperur with recovery occurred when treated with spironolacton, especially when renal function decreased.

Hyperbonemia can be fatal. Serum potassium monitoring in patients with severe heart failure drink Spironolacton. Avoid using other potassium diuretics. Avoid using potassium supplements in patients with serum potassium> 3.5 Meq/l. Recommendations for monitoring potassium and creatinin 1 week after starting or increasing the spironolacton dose, monthly for the first 3 months, then quarters for a year and then every 6 months. Stop or suspend treatment for serum potassium> 5 MEQ/1 or serum creatinine> 4 mg/dl.

Potassium diuretics should be used carefully in children with hypertension with mild kidney failure due to the risk of hyperkalemia.

The ability to drive and operate machinery

drugs have unwanted effects that are common including fatigue, dizziness. Be cautious when driving and operating machinery.

Pregnancy

Spironolacton can be used for pregnant people when suffering from heart disease.

Breastfeeding period

Spironolacton can be used for mothers during breastfeeding.

Drug interaction

simultaneous use of 25mg with domeever with drugs that cause hyperkalemia increases severe potassium.

Spironolacton increases the digoxin selling time of Digoxin, increases serum disco concentration and hinder serum digoxin quantitative.

In patients who taken digoxin and Spironolacton, responding to digoxin should be monitored rather than serum Digoxin concentration, unless the quantitative Digoxin has been shown to be not affected by spironolacton treatment.

If it is necessary to adjust the dose of digoxin, patients should be carefully monitored to identify the increase or decrease of digoxin.

Spironolacton increases the effectiveness of antihypertensive drugs because the dose of these drugs when spironolacton is put into treatment and then adjusts as needed. Because enzyme inhibitors reduce the production of aldosteron, therefore should not regularly use enzyme inhibitors with Spironolacton, especially in patients with significant renal impairment.

Carbenoxolon can cause sodium, thus reducing the effectiveness of spironolacton, thus avoiding simultaneous use.

Steroid anti -inflammatory drugs such as Aspirin , indomethacin and Mefenamic acid can reduce the efficiency of sodium excretion of diuretics due to the supplement of the kidney's prostaglandin and reduce the diuretic effects of spironolacton.

Spironolacton reduces blood vessel response to noradrenalin . Caution should be prudent for patients with local anesthesia or body weight while being treated with Spironolacton.

In quantitative determination of Flo content, Spironolacton can hinder the estimates of compounds with similar fluorescent properties.

Spironolacton increases the metabolism of antipipin.