Spinolac 25mg Hasan medicine is treated by congestion (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Spironolactone

Ingredient

Composition informationContent
Spironolactone25mg

Uses

indications

Spinolac 25 mg is indicated in the following cases:

  • edema due to heart failure congestion. Treatment. Spirorolacton reduces the excretion of potassium, ammonium ions (NH4 +) and H +. The diuretic effect and anti -hypertension evenly through that mechanism. Spironolacton started to work relatively slowly, it takes 2-3 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.

    Spironolacton and its main metabolites 7 alpha thionethyl - spironolacton and canreon) have anti -mineralocorticoid effects. Spironolacton reduces both systolic and diastolic blood pressure, the maximum hypotension effect is achieved after 2 weeks of treatment. The diuretic effect is enhanced when used in combination with conventional diuretics, spironolacton does not cause hyperuricemia or hyperglycemia, as if it happened when using high -dose thiazid diuretics.

    Children: Lack of information on Spironolacton's clinical studies in children. A few tests are performed in children, using Spironolacton in combination with other drugs, a few patients are assessed in each test and different indications. Recommendations for patients based on clinical experience and shift studies in scientific documents.

    Pharmacokinetics

    absorption

    Spironolacton is absorbed through the gastrointestinal tract (about 70%). Born increases when taking medicine with food. Relative bioavailability is over 90% with the bioavailability of Spironolacton solution in polyethylen glycol, the best absorption.

    Distribution

    Spironolacton is strongly linked to plasma proteins (about 90%).

    Metabolism

    The main metabolites of Spironolacton are 1 Alpha - Thiomethyl - Spironolacton and Canrenon.

    Elimination

    The spineolacton waste time is about 1.5 hours, of 7 thionethyl - Spironolacton about 9 - 12 hours and of Canrenon 10 - 35 hours. Spironolacton and metabolites excreted mainly through the urine, partly through the bile. Spironolacton and metabolites can pass the placenta, canrenon is excreted into breast milk. The kidney effect of a single dose of Spironolacton reaches the peak concentration after 7 hours and maintains for at least 24 hours.

    Pharmacokinetics on special clinical subjects

    Children

    There is no dynamic data on the use of children's Spironolacton. Recommendations for patients based on clinical experience and shift studies in scientific documents.

    • Before taking Spinolac 25mg Hasan medicine is treated by congestion (10 blisters x 10 tablets)

    How to use

    Spinolac 25 mg Used orally. Should take medicine with food. Dosage> 100 mg/day should be divided into small doses.

    Dosage

    edema due to congestive heart failure

    Starting dose of 100 mg/day, taking 1 single dose or dividing the dose, can be used 25 - 200 mg/day. The maintenance dose should be determined depending on the patient.

    Severe heart failure (degree III - IV)

    Treatment in combination with standard treatment should start at a dose of 25 mg/day/day if the potassium concentration in plasma ≤ 5 MEQ/L and creatinine level ≤ 2.5 mg/dl. The patient tolerated at a dose of 25 mg/time/day may increase the dose up to 50 mg/time/day. Patients intolerant to a dose of 25 mg/day/day may reduce the dose to 25 mg used for daily.

    ascites and edema

    100 mg/day if the ratio of Na+/K+

    Nephrotic syndrome

    normal dose 100 - 200 mg/day. Spironolacton does not affect the basic pathology, only used if other treatments (such as glucocorticoid) are ineffective.

    Hypertension against treatment

    Start at a dose of 25 mg/time/day. It is necessary to determine the lowest dose effectively and gradually increase to 100 mg/day or more.

    Diagnosis and treatment of hypertrophy of Tien Phat

    Spironolacton can be used as an initial diagnosis to provide evidence of the basis for the hypertrophy of Aldosteron first when the patient is in a normal diet.

  • Long -term inspection: daily dose is 400 mg for 3-4 weeks. Hypoto and hypertension are adjusted to provide a basis or to diagnose the Tien Phat hypertension.
  • Short -term test: Daily dose is 400 mg in 4 days. If the potassium in serum increases during spironolacton, but decreases when stopping spironolacton, a diagnosis of the primary aldosteron hypertension should be considered.
  • Short -term treatment of patients with raw aldosteron hypertrophy before surgery. After diagnosing the increase of aldosteron by official testing, Spironolacton can be specified in doses of 300 - 400 mg/day to prepare for surgery. For patients who are not suitable for surgery, Spironolacton can be used in long -term maintenance therapy with the lowest doses that are effective in each patient.

    • Elderly people

    Treatment mode should start with the lowest dose possible, then gradually increase the dose if necessary to achieve maximum efficiency. Caution in patients with kidney failure, severe liver failure.

    Children

    Starting dose 1 - 3 mg/kg/day, divided many times. The dose should be adjusted based on patient response and tolerance level.

    Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

    Symptoms

    Drowsy, restlessness, nausea, vomiting, dizziness, dizziness, diarrhea. Hypotension may occur, but these effects may not be related to acute overdose.

    How to handle

    There is no specific antidote. Symptoms are improved after the drug is out of the body. If dehydrated and electrolyte balance disorders, symptomatic and supportive treatment, water and electrolytes can be compensated. If hyperkalemia, reduced potassium consumption, use diuretics to excrete potassium, intravenous glucose with insulin or ion exchange resin.

    What to do when forgetting a dose? If close to the next dose time, skip the passing dose and take the next dose as usual. Do not take double dose.

    Side Effects

    When using Spinolac 25 mg you may experience unwanted effects (ADR).

  • The most unwanted effect is the hyperkalemia of the reproductive disorders including big breasts in men but often recovered after treatment.

    • Blood circulatory and lymphatic system: plateletic hypernipation, eosinophilia, Eosin, leukopenia, including granulocytes (rare).

  • The immune system: Eczema , hypersensitivity (rare).
    • tumor: Breast cancer (very rare).
  • Endocrine effects: Mild mild effects, including hairy (unknown frequency).
  • Metabolism, nutrition: hyperkalemia in patients with severe renal impairment used simultaneously with potassium supplements (very common). Hypoglyc sodium (especially when combined with thiazid diuretics); Hypotension in patients with severe renal impairment, simultaneously used with enzyme inhibitors or potassium chloride, elderly people, patients with diabetes (common). Acidosis (rarely). Dehydration, porphyrin metabolic disorders, hyper urea (rare). Metabolic acidosis accompanied by increased chloride in the blood can recover (unknown frequency).
  • Mental: restlessness (rarely).
  • nerve: headache (very common), weakness, coma in patients with hepatic, abnormal (common), lower limb (rare). Eyes, dizziness, loss of air conditioning (unknown frequency).
  • Vascular: Vascular (very rare). Mild hypotension (unknown frequency).
  • digestive: indigestion, diarrhea (very common). Nausea, vomiting (very common). Stomach ulcer, gastrointestinal bleeding (rare).
    • liver - bile: hepatitis (very rare). skin - subcutaneous tissue: rash, urticaria , erythema, skin fungus, foreign rash (rarely). Stevens - Johnson syndrome (SJS), skin necrosis of poisoning caused by eosin -like white blood cells and symptoms of body (dress) (unknown frequency).
  • Bone and connective tissue: muscle, cramps (rare). Lupus erythematosus, bone puree (rarely).
    • Urinary: Increasing plasma creatinine, acute renal failure.

    Reproductive system: Hypotenosis, erectile dysfunction, helplessness, large breasts in men, mammary disorders, soft breasts, menstrual disorders. Change vaginal discharge, reduce vitality.

    Instructions on how to handle ADR

    When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

    Warnings

    Before using the drug you need to read the instructions carefully and refer to the information below.

    Contraindicated

    Spinolac 25 mg contraindicated in the following cases:

  • Sensitive to Spironolacton or any ingredients of the drug.
  • Severe renal failure (EGFR
  • Addison disease .
  • Hyarassic hyperboly (serum potassium level> 5 mmol/l).
  • Hemorrhage reduction.
  • Simultaneously used with eplerenon or diuretics holding potassium, potassium supplements.
  • Average to severe kidney failure.

    • Be cautious when using

    balance of fluid and electrolytes

    The fluid and electrolytes should be regularly controlled during treatment with Spironolacton, especially in the elderly, those who have the ability to fail with liver and kidney failure. Hyperbysical hyperpass can occur in patients with kidney failure or excessive potassium intolerance and may cause abnormal heart rate, which can lead to death. Stop using Spinolac 25 mg if necessary.

    Metabolic acidosis with hyperplasia in the blood can be recovered often related to hyperkalemia has been reported in some patients with compensation cirrhosis, even when normal kidney function.

    Use Spinolac 25 mg simultaneously with potassium diuretics, transferred enzyme inhibitors (ACE), nonsteroidal anti -inflammatory drugs, Angiotensin II receptor anti -receptor, anti -aldosteron, heparin, low molecular weight heparin or other drugs, causing hyperpassia, potassium supplements, potassium -rich diets, or potassium salts Trong.

    urea

    Recovery hyper Urue has been reported when using Spironolacton, especially in patients with renal impairment.

    Hyarassic hyperka in patients with severe heart failure

    Hyperbonemia can be fatal. Serum potassium should be closely monitored and controlled in patients with severe heart failure using Spironolacton. Avoid using diuretics to keep potassium. Avoid using potassium supplements in patients with serum potassium levels> 3.5 Meq/l. Checking blood and creatinine after 1 week of starting or increasing dose, checking monthly for the first 3 months, then 4 times/year and every 6 months. Discontinue spironolacton treatment if serum potassium concentration> 5 MEQ/ml or serum creatinine> 4 mg/dl.

    Children

    Use diuretics to keep potassium caution in children with hypertension with mild kidney failure because of the risk of hyperkalemia.

    The ability to drive and operate machinery

    Sleeping and dizziness is reported in some patients. Caution should be careful when driving, operating machinery until the initial treatment is determined.

    Pregnancy

    spironolacton and metabolites can pass through the placenta. Using Spinolac 25 mg in pregnant women when the benefit is more than the risk that may occur with the mother and the fetus.

    The period of breastfeeding

    The metabolites of Spironolacton are found in breast milk. Spinolac should not be used 25 mg during breastfeeding. If it is necessary to use Spinolac 25 mg, you should stop breastfeeding.

    Interactive drug

    Medications that cause hyperboly, trimethoprim/sulfamethoxazol (cotrimoxazol)

    Concentrated use with Spironolacton causes severe hyperkalemia.

    digoxin

    Spironolacton increases Digoxin's disposal time. Spironolacton has been reported to increase plasma digoxin concentrations and can hinder the amount of digoxin concentration in plasma.

    Antid for hypertension

    Dose reduction when used simultaneously with spironolacton and adjust the dose if necessary. Because enzyme inhibitors specialize in reducing the production of aldosteron, should not be used frequently with spironolacton, especially in patients with renal impairment.

    carbenoxolon

    Causes sodium and reduces the effectiveness of spironolacton. Avoid using these 2 drugs simultaneously.

    Non -steroid anti -inflammatory drugs (aspirin, indomethacin, mefenamic acid)

    Reduces the effect of sodium secretion of diuretics due to prostaglandin synthesis in the kidneys, and reduces the diuretic effect of spironolacton.

    noradrenalin

    Spironolactone reduces vascular response to noradrenalin. Caution should be careful in controlling anesthetic patients while being treated with spironolacton.

    antipipin

    Spironolacton increases metabolism of antipipin.

    anticoagulant

    Spironolacton reduces anticoagulant effects.

    lithium

    Diuretics reduce lithium clearance, increasing the risk of lithium poisoning.

    Alcohol, sedative, barbiturate, anesthetic

    Hypotension may occur.

    cholestyramin, ammonium chloride

    Metabolic acidosis is accompanied by increased blood chloride, often associated with hyperkalemia.

    corticosteroids, ACTH

    Increases the loss of electrolytes, especially reducing blood potassium.

    Storage

    Where dry, less than 30 ° C. Avoid light.

    Other drugs

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