Spironolactone.ppt
- 2. Introduction • Class: Diuretic Potassium Sparing Selective Aldosterone Blocker • Strength: 25MG TAB 50MG TAB 100MG TAB • Pregnancy Category: C
- 3. Pharmacokinetics • Absorption: Rapidly absorbed from GIT after oral administration • Protein Binding: 90% Plasma protein binding • Metabolism: Hepatic & Testicular CYP450 • Excretion: Primarily in Urine, secondarily in Bile • Half Life: 10 minutes
- 4. Indications • Edema associated with: • Congestive Heart Failure • Excessive Aldosterone Excretion • Hypertension • Primary Hyperaldosteronism • Hypokalemia • Acne in Woman • Hirsutism
- 5. Dosage • Edema: Oral: 25-200 mg daily in 1-2 divided doses • Hypokalemia: Oral: 25-100 mg once daily • Hypertension : Oral: 25-50 mg daily in 1-2 divided doses
- 6. • Diagnosis of primary aldosteronism: Oral: Long test: 400 mg once daily for 3-4 weeks; short test: 400 mg once daily for 4 days •Heart Failure: 12.5-25 mg once daily; maximum daily dose: 50 mg. If 25 mg once daily not tolerated, may reduce to 25 mg every other day
- 7. • Acne in women (unlabeled use): • Oral: 50-200 mg once daily • Hirsutism in women (unlabeled use): • Oral: 50-200 mg daily in 1-2 divided doses.
- 8. Common side effect: • Cardiovascular: Vasculitis • Central nervous system: Ataxia, confusion, drowsiness, headache, lethargy • Dermatologic: Erythematous maculopapular rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria • Endocrine & metabolic: Amenorrhea, gynecomastia, hyperkalemia
- 9. • Gastrointestinal: Abdominal cramps, diarrhea, gastritis, gastrointestinal hemorrhage, gastrointestinal ulcer, nausea, vomiting • Genitourinary: Impotence, irregular menses, postmenopausal bleeding • Hematologic & oncologic: Agranulocytosis, malignant neoplasm of breast • Hepatic: Hepatotoxicity
- 10. Interactions • The risk or severity of adverse effects can be increased when Spironolactone is combined with Acebutolol. • Aceclofenac may decrease the antihypertensive activities of Spironolactone. • The therapeutic efficacy of Spironolactone can be decreased when used in combination with Acemetacin. • The therapeutic efficacy of Acetyldigitoxin can be decreased when used in combination with Spironolactone.