Diagnosis of primary hyperaldosteronism. Short-term pre-op treatment of patients w/ primary hyperaldosteronism. Long-term maintenance therapy for patients w/ discrete aldosterone-producing adrenal adenomas who are poor operative risks or who decline surgery &/ or for patients w/ bilateral micro- or macronodular adrenal hyperplasia (idiopathic hyperaldosteronism). CHF, including severe heart failure (NYHA class III-IV) to increase survival & reduce the risk of hospitalization when used in addition to standard therapy. Liver cirrhosis accompanied by edema &/ or ascites. Nephrotic syndrome. Essential HTN. Treatment & prophylaxis of hypokalemia.
Primary hyperaldosteronism Long test: 400 mg daily for 3-4 wk. Short test: 400 mg daily for 4 days. Pre-op: 100-400 mg daily. Edema in adult w/ CHF, hepatic cirrhosis or nephrotic syndrome Initially 100 mg in single or divided doses or 25-200 mg daily. Sole agent for diuresis: Continued for at least 5 days at the initial dosage level, may be adjusted to the optimal therapeutic or maintenance level administered in either single or divided daily doses. Essential HTN Initially 50-100 mg in single or divided doses. Hypokalemia 25-100 mg daily. Severe heart failure (NYHA class III-IV)Patient w/ serum K </5 mEq/L & serum creatinine </2.5 mg/dL 25 mg once daily. May increase to 50 mg once daily if tolerated. May reduce to 25 mg every other day if not tolerated.
Fluid or electrolyte imbalance eg, hypomagnesemia, hyponatremia, hypochloremic alkalosis & hyperkalemia. Hyperkalemia may occur in patients w/ impaired renal function or excessive K intake & can cause cardiac irregularities. Reversible hyperchloremic metabolic acidosis. Dilutional hyponatremia. Gynecomastia. Avoid K supplements & foods containing high levels of K including salt substitutes. Not to be administered concurrently w/ other K-sparing diuretics; lithium. Concomitant use w/ ACE inhibitors or indomethacin. Periodic determination of serum electrolytes at appropriate intervals, particularly in elderly & those w/ significant renal or hepatic impairment. Determine serum & urine electrolyte in vomiting patients. May cause transient elevation of BUN especially in patients w/ preexisting renal impairment. Pregnancy & lactation. Childn.
Sign Out
