Spironolactone; Hydrochlorothiazide

Hydrochlorothiazide:

• Spironolactone; Hydrochlorothiazide information
• Spironolactone; Hydrochlorothiazide indications
• Spironolactone; Hydrochlorothiazide warnings
• Spironolactone; Hydrochlorothiazide intake guidelines
• Spironolactone; Hydrochlorothiazide dosage
• Spironolactone; Hydrochlorothiazide overdose
• Spironolactone; Hydrochlorothiazide missed dose
• Spironolactone; Hydrochlorothiazide side effects
• Spironolactone; Hydrochlorothiazide drug reactions
• Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) reviews

Spironolactone; Hydrochlorothiazide information

Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) is an antihypertensive, diuretic drug that acts on the electrolyte reabsorption in the renal tubular mechanism increasing the excretion of chloride and sodium in equivalent amounts. The exact mechanism of its antihypertensive action is not known at this time.

Spironolactone; Hydrochlorothiazide indications

Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) is typically employed for the treatment of patients suffering from hypertension, either as monotherapy or in combination with other antihypertensive medication. It is also employed in some cases as a diuretic agent. Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) therapy may also be prescribed for the treatment of hepatic cirrhosis, edema (in patients suffering from congestive heart failure), nephrotic syndrome, drug induced edema, chronic renal failure or acute glomerulonephritis. Health care professionals may prescribe this drug in order to treat other medical conditions as well; if you would like to know more about the reasons you have been prescribed this drug, it is advised to ask your personal physician.

Spironolactone; Hydrochlorothiazide warnings

Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) may not be used in the treatment of patients who are allergic to this drug, any of its components or other sulfonamide-derived medication. Also, this drug may not be suitable for use in patients that are suffering from anuria, azotemia or impaired renal functions. Caution should be employed if the patient is suffering from hepatic disease. Other medical conditions may also influence the examining health care provider's decision of prescribing Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide); it is strongly recommended to make sure that the health care professional is fully aware of your health condition and medical history before starting a treatment with this drug.

Use of Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) during pregnancy or breast-feeding is also not recommended. This medicine may affect an unborn baby and it also passes into breast milk. As such, use of this drug in pregnant women or breast-feeding mothers should not be employed.

Spironolactone; Hydrochlorothiazide intake guidelines

You should always take Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) as you have been directed by the prescribing health care specialist. While in some cases daily administration of the drug is recommended, other patients may be prescribed an intermittent therapy. Also, the number of daily doses may vary. As such, it is best that you do not follow another patient's intake schedule. If you have difficulties understanding the intake guidelines that your prescribing health care professional has provided, you should ask for further explanations from an authorized health care specialist - such as a pharmacist, a doctor or a nurse.

Spironolactone; Hydrochlorothiazide dosage

The exact Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) dosage may vary greatly from one case to another, depending on the condition being treated, on the patient's medical history and general health condition, on his or her age as well as on a number of other factors. As such you are advised to use the exact Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) dosage that has been prescribed to you and never use the dosage prescribed to another patient or a dosage that you have been prescribed in the past. Taking a different Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) dose may cause the treatment to not have the desired effect, and if you take this drug in larger doses you may have a higher risk of developing side effects, or you may suffer from an overdose.

Spironolactone; Hydrochlorothiazide overdose

You should never exceed the Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) prescribed dosage, in order to avoid an overdose with this medication. However, if you consider that you are affected by an overdose with this drug it is advised to immediately consult your personal health care provider, the local poisons center or to go to the nearest medical facility to seek emergency medical attention. The common symptoms of an overdose with Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) are dehydration and cardiac arrhythmia. The patient may also suffer from electrolyte depletion and thus may present the relevant signs and symptoms.

Spironolactone; Hydrochlorothiazide missed dose

In case you have missed a dose of Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide), it is advised that you take the dose as soon as you remember. If the moment when you remember is too close to another intake of the medication, you should completely skip the missed Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) dose and take the next scheduled dose on time. You should never take a larger dose of the drug in order to make up for a missed dose, unless your prescribing health care provider directs you to do so.

Spironolactone; Hydrochlorothiazide side effects

In some patients Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) may cause side effects. While they are not very common, it is recommended to let your personal health care provider know if you begin experiencing any side effects. Several types of symptoms are possible: dizziness, headache, paresthesias, gastric irritation, anorexia, nausea and vomiting, diarrhea or constipation, pancreatitis, jaundice, hypotension. Metabolic side effects may include glycosuria, hyperglycemia, hyperuricemia, hypokalemia or hyponatremia. Renal failure or dysfunction may develop, as well as interstitial nephritis. Some patients reported experiencing muscle spasms, restlessness, unusual weakness and blurred vision. In some cases photosensitivity, anaphylactic reactions, respiratory distress, fever, rashes, vasculitis or toxic epidermal necrolysis have occurred.

Spironolactone; Hydrochlorothiazide drug reactions

Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide) may interact with barbiturates and narcotics, as well as with alcohol. If you are also following a treatment course with antidiabetic drugs, their dosage may need to be adjusted before starting to take Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide). This drug may have an additive effect with other antihypertensive medication. ACE inhibitors, ACTH, corticosteroids and skeletal muscle relaxants may also interact with this drug causing unwanted effects. This drug may not be properly absorbed if the patient is also taking Colestipol resins or Cholestyramine. NSAIDs, lithium and Pressor amines may affect or be affected by Spironolactone; Hydrochlorothiazide (Hydrochlorothiazide), and as such it is strongly recommended to let the prescribing health care provider know if you are taking these or any other drugs before starting a therapy course with this medicine. Other drug interactions that are not listed here are also possible.

Spironolactone:

• Pharmacological action
• Pharmacokinetics
• Why is Spironolactone; Hydrochlorothiazide prescribed?
• Dosage and administration
• Spironolactone; Hydrochlorothiazide (Spironolactone) side effects, adverse reactions
• Spironolactone; Hydrochlorothiazide contraindications
• Using during pregnancy and breastfeeding
• Special instructions
• Spironolactone; Hydrochlorothiazide drug interactions
• Spironolactone; Hydrochlorothiazide in case of emergency / overdose
• Spironolactone; Hydrochlorothiazide (Spironolactone) reviews

Pharmacological action

Spironolactone; Hydrochlorothiazide is a potassium, magnesium sparing diuretic. This medication is a competitive antagonist of aldosterone on the effect on distal nephron (competes for binding sites on cytoplasmic protein receptors, reduces the synthesis of permeases in the aldosterone-sensitive part of collecting tubules and distal tubules), increases the excretion of Na+, Cl- and water and reduces the excretion of K+ and urea, reduces the titratable acidity of urine. Increased diuresis causes a hypotensive effect, which is unstable. The hypotensive effect is not dependent on the level of renin in the blood plasma and is not revealed in normal blood pressure.

The diuretic effect is seen at 2-5 days of treatment.

Pharmacokinetics

After oral administration Spironolactone; Hydrochlorothiazide (Spironolactone) absorbed from the gastrointestinal tract, the absorption is 90%. This drug metabolized in the liver, the major active metabolite is canrenone. T_1/2 is 13-24 hours. This medicine derived primarily by the kidneys, some is excreted in the bile.

Why is Spironolactone; Hydrochlorothiazide prescribed?

Edema in congestive heart failure, cirrhosis of the liver (especially in the simultaneous presence of hypokalemia and hyperaldosteronism), in the nephrotic syndrome.

Swelling in the II and III trimester of pregnancy.

Hypertension, including with aldosterone producing adrenal adenoma (in combination therapy).

Primary hyperaldosteronism. Aldosterone produced adrenal adenoma (long-term maintenance therapy with contraindications to surgery or in case of refusal from it). Diagnosis of hyperaldosteronism.

Hypokalemia and its prevention in the treatment of saluretics.

Polycystic ovary syndrome, premenstrual syndrome.

Dosage and administration

The dosage regimen is set individually depending on the severity of violations of water-electrolyte metabolism and hormonal status.

In cases of edema - 100-200 mg / day in 2-3 recepts (usually in combination with the "loop" and / or thiazide diuretic) daily for 14-21 days. The correction of dose should be based on the values of potassium in the plasma. If necessary, repeat it every 10-14 days. In marked hyperaldosteronism and a reduced content of plasma potassium - 300 mg in 2-3 recepts.

Spironolactone; Hydrochlorothiazide (Spironolactone) side effects, adverse reactions

Digestive system: nausea, vomiting, abdominal pain, gastritis, ulcers and bleeding in the gastrointestinal tract, intestinal colic, diarrhea or constipation.

CNS: dizziness, drowsiness, lethargy, headache, lethargy, ataxia.

Metabolism: increased concentrations of urea, hypercreatininemia, hyperuricemia, impaired water-salt metabolism and KSCHR (metabolic acidosis or hypochloremic alkalosis).

Hematopoietic system: megaloblastosis, agranulocytosis, thrombocytopenia.

Endocrine system: in long-term use - gynecomastia, erectile dysfunction in men; women - dysmenorrhea, amenorrhea, metrorrhagia, menopause, hirsutism, deepening voice, breast tenderness, breast carcinoma.

Allergic reactions: urticaria, papular makulopapular and erythematous rash, drug fever, pruritus.

Other: muscle cramps, reduced potency.

Spironolactone; Hydrochlorothiazide contraindications

Addison's disease, hyperkalemia, hypercalcemia, hyponatremia, chronic renal failure, anuria, hepatic failure, diabetes mellitus with confirmed or suspected renal disease, diabetic nephropathy, I trimester of pregnancy, metabolic acidosis, menstrual disorders or breast enlargement, hypersensitivity to Spironolactone; Hydrochlorothiazide (Spironolactone).

Using during pregnancy and breastfeeding

There is no data on adverse effects of Spironolactone; Hydrochlorothiazide on pregnancy and fetal development.

However, in the I trimester of pregnancy this medication is contraindicated, in II and III trimester can be used for prescription. If necessary to use during lactation it should be considered that with breast milk in small amounts canrenone (metabolite of Spironolactone; Hydrochlorothiazide (Spironolactone)) excretes.

Category of the fetus by FDA - C.

Special instructions

Use Spironolactone; Hydrochlorothiazide (Spironolactone) cautiously in AV block (the possibility of strengthening due to the development of hyperkalemia), decompensated cirrhosis, surgery, taking drugs that cause gynecomastia, while taking local and general anesthetics in elderly patients.

Against the background of Spironolactone; Hydrochlorothiazide (Spironolactone) it should not be given medications containing potassium and other diuretics that cause potassium retention in the body. Patients should avoid using this drug with carbenoxolone, causing sodium retention.

In the period of treatment should be periodic determination of electrolytes and urea in the blood.

If taking of Spironolactone; Hydrochlorothiazide (Spironolactone) in combination with other diuretics or antihypertensive the dose of latters is recommended to be reduced.

In the application of this medicatio in conjunction with digoxin it may be necessary to reduce both the saturation and maintenance dose of the latter.

Spironolactone; Hydrochlorothiazide drug interactions

When this drug applied simultaneously with:

- antihypertensive drugs potentiated the hypotensive effect of Spironolactone; Hydrochlorothiazide (Spironolactone).

- ACE inhibitors may develop hyperkalemia (especially in patients with impaired renal function), as ACE inhibitors reduce the content of aldosterone, resulting in a delay of potassium in the body against the removal of potassium restriction.

- preparations of potassium and other potassium-sparing diuretics, salt substitutes and food supplements containing potassium may develop hyperkalemia.

- salicylates decreases the diuretic effect of Spironolactone; Hydrochlorothiazide (Spironolactone) due to blockade of canrenone excretion by the kidneys.

- decreases hypoprothrombinemic effect of oral anticoagulants.

- digitoxin may gain as well as reducing the effects of digitoxin.

- Spironolactone; Hydrochlorothiazide (Spironolactone) inhibits the excretion of digoxin by the kidneys, and probably reduce its volume of distribution. This may cause an increased concentration of digoxin in plasma.

- candesartan, losartan, eprosartan is a risk of hyperkalemia.

- cholestyramine it been described a case of hypochloremic alkalosis.

- lithium carbonate may increase the concentration of lithium in blood plasma.

- norepinephrine may decrease the sensitivity of vessels to noradrenaline.

- amplified effect triptorelin, buserelin, gonadorelin. Indomethacin and mefenamic acid inhibit the excretion of canrenone by kidneys.

Spironolactone; Hydrochlorothiazide in case of emergency / overdose

Symptoms: nausea, vomiting, drowsiness, dizziness, confusion, leg cramps, skin rash, diarrhea, dehydration may, disruption of water and electrolyte balance.

Treatment: discontinuation of the drug, induction of vomiting, gastric lavage, symptomatic treatment of dehydration and disorders of water and electrolyte balance, arterial hypotension, maintenance of vital functions; in the case of hyperkalemia - fast IV injection of 20-50% solution of glucose and insulin - 0.25-0.5 units / g of glucose. Used diuretics, and potassium carve ion exchange resins. Perhaps hemodialysis. There is no specific antidote for Spironolactone; Hydrochlorothiazide (Spironolactone) Quality Pharmaceutical Laboratory.