Generic Aldactone (Spironolactone)
Heart failure is a common and potentially life-threatening condition in which the heart begins to pump blood through the vessels with difficulties. Because of this, due to the lack of nutrients and oxygen it becomes more and more difficult for the body to perform daily physical exertion. Most often, the kidneys, liver, muscles, and the central nervous system are affected due to circulatory disorders.
The mechanism of development of congestive heart failure (CHF) is based on the suppression of ventricular function due to arterial hypertension, valvular heart disease, dilated cardiomyopathy, ischemic heart disease, myocarditis, restriction of ventricular filling observed in mitral stenosis, restrictive cardiomyopathy, and pericardial damage.
The sympathoadrenal and renin-angiotensin-aldosterone system is activated in response to a decrease in cardiac output. Initially, these mechanisms perform a compensatory role, then, increasing the load on the heart, contribute to the progression of heart failure. There are also violations of water and electrolyte balance – an increase in the excretion of potassium, water retention, sodium. Electrolyte disorders cause heart rhythm disturbances, aggravating its insufficiency.
According to doctors, one of the main prerequisites for the development of CHF is hypertension. This disorder is diagnosed in about 40% of the world's population. According to statistics often the pressure begins to regularly jump above the norm (130 to 80 mm Hg) after 35 years. The second major cause of heart failure is coronary heart disease. Also, myocardial infarction is often the impetus for the occurrence of CHF.
The main danger is the deterioration of the disease and the condition of the patient development occurring after each disease exacerbation.
It is as if the person is on an escalator that moves him down, and after each aggravation the escalator becomes steeper and moves faster and faster. Finally, the result of this movement is usually fatal. Up to 30% of patients with decompensated heart failure after discharge from the hospital die within a year.
Therefore, cardiologists told what the main symptoms should alert each of us. These are five signs:
- shortness of breath,
- weakness, fatigue,
- the appearance of edema, primarily in the area of the feet and ankles.
Heart failure is a complication of most chronic cardiovascular diseases, and with proper organization of treatment, nutrition and physical activity, you can significantly reduce the risk of this condition.
The main groups of drugs used to treat patients with congestive heart failure are cardiac glycosides, diuretics (including potassium-sparing, for example, Aldactone (Spironolactone) and others.
It is necessary to emphasize the great importance of therapy with the use of Spirolactone-containing medications in chronic heart failure. Thus, its prescription, even in severe chronic heart failure, leads to a significant reduction in all-cause mortality and slows the progression of the disease.
The drug is prescribed with caution in the following cases:
- Severe renal failure (creatinine clearance less than 10 ml / min).
- Hypersensitivity to any of the components of the drug.
Care should be taken in case of hypercalcemia, metabolic acidosis, AV blockade (hyperkalemia increases it), diabetes mellitus (with confirmed or suspected chronic renal failure), diabetic nephropathy, surgical interventions, medications that cause gynecomastia, local and general anesthesia, menstrual disorders, breast enlargement, liver failure, liver cirrhosis, as well as elderly patients.
Aldactone should not be taken concurrently with other agents that slow down the excretion of potassium-containing additives, since hyperkalemia may develop.
This drug should not be used in children younger than 18 years.
The dosage of this medication has to be prescribed by the attending physician individually. The dose usually depends on the severity of water and electrolyte metabolism disorders and hormonal status.
In case of diagnosed edematous syndrome the dose of the substance amounts to 100-200 mg / day, (less often – 300 mg / day) divided in 2-3 doses per day for 14-21 days. Dose adjustment should be carried out with consideration of plasma potassium concentrations. If necessary, the courses are repeated every 10-14 days. In case of pronounced hyperaldosteronism including reduced plasma potassium the dose amounts to 300 mg / day divided in 2-3 doses.
How to take Aldactone?
The method of application and the dosage regimen of a particular drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular preparation with the indications for use and the dosage regimen.
It is recommended to take Spironolactone-containing agent once a day with a meal.
The daily dose for adults is usually 50-100 mg once at a time, which can be increased to 200 mg, observing that the dose is increased gradually, 1 time in 2 weeks. To achieve an adequate response to therapy, the drug must be taken at least 2 weeks.
Doctors advise above all to eat right and control weight. This reduces the risk of developing hypertension and coronary heart disease. Furthermore, of all physical activity, preference should be given to fast walking: at least half an hour a day.
Spironolactone is a heavy drug, which may result in numerous adverse effects. Some of them: nausea, vomiting, constipation, increased manifestations of chronic gastritis, which are not considered as unambiguous indications for drug withdrawal. The final decision should be taken by the attending physician, who is aware of all the details of the patient's condition. The following side effects of the substance are common, for example:
- Effect on the gastrointestinal tract: diarrhea or constipation, stomach pain, the transition of gastritis into an ulcer.
- On the central nervous system: headache, dizziness, lethargy, ataxia (loss of coordination). The manual recommends caution when driving a car while taking the discussed drug.
- Exchange disorders: hypercreatininemia, hyperuricemia, acidosis, alkalosis, hyperkalemia, hyponatremia, agranulocytosis.
- In case of prolonged use there can be hormonal imbalance resulting in voice coarsening, dysmenorrhea or amenorrhea, hirsutism, breast carcinoma in women, gynecomastia, impotence in men. Possible rash due to individual intolerance to the components of the drug.
Spironolactone is a drug that must be taken in the indicated amount. Exceeding the dose leads to serious deviations of vital activity, biological processes. Overdose is fraught with an increase in urea concentration, dehydration, headache, nausea, vomiting. Hyponatremia is usually manifested in the form of thirst, dry mouth. Hyperkalemia in extreme cases can lead to cardiac arrest. In individuals with hypertension, there is a sharp decrease in blood pressure, convulsions, arrhythmia.
The action of Aldactone enhances the work of drugs designed to lower blood pressure, so there is a risk of temporary hypotension. If you take the drug simultaneously with lithium preparations, the concentration of lithium in the blood plasma increases. Hyperkalemia and hypercalcemia are likely in patients receiving ATP inhibitors. The drug reduces the effect of anticoagulants, norepinephrine.
When taken simultaneously, Aldactone reduces the effect of anticoagulants, indirect anticoagulants and the toxicity of cardiac glycosides. It enhances the metabolism of phenazole as well as the toxic effect of lithium due to reduced clearance.
The use of alcoholic beverages may increase the risk of sedation.
Aldactone, like many other drugs, cannot be combined with alcohol. The killing combination of the drug with alcohol can destroy healthy liver cells, in place of which ordinary connective tissue will appear, resulting in inability to process toxins and other harmful elements that accumulate in human’s body. Aldactone and alcohol load excessively the heat, which can lead to fatal consequences.
Below there are comments and feedback given by both physicians and patients.
Teresa: The doctor diagnosed me with congestive heart failure and, along with other drugs, ordered me to take Aldactone.
The main active ingredient of this diuretic drug is spironolactone. This is a potassium-sparing drug. The doctor said that I had to take it at least a month. It removes excess fluid. The most important difference is that this medicaion does not remove potassium from the body. I felt myself much better and now I continue treatment course.
Alisa: Being diagnosed with heart failure I was recommended to take spironolactone –containing potassium-sparing diuretic. I decided to go for Aldactone. Positive changes I felt almost immediately. Legs edema disappeared on the third day. I could walk without pain and feeling of heavy legs.
Olivia: I have some disorders in gynecology and my doctor recommended me to start using spironolactone –containing diuretic. I was recommended to take it before night. I was afraid that this medicine would eliminate potassium and magnesium from my body. So in order to make me calm the doctor offered me to add to my diet such products as raisins, dried apricots and bananas.
Cardiologist: I used to deal with heart failures for more than 15 years. When I see a patient with such a disorder accompanied by limbs swelling most often I prescribe spironolactone –containing potassium-sparing diuretic, which aimed at eliminating excessive fluids from the body but preserving needed levels of potassium and magnesium.
In most cases this medication is well tolerated unless there are any contraindications or other conditions when it has to be used with caution.
Nephrologist: In my longstanding practice I used to prescribe Aldactone, which is potassium-sparing diuretic to the patients suffering from swelling due to renal insufficiency.
It has to be mentioned that it is not recommended concurrent using of more than one spironolactone –containing diuretics as it may result in blood potassium concentration increase. Therefore before starting using any medications of this kind it is strongly recommended to seek medical advice.