Generic Name: Spironolactone 100mgÂ
Manufacturer/Distributor: Popular Pharmaceuticals Ltd.Â
Spirocard is a long-acting aldosterone antagonist that works by competitively inhibiting aldosterone at the sodium-potassium exchange site in the distal renal tubule. This leads to the excretion of sodium and water while retaining potassium and magnesium.
Pharmacology
Spironolactone, the active ingredient in Spirocard, acts as a specific pharmacologic antagonist of aldosterone. It binds to receptors at the aldosterone-dependent sodium-potassium exchange site, preventing aldosterone from enhancing the expression of the sodium-potassium ATPase and sodium channels in the distal tubule. This results in increased excretion of sodium and water while conserving potassium. Spironolactone serves as both a diuretic and an antihypertensive agent and can be used alone or with other diuretics.
Dosage & Administration
1. Edema in adults (due to congestive heart failure, hepatic cirrhosis, or nephrotic syndrome):
- Initial dose: 100 mg daily (can be given as a single dose or divided into multiple doses).
- Dose range: 25–200 mg daily, depending on the patient’s response.
- In cases requiring rapid diuresis, combination therapy with other diuretics may be needed.
2. Primary hyperaldosteronism:
- Pre-surgery: 100–400 mg daily.
- Long-term maintenance: Use the lowest effective dose for patients not undergoing surgery.
3. Essential hypertension:
- Initial dose: 50–100 mg daily in single or divided doses.
4. Hypokalemia:
- Dose range: 25–100 mg daily to treat diuretic-induced hypokalemia.
Use only as directed by your physician.
Drug Interactions
- ACE inhibitors: May cause severe hyperkalemia when used with potassium-sparing diuretics.
- Alcohol, barbiturates, or narcotics: May enhance orthostatic hypotension.
- Corticosteroids/ACTH: Can intensify electrolyte depletion, especially hypokalemia.
- Lithium: Diuretics reduce renal clearance of lithium, increasing the risk of toxicity.
- Digoxin: Spirocard can prolong the half-life of digoxin.
Contraindications
Spirocard is contraindicated in patients with:
- Acute renal insufficiency
- Severe renal impairment
- Anuria
- Hyperkalemia
- Hypersensitivity to spironolactone
Side Effects
- Gynecomastia (enlargement of male breast tissue)
- Gastrointestinal issues: cramping, diarrhea
- Drowsiness, lethargy, headache
- Skin reactions: urticaria
- Mental confusion, impotence
- Irregular menstrual cycles, amenorrhea, or post-menopausal bleeding
Pregnancy & Lactation
- Pregnancy: Spirocard should not be used during pregnancy.
- Lactation: Canrenone, an active metabolite of spironolactone, is present in breast milk. If the drug is essential, alternative feeding methods should be considered.
Precautions & Warnings
- Monitor all patients on diuretics for fluid or electrolyte imbalances.
- Hyperkalemia: May occur in patients with impaired renal function or excessive potassium intake and can cause life-threatening cardiac irregularities.
Overdose Effects
Symptoms of overdose include:
- Drowsiness
- Mental confusion
- Dizziness
- Diarrhea and vomiting
Treatment: Induce vomiting or perform gastric lavage to remove the drug.
Therapeutic Class
- Potassium-sparing diuretics
- Aldosterone antagonists
Storage Instructions
- Store in a cool, dry place, away from light.
- Keep out of the reach of children.