SPIROLANG ® is a drug based on Spironolactone
THERAPEUTIC GROUP: Diuretics / Antialdosteronic diuretics
IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects
Indications SPIROLANG ® Spironolattone
SPIROLANG ® is indicated in the treatment of primary and secondary hyperaldosteronism with relative edematous condition, of edema due to congestive heart failure, liver cirrhosis and ascites, nephrotic syndrome.
SPIROLANG ® also has therapeutic efficacy in the treatment of arterial hypertension in patients refractory to other antihypertensive therapies.
Mechanism of action SPIROLANG ® Spironolactone
SPIRONOLATTONE, active ingredient of SPIROLANG ® is a synthetic compound of steroid nature, structurally similar to aldosterone, which after oral administration is effectively absorbed in the intestine. Its active metabolite, CANRENONE, reaches maximum plasma peaks around the third-fourth hour, with a half-life of about 8/12 hours linked to the speed of renal and biliary elimination.
The diuretic action of SPIROLANG ® is due to its antialdosteronic action, carried out at the level of the distal tubule and the collector duct of the nephron (functional element of the kidney, engaged in the filtration / resorption process), where by inhibiting the aldosterone binding / specific receptor guarantees :
- Reduction of the sodium permeability of the main cells of the apical membrane, with consequent reduction of the reabsorption of this ion;
- Inhibition of active potassium excretion.
These two characteristics result in an increase in diuresis without subjecting the patient to the risk of hypokalemia; for this reason, drugs based on similar active ingredients are defined as DIOXICES POTASSIUM SAVINGS.
Studies carried out and clinical efficacy
ANTIALDOSTERONI AND COGNITIVE CAPACITY OF THE HYPERTESUS
Studies show that high levels of aldosterone, typical among hypertensive patients, can affect normal cognitive abilities, interacting with receptors for mineralocorticoids present in the hippocampus. The analysis carried out on 68 patients suffering from hyperaldosteronism hypertension showed that treatment with spironolactone can reduce not only the cardiovascular risk associated with this pathology, but also improve the cognitive abilities of enrolled patients.
EFFECTIVENESS OF THE SPIRONOLATTONE IN THE HYPERTENSION
This study, conducted in meta-analysis from 2005 to 2009, shows the therapeutic efficacy of spironolactone in the treatment of primary hypertension. More precisely, a reduction of the systolic pressure of about 20mmHg and of the diastolic pressure of about 7mmHg has been observed, with the absence of particular side effects. Of note is the absence of a dose / response correlation for doses above 100 mg / day of spironolactone. Therefore, given the same therapeutic efficacy and the increase in side effects exceeding the 100mg dose, we recommend a range of application between 25 and 100mg / day.
THE INHIBITORS OF ALDOSTERONE IN THE TREATMENT OF CHRONIC RENAL FAILURE: BETWEEN HOPES AND LIMITS
Recent experimental studies have shown that the intake of aldosterone in chronic renal failure can determine a significant reduction in inflammation, oxidative stress, proteinuria and tubular and glomerular damage. Despite the important positive effects, one of the most serious limitations of this therapeutic approach is the persistence of hyperkalemia events, which inevitably compromise its application.
Future efforts are therefore oriented towards the identification of correct therapeutic combinations that can maintain the positive effects of spironolactone avoiding hyperkalemia.
Method of use and dosage
The drug is presented in 25/50/100 mg capsules of the active ingredient spironolactone, however the therapeutic protocol is subject to variability of the doses based on the patient's physiopathological conditions. Therefore, the correct dosage must be established by the doctor after a careful evaluation of the patient's clinical picture.
In principle the recommended doses vary from 50 to 200 mg / day, in divided doses during the day.
Warnings SPIROLANG ® Spironolattone
Treatment with SPIROLANG ® should be preceded, and accompanied during the therapeutic course, by the evaluation of serum sodium, potassium, chlorine and nitrogen residues. It is necessary to consider that the mechanism of action of SPIRONOLATTONE does not expose the patient to hypokalemia, therefore it is not necessary to combine the potassium salt supplements or a diet prescription with foods rich in this ion.
Prolonged and not carefully monitored treatment could cause an alteration of the normal electrolytic homeostasis, with possible hyperkalemia and hyponatremia (especially when SPIROLANG ® is associated with other diuretics) and consequent dry mouth, drowsiness and arrhythmias until cardiac arrest in most cases serious.
SPIROLANG ® does not directly alter the normal driving ability or use of the machines; however, the possible presence of hypotensive episodes could determine a significant drop in the patient's attention and reaction times.
PREGNANCY AND BREASTFEEDING
The use of SPIROLANG ® in pregnant women should be carefully evaluated and carried out only in case of real need, naturally under medical supervision.
SPIROLANG ® is not recommended during breastfeeding, as spironolactone is - although in small part - whole and functional secret in breast milk.
Interactions
The action of SPIROLANG ® can be enhanced by the concomitant administration of other antihypertensive drugs; therefore, in this case, it would be appropriate to adequately adjust the dosage.
SPIROLANG ® may, by reducing renal clearance, increase the toxic effects of digoxin and lithium salts.
Contraindications SPIROLANG ® Spironolattone
The use of SPIROLANG ® is strictly contraindicated in cases of acute renal failure, lack of patency of the urinary tract with consequent anuria, and in cases of altered electrolyte balance (hyperkalemia and hyponatremia).
Undesirable effects - Side effects
The intake of SPIROLANG ® even at therapeutic doses has been associated with episodes of nausea, drowsiness, headache, disorders of the motility of the gastro-intestinal tract, rashes, numbness and temperature rises.
Androgenic effects, gynecomastia, impotence and irregularity of the menstrual cycle have also been described, which tended to regress completely with the suspension of treatment.
Prolonged treatment with SPIROLANG ® can alter the electrolyte balance.
Note
SPIROLANG ® is salable only under medical prescription.
The use of SPIROLANG ® should always take place after consulting your doctor.
The indiscriminate use of SPIROLANG ® between athletes and non-athletes, in the search for the loss of a few pounds, exposes the body to serious side effects. Furthermore, it is always advisable to reiterate that weight loss is dictated by the elimination of liquids and salts and not by a real weight loss effect, understood as a loss of fat mass.
Therefore SPIROLANG ® is classified among the DOPANTI substances.
