SPIROLANG ® is a drug based on Spironolactone
THERAPEUTIC GROUP: Diuretics / antialdosteronic diuretics
Indications SPIROLANG ® Spironolactone
SPIROLANG ® is indicated in the treatment of primary and secondary aldosteronism with relative edematous condition, of edema due to congestive heart failure, liver cirrhosis and ascites, nephrotic syndrome.
SPIROLANG ® also has a therapeutic efficacy in the treatment of arterial hypertension in patients refractory to other antihypertensive therapies.
Mechanism of action SPIROLANG ® Spironolactone
SPIRONOLACTONE, active ingredient of SPIROLANG ® is a synthetic steroid compound, 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 rate 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, involved in the filtration / reabsorption process), where by inhibiting the aldosterone / specific receptor bond it 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 translate into an increase in diuresis without subjecting the patient to the risk of hypokalaemia; for this reason, drugs based on similar active ingredients are defined as POTASSIUM-SAVING DIURETICS.
Studies carried out and clinical efficacy
ANTIALDOSTERONICS AND "COGNITIVE" CAPACITY OF HYPERTHESUM
Hypertens Res. 2010 Sep 23. [Epub ahead of print]
High plasma aldosterone concentration is a novel risk factor of cognitive impairment in patients with hypertension.
Yagi S, Akaike M, Aihara KI, Iwase T, Yoshida S, Sumitomo-Ueda Y, Ikeda Y, Ishikawa K, Matsumoto T, Sata M.
Studies show how high levels of aldosterone, typical among hypertensive patients, can affect normal cognitive abilities by interacting with the receptors for mineralocorticoids present in the "hippocampus." The analysis carried out on 68 patients suffering from hypertension from hyperaldosteronism, has shown that treatment with spironolactone can reduce not only the cardiovascular risk associated with this pathology, but also improve the cognitive abilities of the enrolled patients.
EFFECTIVENESS OF SPIRONOLACTONE IN HYPERTENSION
Cochrane Database Syst Rev. 2010 Aug 4
Spironolactone for hypertension.
Batterink J, Stabler SN, Tejani AM, Fowkes CT.
This study, conducted in meta-analyzes from 2005 to 2009, shows the therapeutic efficacy of spironolactone in the treatment of primary hypertension. More precisely, a reduction of systolic pressure of about 20mmHg and of diastolic pressure of about 7mmHg was observed, with the absence of particular side effects. Worthy 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 beyond the 100mg dose, a range of application between 25 and 100mg / day is recommended.
THE INHIBITORS OF "ALDOSTERONE IN THE TREATMENT OF CHRONIC KIDNEY INSUFFICIENCY: BETWEEN HOPES AND LIMITS
Curr Opin Nephrol Hypertens. 2010 Sep; 19: 444-9.
Aldosterone blockade in chronic kidney disease: can it improve outcome?
Toto RD.
Recent experimental studies have shown how the intake of aldosterone in chronic renal failure can lead to 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 aimed at identifying correct therapeutic combinations that can maintain the positive effects of spironolactone while avoiding hyperkalemia.
Method of use and dosage
The drug is presented in capsules of 25/50/100 mg of the active ingredient spironolactone, however the therapeutic protocol is subject to variability of the doses based on the physio-pathological conditions of the patient. Therefore, the correct dosage must be established by the physician after a careful evaluation of the patient's clinical picture.
In general, the recommended doses vary from 50 to 200 mg / day, in divided doses during the day.
Warnings SPIROLANG ® Spironolactone
The treatment with SPIROLANG ® should be preceded, and supported during the therapeutic course, by the evaluation of the serum levels of sodium, potassium, chlorine and nitrogen residues. It is necessary to consider that the mechanism of action of SPIRONOLACTONE does not expose the patient to hypokalaemia, therefore it is not necessary to combine the therapy with potassium salt supplements or a dietary prescription with foods rich in this ion.
Prolonged and not carefully monitored treatment could lead to an "alteration of normal electrolyte homeostasis, with possible hyperkalaemia and hyponatremia (especially when SPIROLANG ® is combined with other diuretics) and consequent dry mouth, drowsiness and arrhythmias up to" cardiac arrest in the most severe cases. serious.
SPIROLANG ® does not directly alter the normal driving or use abilities of the machines; however, the possible presence of hypotensive episodes could cause a significant decrease in the patient's attention and reaction times.
PREGNANCY AND BREASTFEEDING
The use of SPIROLANG ® in pregnant women must be carefully evaluated and carried out only in case of real need, naturally under medical supervision.
SPIROLANG ®, on the other hand, is not recommended during breastfeeding, as spironolactone is - albeit to a small extent - secreted intact and functional in breast milk.
Interactions
The action of SPIROLANG ® can be enhanced by the concomitant administration of other antihypertensive drugs; therefore, in this case, the dosage should be adjusted appropriately.
SPIROLANG ® can, by reducing renal clearance, increase the toxic effects of digoxin and lithium salts.
Contraindications SPIROLANG ® Spironolactone
The use of SPIROLANG ® is strictly contraindicated in case of acute renal insufficiency, lack of patency of the urinary tract with consequent anuria, and in cases of altered electrolyte balance (hyperkalaemia and hyponatremia).
Undesirable Effects - Side Effects
The use of SPIROLANG ® even at therapeutic doses has been associated with episodes of nausea, somnolence, headache, disorders of the motility of the gastrointestinal tract, skin rashes, numbness and temperature rises.
Androgenic effects, gynecomastia, impotence and menstrual irregularities have also been described, which tended to completely regress upon discontinuation of treatment.
Prolonged treatment with SPIROLANG ® can cause an "alteration of the electrolyte balance".
Note
SPIROLANG ® can only be sold under medical prescription.
The use of SPIROLANG ® should always be done after consulting your doctor.
The indiscriminate use of SPIROLANG ® among athletes and non-athletes, to search for the loss of a few kilos, 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 slimming effect, intended as a loss of fat mass.
Therefore SPIROLANG ® is classified among the DOPING substances.
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