Introduction
Spirocard 50 is a medicine known as a diuretic (water pill). It is mainly used in the treatment of heart failure and high blood pressure. It reduces the swelling (edema) caused by some other conditions. This medicine is also used to treat low potassium levels in the body (hypokalemia).
Spirocard 50 should be taken with food at the same time each day to get the most benefit. Taking it early in the day can help prevent you from having to get up at night to go to the toilet frequently, You should keep using this medicine as it has been prescribed, even if you feel well. If you stop taking it, your condition may get worse. Follow your doctor's advice about the type and amount of liquids you should drink. If you are being treated for high blood pressure, lifestyle changes such as exercising regularly, and making changes to your diet like low-salt diet may increase the effectiveness of this medicine.
The common side effects include nausea, vomiting, dizziness and swelling, or tenderness of your breasts (men and women). If these bother you, or appear serious, let your doctor know. There may be ways of reducing or preventing them. Drinking alcohol can increase certain side effects and should be avoided.
You should be careful about using Spirocard 50 if you have kidney problems or are unable to urinate. Before taking it, tell your doctor if you have ever had kidney, liver or heart disease or are pregnant. Also let your healthcare team know about all other medications you are using as they may affect, or be affected by this medicine. Pregnant or breastfeeding women should consult their doctor before taking this medicine. While using this medicine, you may be advised to limit your intake of salt or salt substitutes, and you should have your blood pressure checked frequently. Some other tests like kidney function (e.g., creatinine) and potassium levels will be done to monitor your progress.
Uses of Spirocard 50
- Hypertension (high blood pressure)
- Edema
Side effects of Spirocard 50
Common
- Nausea
- Vomiting
- Leg cramps
- Dizziness
- Drowsiness
- Confusion
- Breast enlargement in male
- Increased creatinine level in blood
How to use Spirocard 50
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Spirocard 50 is to be taken with food.
How Spirocard 50 works
Spirocard 50 is a potassium-sparing diuretic. It lowers blood pressure and swelling by removing the extra water and electrolytes from the body without loss of potassium.
What if you forget to take Spirocard 50?
If you miss a dose of Spirocard 50, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Oedema, Hirsutism, Hypertension, Hepatic cirrhosis w/ ascites and oedema, Hyperaldosteronism, Severe CHF, Hypokalaemia
Administration
Should be taken with food.
Adult Dose
Oral
Oedema
Adult: Initially, 100 mg daily, may adjust dose according to response up to 400 mg daily.
Hepatic cirrhosis with ascites and oedema
Adult: Depending on urinary Na/K ratio: If >1: Initially, 100 mg daily; if <1: Initially, 200-400 mg daily.
Diagnosis of primary hyperaldosteronism
Adult: Long test: 400 mg daily for 3-4 wk. Short test: 400 mg daily for 4 days.
Preoperative management of hyperaldosteronism
Adult: 100-400 mg daily. Long-term maintenance in the absence of surgery: Admin the lowest effective dose.
Hypertension
Adult: As monotherapy: Initially, 50-100 mg in 1-2 divided doses, may adjust dose after 2 wk.
Severe congestive heart failure
Adult: As adjunct: Initially, 25 mg once daily to max 50 mg daily. May reduce to 25 mg every other day if 25 mg once daily dose is not tolerated.
Diuretic-induced hypokalaemia
Adult: 25-100 mg daily.
Hirsutism
Women with hirsutism
Adult: 50-200 mg qDay or divided q12hr
Elderly: Initiate w/ the lowest dose then titrate upward if needed.
Child Dose
Oral
Hepatic cirrhosis with ascites and oedema
Child: Initially, 3 mg/kg given in divided doses, may adjust according to response.
Diagnosis of primary hyperaldosteronism
Child: Initially, 3 mg/kg given in divided doses, may adjust according to response.
Preoperative management of hyperaldosteronism
Child: Initially, 3 mg/kg given in divided doses, may adjust according to response.
Severe congestive heart failure
Child: Initially, 3 mg/kg given in divided doses, may adjust according to response.
Renal Dose
Renal impairment
CrCl >50 mL/min/1.73 m²: 12.5-25 mg qDay; use maintenance dose of 25 mg qDay or q12hr after 4 weeks of treatment with potassium <5 mEq/L
CrCl 30-49 mL/min/1.73 m²: 12.5 mg qDay or every other day; use maintenance dose of 12.5-25 mg qDay after 4 weeks of treatment with potassium <5 mEq/L
CrCl <30 mL/min/1.73 m²: Avoid use
Contraindication
Anuria, hyperkalaemia, acute or progressive renal insufficiency. Addison's disease.
Mode of Action
Spironolactone acts on the distal renal tubules as a competitive antagonist of aldosterone. It increases the excretion of sodium chloride and water while conserving potassium and hydrogen ions.
Precaution
Patient at risk of developing hyperkalaemia and acidosis, w/ DM. Renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness and somnolence, if affected do not drive or operate machinery. Monitoring Parameters Monitor serum electrolytes periodically; BP, renal function.
Lactation: Metabolite excreted into breast milk; discontinue breastfeeding or do not use drug
Side Effect
Drowsiness, dizziness, headache, lethargy, leg cramps, GI disturbances (e.g. diarrhoea, cramps), ataxia, mental confusion, rashes, pruritus, alopecia, hyponatraemia, electrolyte disturbances, gynaecomastia, hirsutism, menstrual irregularities, breast pain, deepening of the voice, impotence, leucopenia (including agranulocytosis), thrombocytopenia, transient elevation in BUN concentration. Rarely, breast enlargement.
Potentially Fatal: Hyperkalaemia.
Interaction
Increased risk of hyperkalaemia w/ other K-sparing diuretics or K supplements, ACE inhibitors, angiotensin II receptor antagonists, trilostane, heparin, LMWH. Increased risk of nephrotoxicity w/ ciclosporin, NSAIDs. Increased risk of lithium toxicity. May reduce ulcer-healing properties of carbenoxolone. May increase serum level of digoxin. May reduce vascular response to norepinephrine. Concurrent use w/ colestyramine may cause hyperkalaemic metabolic acidosis. Potentiation of orthostatic hypotension may occur w/ barbiturates or narcotics.
Potentially Fatal: May enhance hyperkalaemic effect w/ eplerenone. Increased risk of lithium toxicity when used concurrently.