Cardiovascular – Renal Drugs : Diuretics
OALDA2 “Aldactin tablet” 25 mg/tab
適應症：利尿、高血壓、原發性醛類脂醇過多症。
Usual dose:
Edema: initial, 100 mg/day (range 25-200 mg/day) in single or divided doses; after 5 days, adjust dosage, max. 400 mg/day, then if response is inadequate after 5 days, consider adding another diuretic.
Hirsutism: 50-200 mg daily or 200 mg/day for 20 days/mon; duration of therapy, several months up to 1 yr.
Hypertension: initial, 50-100 mg/day in single or divided doses; continue for 2 wks, then adjust to response, max. 400 mg/day.
Hypokalemia: 25-100 mg daily.
Primary aldosteronism: initial, 100-400 mg/day; maintenance, lowest effective dosage; max. 400 mg/day.
Dose adjustment:
Geriatric: more careful monitoring due to increased risk of hyperkalemia; serum potassium above 6 mEq can trigger cardiac arrhythmias.
Hepatic insufficiency: initial 100-200 mg qd; maintenance, up to 400 mg qd; alternate day dosing may be considered.
Renal impairment: mild renal failure (GFR > 50 ml/min), dosing interval of 6-12 h; moderate renal failure (GFR 10-50 ml/min), dosing interval of 12-24 h; severe renal failure (GFR < 10 ml/min), avoid use of spironolactone.
Contraindication:
Anuria, hyperkalemia, acute renal insufficiency.
Adverse effect:
Common: rash, urticaria, gynecomastia, hyperkalemia, diarrhea, nausea and vomiting, stomach cramps, vomiting, headache, lethargy, somnolence, confusion, disorder of menstruation, impotence.
Serious: skin ulcer, severe hyperkalemia, metabolic acidosis, gastric hemorrhage, gastritis, agranulocytosis, systemic lupus erythematosus, breast cancer, cause and effect not established.