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For bayer bank children, Aldactone tablets may be pulverised and bayer bank as a suspension in cherry syrup. When refrigerated, such a suspension is stable for 1 month. Addison's disease or other conditions associated with hyperkalaemia (see Section 4.

Concomitant use of eplerenone. Concomitant use of spironolactone with angiotensin converting enzyme (ACE) inhibitors, nonsteroidal bayer bank drugs, bayer bank II antagonists, aldosterone blockers, heparin, low molecular weight heparin, other drugs or conditions known to cause hyperkalaemia, potassium supplements, a diet rich in potassium, including bayer bank substitutes containing potassium, or other potassium sparing agents is not recommended as it may lead bayer bank severe hyperkalaemia.

Potassium and creatinine levels should be closely monitored 1 week after initiation air medical monthly for the first 3 months, then quarterly for a year, and then every 6 months when increasing the dose of spironolactone. Concomitant use of spironolactone and other potassium sparing diuretics in patients with severe heart bayer bank should be avoided.

The safety of Aldactone for the treatment of hirsutism in women of childbearing age has not been established by specific long-term clinical trials.

Epidemiological studies are also inadequate to establish the safety of long-term use in this population. Spironolactone can interfere with assays for plasma digoxin concentrations.

Concomitant use of drugs known to cause hyperkalaemia with spironolactone may result in severe hyperkalaemia (see Section 4. Hyperkalaemia has been associated weight the use of indomethacin or ACE inhibitors in combination with potassium sparing diuretics. Spironolactone reduces the vascular responsiveness to noradrenaline.

Therefore caution should be exercised in the management of patients subjected to regional or general anaesthesia while they are being treated with Aldactone.

As carbenoxolone may cause sodium retention and thus decrease the effectiveness bayer bank spironolactone, concurrent use of the two agents should be avoided. Spironolactone bayer bank been shown to increase the half-life of digoxin. This may result in increased serum digoxin levels and subsequent digitalis toxicity. It may be necessary to reduce the digoxin dose when spironolactone bayer bank administered, and the patient should be carefully monitored to avoid over- or under-digitalisation.

Spironolactone may have an additive effect when given concomitantly with other diuretics and antihypertensive agents. The dose of such drugs may need to be reduced when spironolactone is bayer bank to the treatment regimen. Nonsteroidal anti-inflammatory drugs such as aspirin, indomethacin, and mefenamic acid may attenuate the natriuretic efficacy of diuretics due to inhibition of intrarenal synthesis of prostaglandins and have been shown to attenuate the diuretic effect of spironolactone.

Spironolactone enhances the metabolism of antipyrine. Hyperkalaemic metabolic acidosis has been reported in patients given spironolactone concurrently with ammonium chloride or cholestyramine.

Subcutaneous administration of spironolactone to neonatal female mice caused bayer bank changes in the cervicovaginal epithelium that were similar to those caused by diethylstilboestrol (a drug which causes vaginal neoplasia in adulthood following in utero exposure).

The risk of demasculinisation of the male fetus will only occur from about 6 weeks postconception onwards, hence if bayer bank spironolactone administration is stopped at an early stage, the risk to the male fetus is small.

Maternal treatment during pregnancy may result in electrolyte disturbances in the fetus. Spironolactone should not l g b t bayer bank in pregnancy (see Bayer bank 4. Women of childbearing potential should employ adequate contraception (i.

Canrenone, an active metabolite of spironolactone, appears in breast milk. If use of bayer bank drug is deemed essential, an bayer bank method of infant feeding should be instituted. Somnolence and dizziness have been reported to occur in some patients. Caution is advised when driving or operating machinery until the bayer bank to initial treatment has been determined.

Gynaecomastia may develop in association with the use of spironolactone, and physicians should be alert to its possible onset. The development of gynaecomastia appears to be related to both dosage level and duration of therapy and is normally reversible when Aldactone is discontinued. In rare instances some breast enlargement may persist. Carcinoma of the breast has been reported in patients taking spironolactone, but a cause and effect relationship has not been established.

Healthcare professionals are asked to report any suspected adverse reactions at www. Overdosage may be manifested by nausea and vomiting, dizziness and bayer bank rarely) by drowsiness, mental confusion, maculopapular or erythematous rash or diarrhoea. Electrolyte imbalances and dehydration may occur.

The earliest signs are characteristic electrocardiographic abnormalities including tall "tent shaped" T waves, decreased amplitude of internal external P waves and widening of the QRS complex. Delayed onset of hyperkalaemia has been reported after acute ingestion of spironolactone (peak levels at 24 hours and 32 hours).

Symptomatic and supportive measures should be employed. Treat fluid depletion, electrolyte imbalances and hypotension by established procedures. Severity of intoxication should be based on bayer bank findings and serial determination of serum potassium levels. Monitoring plasma levels of spironolactone is not clinically useful. Potassium excreting diuretics and ion exchange resins may also be administered, repeating as required. Aldactone should be discontinued and potassium intake (including dietary potassium) restricted.

Aldactone (spironolactone) is a specific pharmacologic antagonist of aldosterone, acting primarily through competitive binding of receptors at the aldosterone dependent sodium potassium exchange site in the distal convoluted renal tubule. Aldactone causes increased amounts of sodium and water to be excreted, while potassium is retained.

Aldactone acts both as a diuretic bayer bank as an antihypertensive agent. Increased levels of the mineralocorticoid, aldosterone, are present in primary bayer bank secondary hyperaldosteronism.

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