REMSIMA SC 120 mg/ ml Price

Overview

Welcome to Dwaey, specifically on REMSIMA SC 120 mg/ ml page.
This medicine contains an important and useful components, as it consists of
Infliximabis available in the market in concentration

Name

Spironolactone

Precaution

Before starting **spironolactone**, it is essential for patients to consult their healthcare provider to assess if this medication is appropriate for their condition. Key precautions to consider include: - **Hyperkalemia**: Spironolactone can increase potassium levels in the blood, leading to **hyperkalemia**, which can be life-threatening. Patients should have their potassium levels monitored regularly, especially if they have **kidney problems** or are on a **potassium-rich diet**. - **Renal Impairment**: Spironolactone is primarily eliminated through the kidneys, so patients with **renal insufficiency** or **renal failure** may be at an increased risk of **electrolyte imbalances**, including hyperkalemia. The drug should be used cautiously in these patients, and regular renal function monitoring is essential. - **Pregnancy and Lactation**: Spironolactone is classified as a **Category C** drug during pregnancy, meaning it should be used only if the potential benefit justifies the potential risk to the fetus. It is generally **not recommended** during **pregnancy**, especially during the first trimester. Spironolactone is excreted in breast milk, so caution should be exercised if used during lactation. - **Endocrine Effects**: Spironolactone has **anti-androgenic properties** and can cause **gynecomastia** (enlarged breasts in men), **impotence**, and **menstrual irregularities**. These effects should be considered before starting the drug, particularly for men and postmenopausal women. - **Drug Interactions**: Spironolactone can interact with several medications, including **ACE inhibitors**, **angiotensin II receptor blockers (ARBs)**, and **NSAIDs**, which can increase the risk of **hyperkalemia**. Always inform the healthcare provider of other medications being taken.

Indication

Spironolactone is primarily used for the following conditions: - **Hypertension**: It is used as an adjunct to other antihypertensive agents to manage **high blood pressure**. - **Heart Failure**: It is prescribed in **chronic heart failure**, especially in patients with **left ventricular dysfunction** or **edema**. - **Edema**: Spironolactone is used to treat **edema** caused by conditions like **cirrhosis**, **nephrotic syndrome**, or **chronic kidney disease**. - **Hyperaldosteronism**: It is used in the treatment of **primary hyperaldosteronism** (Conn's syndrome), where there is excessive secretion of aldosterone, leading to **fluid retention**, **high blood pressure**, and **low potassium levels**. - **Polycystic Ovary Syndrome (PCOS)**: Due to its anti-androgenic effects, spironolactone is sometimes used off-label to manage **hirsutism** (excessive hair growth) associated with PCOS. - **Acne and Hair Loss**: It is used off-label to treat **hormonal acne** and **androgenic alopecia** in women.

Contra indication

Spironolactone should not be used in the following situations: - **Hyperkalemia**: Spironolactone should not be used in patients with **pre-existing hyperkalemia**, as it can exacerbate the condition and lead to life-threatening complications. - **Anuria**: Spironolactone is contraindicated in patients with **anuria** (the inability to urinate) because it may worsen renal function. - **Severe Renal Dysfunction**: It is contraindicated in patients with severe renal impairment (e.g., **creatinine clearance** < 30 mL/min). - **Pregnancy**: It is contraindicated in **pregnancy**, particularly during the **first trimester**, due to the potential for adverse effects on the developing fetus, including **fetal malformations** and **potassium imbalances**. - **Aldosterone-Producing Adrenal Tumors**: In patients with **aldosterone-producing adrenal tumors**, spironolactone should not be used due to its anti-androgenic effects and interference with adrenal function.

Side Effect

Spironolactone can cause a range of side effects, both common and serious: - **Common Side Effects**: - **Hyperkalemia**: Elevated potassium levels, which can lead to **heart arrhythmias**, muscle weakness, or fatigue. - **Gynecomastia**: Enlargement of breast tissue in men due to the anti-androgenic properties of the drug. - **Menstrual Irregularities**: Women may experience changes in their menstrual cycles, including **amenorrhea** (absence of menstruation) or **oligomenorrhea** (infrequent periods). - **Dizziness**: A sensation of lightheadedness or dizziness, especially when standing up quickly. - **Gastrointestinal Issues**: Nausea, vomiting, or stomach cramps. - **Serious Side Effects**: - **Severe Hyperkalemia**: This condition can lead to **life-threatening arrhythmias** or **cardiac arrest** and requires immediate medical intervention. - **Severe Hypotension**: Extremely low blood pressure, especially when used with other antihypertensive drugs. - **Renal Failure**: In patients with pre-existing renal impairment, spironolactone may exacerbate kidney dysfunction. - **Hepatic Toxicity**: Liver problems, including **hepatitis** or **jaundice**, can occur in rare cases. Patients should seek immediate medical attention if they experience **severe dizziness**, **swelling in the legs**, **chest pain**, **heart palpitations**, or **severe shortness of breath**.

Pregnancy Category ID

3

Mode of Action

Spironolactone is a **potassium-sparing diuretic** that works by blocking the effects of **aldosterone**, a hormone responsible for regulating **sodium and water retention** in the kidneys. By antagonizing aldosterone at its receptor sites, spironolactone reduces sodium reabsorption in the distal tubules and collecting ducts of the kidneys, which in turn promotes the excretion of sodium and water. This diuretic effect helps reduce **blood pressure** and **fluid retention**. Because it inhibits aldosterone, spironolactone also causes potassium retention, making it a **potassium-sparing** diuretic. This is beneficial in preventing hypokalemia (low potassium levels), but it can also increase the risk of **hyperkalemia** if not monitored closely.

Interaction

Spironolactone has potential interactions with a variety of drugs and substances: - **Potassium-Sparing Effects**: Spironolactone may enhance the effects of **potassium-sparing drugs** (e.g., **ACE inhibitors**, **ARBs**, **potassium supplements**) and increase the risk of **hyperkalemia**. It is crucial to avoid combining these drugs unless under strict medical supervision. - **Lithium**: Spironolactone can reduce the renal clearance of **lithium**, potentially leading to **lithium toxicity**. Close monitoring of **serum lithium levels** is necessary when these drugs are used together. - **NSAIDs**: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as **ibuprofen**, can reduce the effectiveness of spironolactone and increase the risk of **kidney damage** and **electrolyte imbalances**. - **Corticosteroids**: When used together with corticosteroids, spironolactone can increase the risk of **electrolyte disturbances** like **hyponatremia** (low sodium) and **hyperkalemia**. - **Other Diuretics**: Combining spironolactone with other **diuretics**, particularly **thiazide diuretics** or **loop diuretics**, may increase the risk of dehydration, **hypotension**, and **electrolyte imbalances**. - **Alcohol**: Alcohol can increase the blood pressure-lowering effect of spironolactone, increasing the risk of **orthostatic hypotension** (dizziness upon standing). Patients should inform their healthcare provider of all current medications, including over-the-counter drugs and supplements, to prevent adverse interactions.

Pregnancy Category Note

Information not available

Adult Dose

The typical **adult dose** of spironolactone depends on the condition being treated: - **Hypertension**: The usual dose is **25 to 100 mg** per day, taken in one or two divided doses. The dose can be adjusted based on the patient's response. - **Heart Failure**: For chronic heart failure, the typical dose is **12.5 to 25 mg** per day, with possible titration up to **50 mg** per day. - **Edema**: The dose for edema due to conditions like cirrhosis or nephrotic syndrome is typically **25 to 200 mg** per day, depending on severity. - **Hyperaldosteronism**: The initial dose is often **100 mg** daily, which may be increased depending on the patient's condition.

Child Dose

The dosage for children is based on age, weight, and the specific condition being treated: - **Edema**: For children, the usual dose is **1 to 3 mg/kg per day**, divided into one or two doses. - **Hyperaldosteronism**: For children with hyperaldosteronism, the dose is usually **1 to 2 mg/kg** per day, with adjustments based on response and renal function. As with any medication, a pediatrician should determine the appropriate dose and monitor the child for potential side effects, especially related to **electrolyte imbalances**.

Renal Dose

In patients with **renal impairment**, spironolactone should be used with caution, as it can exacerbate **hyperkalemia**. The dose may need to be reduced or adjusted, especially if the patient has **severe renal dysfunction** (creatinine clearance < 30 mL/min). Close monitoring of renal function and electrolytes is necessary. Spironalactone should generally be avoided in patients with **severe renal impairment**.

Administration

Information not available