Malignant ascites
Adult: Initially, 100-200 mg daily, may be gradually increased up to 400 mg daily for severe cases. Maintenance dose must be adjusted according to individual response.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Oral
Oedema
Adult: Initially, 100 mg daily, may be adjusted up to 400 mg daily according to response.
Oral
Congestive heart failure with oedema
Adult: For the management of oedema: Initially, 100 mg daily or 25-200 mg daily as a single dose or in divided doses. Maintenance dose must be adjusted according to individual response.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Oral
Nephrotic syndrome
Adult: If glucocorticoids are insufficiently effective: Usual dose: 100-200 mg daily.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Oral
Diagnosis of primary hyperaldosteronism
Adult: Long test: 400 mg daily for 3-4 weeks. Short test: 400 mg daily for 4 days.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Oral
Hypertension
Adult: Adjunct in patients who are not adequately controlled on other agents: As tab: Initially, 25-100 mg daily as a single dose or in divided doses. As susp: Initially, 20-75 mg daily a single dose or in divided doses. Dosage may be titrated at 2-week intervals, if needed, according to response and tolerability.
Oral
Preoperative management of hyperaldosteronism
Adult: 100-400 mg daily. As long-term maintenance therapy in patients who are considered unsuitable for surgery: Use the lowest effective dose.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Oral
Hepatic cirrhosis with ascites and oedema
Adult: Initiate treatment in the hospital and slowly titrate the dose. If urinary Na/K ratio is >1: Initially, 100 mg daily. If urinary Na/K ratio is <1: Initially, 200-400 mg daily. Maintenance dose must be adjusted according to individual response.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Child: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Oral
Heart failure
Adult: In conjunction with standard therapy for the treatment of New York Heart Association (NYHA) Class III-IV cases: Patients with serum K ≤5 mEq/L and eGFR >50 mL/min/1.73 m2: As tab: Initially, 25 mg once daily, if tolerated, may be increased to 50 mg once daily as clinically indicated. As susp: Initially, 20 mg once daily, if tolerated, may be increased to 37.5 mg once daily as clinically indicated. Patients who develop hyperkalaemia on initial dose: As tab: May reduce dose to 25 mg every other day. As susp: May reduce dose to 20 mg every other day.
Child: As tab: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.
Child: As tab: Initially, 1-3 mg/kg daily in divided doses, may be adjusted according to response and tolerance.
Elderly: Initiate with the lowest dose and titrate upwards if needed.