Heart failure. Refractory edema & adjunct to standard therapy in lower doses. For refractory edema associated w/ cirrhosis of the liver or nephrotic syndrome & in cites associated w/ malignancy. Essential HTN. Diagnosis & treatment of primary aldosteronism.
Patients diagnosed w/ porphyria & suffering from menstrual abnormalities or breast enlargement. Hyperkalemia, hypernatremia & increased blood urea. Evaluate for possible disturbances of fluid & electrolyte balance.
Headache, drowsiness, GI disturbances including cramps, diarrhea, ataxia, mental confusion, skin rashes, gynecomastia, endocrine disorders including hirsutism, deepening of the voice, menstrual irregularities, impotence; transient increase in BUN conc, mild acidosis, hyponatremia, breast cancer, agranulocytosis, effects on electrolyte balance, increased serum-cholesterol conc, lichen-planus-like skin eruptions & chloasma-like pigmentation on the face.
Decrease aldosterone production, severe hyperkalemia & enhanced hypotensive effect w/ ACE inhibitors. Increased risk of hyponatremia w/ chlorpropamide. Reduced diuretic effect w/ aspirin. May reduce vascular response to noradrenaline (norepinephrine); caution use w/ regional or general anesth. Antagonized diuretic effect by estrogen. Monitor prothrombin time ratio or INR w/ coumarins (warfarin) & reassess periodically.
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