Hyles Dosage/Direction for Use

Recommended Doses: Edema Conditions: Usual dosage: 25 to 200 mg daily.
Initial dosage: 100 mg daily in either single or divided doses. When given as the sole agent for diuresis, continue for at least 5 days at the initial dosage level, after which it may be adjusted to the optimal therapeutic or maintenance level administered in either single or divided daily doses.
Concomitant therapy: If, after 5 days, an adequate diuretic response has not occurred, a second diuretic that acts more proximally in the renal tubule may be added to the regimen. Because of the additive effect of spironolactone when coadministered with such diuretics, an enhanced diuresis usually begins on the first day of combined treatment; combined therapy is indicated when more rapid diuresis is desired. The dosage of spironolactone should remain unchanged when other diuretic therapy is added.
Essential Hypertension: Initial dosage: 50 to 100 mg daily in single or divided doses.
Dosage adjustment: Dosage should be adjusted according to the response of the patient.
Duration of therapy: Treatment should be continued for at least 2 weeks, because the maximum response may not occur before this time.
Concomitant therapy: May be given with diuretics that act more proximally in the renal tubule or with other antihypertensive agents.
Congestive Heart Failure: Spironolactone is indicated for the management of severe congestive heart failure in patients receiving an ACE inhibitor and a loop diuretic with or without a cardiac glycoside.
Initial dosage: 12.5 to 25 mg daily.
Dosage adjustment: the dosage of spironolactone has been increased to 50 mg daily after 8 weeks of therapy in patients who exhibited signs and symptoms of progressive heart failure and who had no hyperkalemia (serum potassium concentrations of 5.5 mEq/L). When hyperkalemia occurred, dosage of spironolactone was decreased to 25 mg every other day.
Primary Hyperaldosteronism: Usual dosage: 100 to 400 mg daily in preparation for surgery.
Maintenance dosage: For patients who are considered unsuitable for surgery, administer long-term maintenance therapy at the lowest effective dosage determined for the individual patient.
Diagnosis: Long test: 400 mg daily for 3 to 4 weeks. Correction of hypokalemia and of hypertension provides presumptive evidence for the diagnosis of primary hyperaldosteronism.
Short test: 400 mg daily for 4 days. If serum potassium increases during spironolactone administration but drops when spironolactone is discontinued, a presumptive diagnosis of primary hyperaldosteronism should be considered.
Hypokalemia: Usual dosage: 25 to 100 mg daily.
Severe heart failure (NYHA class III to IV): Initial dosage: 25 mg once daily if the patient's serum potassium is 5 mEq/L or less and the patient's serum creatinine is 2.5 mg/dL or less.
Dosage adjustment: Patients who tolerate 25 mg once daily may have their dosage increased to 50 mg once daily as clinically indicated. Patients who do not tolerate the 25 mg once daily dose may have their dosage reduced to 25 mg every other day.
Renal function impairment: Contraindicated in patients with anuria, acute renal insufficiency, and/or significant impairment of renal excretory function.
Mode of Administration: Spironolactone is administered orally. Although it has frequently been recommended that spironolactone be administered in 3 to 4 doses daily, more recent information suggests that 1 or 2 doses daily may be adequate.