ISSN 2398-2985      

Spironolactone

4ferrets

Synonym(s): Cardalis, Prilactone, Tempora, Aldactone


Introduction

Name

  • Spironolactone.

Class of drug

  • Aldosterone antagonist.
  • Potassium sparing diuretic.

Description

Chemical name

  • Spironolactone.
  • Several active metabolites.

Molecular formula

  • C24H32O45S.

Molecular weight

  • 416.57.

Physical properties

  • Cream-colored to light tan, crystalline powder with a faint mercaptan-like odor.
  • Practically insoluble in water and soluble in alcohol.

Storage requirements

  • Store at room temperature in tight, light-resistant containers.
  • An oral suspension can be prepared by pulverizing tablets and mixing them with syrup. This preparation is stable for at least one month when refrigerated.
  • Any unused product should be disposed of in accordance with local requirements.

Uses

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Indications

  • Treatment (in combination with standard therapy) of patients with congestive heart failure who do not adequately respond to furosemide and ACE inhibitors or when problems of hypokalemia develop.
  • It may also be effective on treating ascites as it has less potential to increase ammonia levels than other diuretics.
  • Little diuresis is caused when used alone. Maximum diuretic effects when combined with a thiazide or loop diuretic.
  • Useful to treat hypertension.
  • It has been used in a ferret in a reported case of primary hyperaldosteronism caused by an adrenocortical adenoma.

Administration

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Pharmacokinetics

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Precautions

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Interactions

with other drugs

  • Not recommended to be given with NSAIDs to animals with renal insufficiency.
  • The administration of NSAIDs with spironolactone may lead to a significant reduction of urinary sodium excretion.
  • Can be given in combination with furosemide and pimobendan.
  • Spironolactone administration in combination with other potassium-sparing drugs (ACE inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers) may lead to hyperkalemia:
    • In a recent clinical trial, an increased incidence of hyperkalemia was NOT observed when combining spironolactone with ACE inhibitors.
    • Regular monitoring is still advised, especially in patients with renal insufficiency as there may be a risk of hyperkalemia.
  • Spironolactone decreases digoxin elimination and as a consequence would raise digoxin plasma concentration. Monitor digoxin serum levels after 10 days of therapy. Use 0.5-2.0 ng/ml as a guide to therapeutic levels. Significant individual variation has been recorded.
  • Spironolactone may cause both induction and inhibition of cytochrome P450 enzymes and may affect the metabolism of other drugs using these pathways.
  • Monitor kidney function and serum potassium levels before initiating treatment with spironolactone and ACE inhibitors.
  • Monitor sodium and potassium levels during long-term treatment with spironolactone.

Adverse Reactions

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Further Reading

Publications

Refereed papers

Other sources of information

  • Plumb D (2015) Plumb’s Veterinary Drug Handbook. 8th edn. Wiley-Blackwell. pp 1296.
  • Fox J G & Marini R P (2014) Eds Biology and Diseases of the Ferret. 3rd edn. Wiley Blackwell, USA. pp 835.

Organisation(s)

  • National Office of Animal Health (NOAH) Compendium of Data Sheets for Animal Medicines. Website: www.noahcompendium.co.uk.
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