سعر سبيروميد 50/20مجم 10 قرص 2024

Spiromide 50/20 mg film-coated tablets (Sedico, Egypt), pack of 10: fixed combination of spironolactone 50 mg (aldosterone antagonist) and furosemide 20 mg (loop diuretic) for resistant oedema with secondary hyperaldosteronism.

• Resistant oedema associated with secondary hyperaldosteronism, including chronic congestive cardiac failure and hepatic cirrhosis; reserve for cases refractory to a diuretic alone and use the fixed ratio only if titration with the separate components shows it is appropriate.Population: AdultsPharmacy and Poisons Board (Kenya) product register
• Essential hypertension only in patients with demonstrated hyperaldosteronism, and only if titration with the components shows the fixed combination is appropriate.Population: AdultsPharmacy and Poisons Board (Kenya) product register

• Electrolyte and fluid disturbances (hypo- or hyperkalaemia, hyponatraemia, hypocalcaemia, metabolic alkalosis, hypovolaemia, dehydration); hypotension, dizziness, headache; bone marrow depression, thrombocytopenia, rarely agranulocytosis or aplastic/haemolytic anaemia; tinnitus and hearing disorders, uncommonly deafness; intrahepatic cholestasis, raised transaminases, pancreatitis; skin reactions including photosensitivity, vasculitis, SJS/TEN, AGEP, DRESS; acute urinary retention with outflow obstruction.International label, same formulation · Pharmacy and Poisons Board (Kenya) product register

• Hypovolaemia or dehydration; creatinine clearance below 30 ml/min/1.73 m2, anuria or renal failure with anuria not responding to furosemide, renal failure due to nephrotoxic/hepatotoxic poisoning or associated with hepatic coma; hyperkalaemia, severe hypokalaemia, severe hyponatraemia; Addison's disease; pregnancy and breastfeeding; hypersensitivity to furosemide, spironolactone, sulphonamides or excipients.International label, same formulation · Pharmacy and Poisons Board (Kenya) product register

• Avoid in raised serum potassium; concomitant triamterene, amiloride, potassium supplements or NSAIDs not recommended (hyperkalaemia).International label, same formulation · Pharmacy and Poisons Board (Kenya) product register
• Secure urinary output; patients with partial urinary outflow obstruction (e.g. prostatic hypertrophy) risk acute retention.International label, same formulation · Pharmacy and Poisons Board (Kenya) product register
• Careful monitoring in hypotension, latent or manifest diabetes, gout, hepatic cirrhosis with renal impairment and hypoproteinaemia; symptomatic hypotension may occur, especially in the elderly.International label, same formulation · Pharmacy and Poisons Board (Kenya) product register

• ACE inhibitors / angiotensin II receptor antagonistsMarked fall in blood pressure and deterioration of renal function; hyperkalaemia; reduce or stop the combination for at least 3 days before starting or increasing them.Pharmacy and Poisons Board (Kenya) product register
• Potassium salts, potassium-retaining drugs, NSAIDsIncreased serum potassium and hyperkalaemia; NSAIDs may also attenuate the diuretic effect and cause acute renal failure in hypovolaemia.Pharmacy and Poisons Board (Kenya) product register
• LithiumIncreased serum lithium and toxicity; monitor lithium levels.Pharmacy and Poisons Board (Kenya) product register

• Must not be used in pregnancy unless there are compelling medical reasons (listed among contraindications); furosemide crosses the placenta; spironolactone anti-androgenic effects with risk of ambiguous genitalia in male newborns; monitor foetal growth if used.International label, same formulation · Pharmacy and Poisons Board (Kenya) product register
• Must not be used in breastfeeding mothers: furosemide passes into milk and may inhibit lactation; canrenone (spironolactone metabolite) appears in milk.International label, same formulation · Pharmacy and Poisons Board (Kenya) product register

• Spironolactone: Competitive aldosterone antagonist acting at the renal tubules (and inhibiting adrenal aldosterone effects), increasing sodium and water excretion while conserving potassium.
• Furosemide: Loop diuretic: inhibits active chloride transport in the thick ascending limb of the loop of Henle, reducing sodium chloride reabsorption.