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Spironolactone also commonly and dose-dependently produces gynecomastia (breast development) as a side effect in men. [ 110 ] [ 129 ] [ 131 ] [ 132 ] At low doses, the rate is only 5 to 10%, [ 132 ] but at high doses, up to or exceeding 50% of men may develop gynecomastia.
A study found that oral spironolactone had "about 10 to 20% of the feminizing effect of cyproterone acetate" on sexual differentiation in male rat fetuses, with a dose of 40 mg/day spironolactone having an effect equal to 1–3 mg/day cyproterone acetate. [35] [36]
Generally, the starting dose is oral spironolactone 100 mg/day (max 400 mg/day). 40% of people will respond to spironolactone. [22] For nonresponders, a loop diuretic may also be added and generally, furosemide is added at a dose of 40 mg/day (max 160 mg/day), or alternatively ( bumetanide or torasemide ).
Dosage typically includes information on the number of doses, intervals between administrations, and the overall treatment period. [3] For example, a dosage might be described as "200 mg twice daily for two weeks," where 200 mg represents the individual dose, twice daily indicates the frequency, and two weeks specifies the duration of treatment.
Weight gain of more than 2 pounds is associated with admission to the hospital for heart failure. [ 6 ] Sodium restriction – excessive sodium intake may precipitate or exacerbate heart failure, thus a "no added salt" diet (60–100 mmol total daily intake) is recommended for patients with CHF.
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Pharmacokinetics of 100 mg/day spironolactone and its metabolites Compound C max Tooltip Peak concentrations (day 1) C max Tooltip Peak concentrations (day 15) AUC Tooltip Area-under-the-curve concentrations (day 15) t 1/2 Tooltip Elimination half-life; Spironolactone: 72 ng/mL (173 nmol/L) 80 ng/mL (192 nmol/L) 231 ng•hour/mL (555 nmol ...