Luoneizhi Pian
Luo Nei Zhi Pian
Luoneizhi Tablets
FUNCTION and INDICATIONS
1.Edema disease combined with other diuretics to treat edematous diseases such as congestive edema, cirrhosis, ascites, renal edema, etc., the purpose of which is to correct the secondary aldosterone secretion associated with the above diseases, and to fight against other diuretics Potassium effect. Also used for the treatment of idiopathic edema.
2.Hypertension As an adjunct to the treatment of hypertension.
3.Primary aldosteronism Spironolactone can be used for the diagnosis and treatment of this disease.
4.Prevention of hypokalemia In combination with thiazide diuretics, it enhances diuretic effects and prevents hypokalemia.
INGREDIENTS
The main ingredient of this product is spironolactone.
DESCPRIPTION
Tablets.
SPECIFICATION AND PACKAGE
20mg*100 tablets/box.
USAGE AND DOSAGE
Adult
1.Treatment of edematous disease, daily 40 ~ 120mg, divided into 2 ~ 4 times, at least for 5 days. Adjust the dose as appropriate.
2.Treatment of high blood pressure, starting daily 40 ~ 80mg, divided into doses, at least 2 weeks, after the discretion to adjust the dose, should not be combined with angiotensin converting enzyme inhibitors, so as not to increase the chance of hyperkalemia.
3.Treatment of primary aldosteronism, the daily dose of patients before surgery, 100 ~ 400mg, divided into 2 ~ 4 times. For patients who are not suitable for surgery, use a smaller dose to maintain.
4.Diagnosis of primary aldosteronism. Long-term test, 400mg daily, divided into 2~4 times for 3~4 weeks. Short-term test, 400mg daily, divided into 2~4 times for 4 consecutive days. Older people are more sensitive to this drug, and the starting dose should be smaller.
Children:
For the treatment of edematous diseases, start daily weight of 1 ~ 3mg / kg or body surface area of 30 ~ 90mg / m2, single or divided into 2 ~ 4 times, and even after 5 days, adjust the dose as appropriate. The maximum dose is 3~9mg/kg or 90~270mg/m2 per day.
REFERENCES
ADVERSE REACTION
Common ones are:
1.Hyperkalemia, the most common, especially when used alone, eating a high-potassium diet, with potassium or potassium-containing drugs such as penicillin potassium and kidney damage, oliguria, no urine. Even with thiazide diuretics, the incidence of hyperkalemia can still reach 8.6% ~ 26%, and often arrhythmia as the first performance, so blood potassium and ECG must be closely followed during medication;
2.Gastrointestinal reactions such as nausea, vomiting, stomach cramps and diarrhea; there have been reports of peptic ulcers.
Less to see are:
1.Hyponatremia, rare in single application, increased incidence with other diuretics;
2.Anti-androgen-like effects or effects on other endocrine systems, long-term use of this drug in men can cause male breast development, impotence, Sexual function is low, in women can cause breast pain, thickening of the voice, increased hair, menstrual disorders, decreased sexual function;
3.The central nervous system shows that long-term or large doses of this drug can cause uncoordinated walking, headache, and the like.
Rare are:
1.Allergic reaction, rash or even difficulty breathing;
2.Temporary plasma creatinine and urea nitrogen increased, mainly related to excessive diuresis, insufficient blood volume, and decreased glomerular filtration rate.
3 mild hyperchloric acidosis
4.Tumors, it has been reported that 5 patients with long-term use of this drug and hydrochlorothiazide to develop breast cancer.
CONTRAINDICATIONS
Contraindicated in patients with hyperkalemia.
Warning
1.The product can pass through the placenta, but the impact on the fetus is unclear. Pregnant women should be prescribed under the guidance of a physician and should be administered as short as possible.
2. Older people are more likely to have hyperkalemia and excessive diuresis.
3.Interference with the diagnosis:
1.The fluorescence method is used to determine the increase of plasma cortisol concentration, so the drug should be discontinued 4~7 days before taking blood or other methods can be used instead;
2.Increase the following measured values, plasma creatinine and urea nitrogen (especially when the original renal function is impaired), plasma renin, serum magnesium, potassium; urinary calcium excretion may increase, and urinary sodium excretion decreased.
4.Patients with hyperkalemia are banned.
5.Use the following carefully:
1.No urine;
2.Renal insufficiency;
3.Liver dysfunction, due to electrolyte imbalance caused by this drug can induce hepatic coma;
4.hyponatremia;
5.Acidosis, on the one hand, acidosis can aggravate or promote hyperkalemia caused by the drug; on the other hand, the drug can aggravate acidosis;
6 breast enlargement or menstrual disorders.
Pregnant women and lactating women:
The drug can pass through the placenta, but the impact on the fetus is unclear. Pregnant women should be prescribed under the guidance of a physician and should be administered as short as possible.
Pediatric medication:
This experiment was not performed and there is no reliable reference.
Geriatric medication:
Older people are more likely to have hyperkalemia and excessive diuresis.
DRUG INTERACTION
1.Adrenal cortex hormones, especially those with strong mineralocorticoids, adrenocorticotropic hormone can attenuate the diuretic effect of the drug, and antagonize the potassium-potassium effect of the drug.
2.Estrogen can cause sodium retention, which reduces the diuretic effect of the drug.
3.Non-steroidal anti-inflammatory analgesics, especially indomethacin, can reduce the diuretic effect of the drug, and the nephrotoxicity increases when combined.
4.Sympathomimetic drugs reduce the antihypertensive effect of this drug.
5.Dopamine enhances the diuretic effect of the drug.
6.In combination with drugs that cause a drop in blood pressure, both diuretic and antihypertensive effects are enhanced.
7.When combined with the following drugs, the chance of hyperkalemia increases, such as potassium-containing drugs, blood in stock (potassium containing 30mmol/L, such as potassium in the stock for more than 10 days, up to 65mmol/L), angiotensin-converting enzyme inhibition Agent, angiotensin II receptor antagonist and cyclosporin A. 8. In combination with glucose insulin solution, alkaline agent, and sodium-type potassium-reducing exchange resin, the chance of hyperkalemia is reduced.
9.This medicine prolongs the half-life of digoxin.
10.It is prone to metabolic acidosis when combined with ammonium chloride.
11.In combination with nephrotoxic drugs, increased nephrotoxicity.
12.Sodium carbamate and licorice preparations have an aldosterone-like effect, which can reduce the diuretic effect of the drug.
PHARMACOLOGIC ACTION
The product is similar in structure to aldosterone and is a competitive inhibitor of aldosterone. Acting on the distal convoluted tubule and collecting tube, blocking Na+-K+ and Na+-H+ exchange, the results showed that Na+, C1- and water excretion increased, K+, Mg2+ and H+ excretion decreased, and the effects on Ca2+ and P3- were uncertain. Because the drug only acts on the distal convoluted tubules and collecting ducts, it has no effect on other segments of the renal tubules, so the diuretic effect is weak. In addition, the drug also has an effect on aldosterone target organs other than the renal tubules.
Pharmacokinetics:
The drug has good oral absorption, the bioavailability is greater than 90%, and the plasma protein binding rate is above 90%. After entering the body, 80% is rapidly metabolized by the liver to active canrenone, which takes effect on or about 1 day. The peak will reach 2 to 3 days, and the effect can still be maintained for 2 to 3 days after stopping the drug. There is a difference in T1/2 depending on the mode of administration. The average daily dose is 1 hour and 2 hours (13~24 hours), and the daily dose is shortened to 12.5 hours (9~16 hours). Inactive metabolites are excreted from the kidneys and biliary tract, and approximately 10% are excreted from the kidneys in their original form.
STORAGE
Hermetically sealed,keep in cool and dry places.
PERIOD OF VALIDITY
24 months.
CERTIFICATE NO
Stage Food and Drug Administration Approval number:H33020070.
Manufactured
HANGZHOU MINSHENG PHARMACEUTICAL CO.,LTD
Tips: Please read the directions for use in retail or directed by physician.
Part of the goods frequent replacement of packaging, such as goods and pictures are not exactly the same, please refer to the goods you receive.
General Cautions
Keep away from animals and children.This product has not been evaluated by the FDA. It is not intended to diagnose, treat, cure, or prevent any disease.We highly recommend that you consult with a Traditional Chinese Medical practitioner or physician before taking any products or if you have any questions regarding your health.
