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Domever 25mg drug is made in the form of tablets, with the main ingredient being Spironolacton. The drug is indicated for use in the treatment of congestive heart failure, edema, ascites, nephrotic syndrome,...
1. Effects of Domever
Domever 25mg medicine has the main ingredient is Spironolacton 25mg. Spironolactone is a mineralocorticoid antagonist, which increases sodium and water excretion. At the same time, Spironolactone also reduces the excretion of potassium, ammonium and H+ ions. This ingredient is also diuretic and antihypertensive.
Indications to use Domever :
Treatment of congestive heart failure ; Treatment of cirrhosis ascites and edema; Treatment of malignant ascites; Treatment of nephrotic syndrome; Diagnosis and treatment of primary hyperaldosteronism. Contraindications to the use of Domever:
People with hypersensitivity to Spironolacton or other components of the drug; People with Addison's disease; Patients with acute renal failure, severe kidney damage or anuria; Patients with hyperkalemia; Concomitant use with eplerenone or potassium-sparing diuretics; Children with moderate to severe renal failure.
2. How to use and dose Domever
Usage: Orally, take 1 time / day with meals.
Dosage:
Dosage in adults:
Edema due to congestive heart failure: Initial dose is 100mg/day, can be taken once or divided into several small doses. Dosage ranges from 25-200mg/day. The maintenance dose can be adjusted according to the individual patient; Severe Heart Failure (Grade 3 - 4): Combination therapy with standard therapy may be initiated at a dose of 25 mg once daily if serum potassium ≤ 5.0 mEq/l and serum creatinine ≤ 2.5 mg/dl. For patients who tolerate a dose of 25 mg/day, the dose may be increased to 50 mg/day. In patients who are intolerant to 25 mg once daily, the dose may be reduced to 25 mg orally every other day; Cirrhosis, ascites and edema: If the Na+/K+ ratio is above 1.0, take 100mg/day. If the Na+/K+ ratio is less than 1.0, 200-400mg/day should be taken. The maintenance dose will be adjusted on a patient-by-patient basis; Malignant ascites: The usual initial dose is 100-200 mg/day. In severe cases, the dose can be gradually increased up to 400mg/day. Domever can be used when glucocorticoid alone is not effective; Diagnosis and treatment of primary hyperaldosteronism: Aldosterone can be used as an initial diagnostic measure for primary hyperaldosteronism if the patient is on a normal diet: Long trial: Oral Domever with 400mg/day for 3-4 weeks. Correction of hypokalemia and hypertension will provide evidence for the diagnosis of primary hyperaldosteronism; Short trial: Oral domever at 400mg/day for 4 days. If serum potassium increases during dosing but decreases with discontinuation, the diagnosis of primary hyperaldosteronism may be considered; After the diagnosis of primary hyperaldosteronism, Domever is used at a dose of 100-400mg/day in preparation for surgery. For patients who are not suitable for surgery, Domever can be used for long-term maintenance treatment with the lowest effective dose (depending on the patient). Dosage in other subjects:
Elderly: Treatment should be started with the lowest dose, increasing the dose as required to achieve maximum effect. Domever should be used with caution in patients with severe hepatic and renal impairment because these conditions may alter the metabolism and elimination of the drug; Children: The starting dose is 1-3mg/kg/day, divided into several times. Dosage in children should be adjusted based on response and tolerability. Children should be treated with Domever only under the direction of a pediatrician. Overdose: The acute overdose of Domever can cause symptoms such as drowsiness, nausea, vomiting, mental confusion, dizziness, diarrhea,... The patient may have hyponatremia. or hyperkalemia. Symptoms of hyperkalemia often include paresthesias, weakness, muscle spasms, muscle paralysis, etc. The earliest sign of potassium disturbances is electrocardiographic changes. There is currently no specific antidote for an overdose of Domever. Overdose symptoms may improve after discontinuation of the drug. In addition, the patient received general supportive treatment with fluid and electrolyte replacement. For patients with hyperkalemia, potassium intake should be reduced, potassium-sparing diuretics, oral ion exchange resins or intravenous glucose infusions with short-acting insulin should be given.
3. Domever 25mg . side effects
When using Domever 25mg drug, patients may experience some side effects such as:
Body as a whole: Fatigue; Tumor: Benign breast tumor; Gastrointestinal: Nausea, digestive disorders; Blood and lymphatic system: Thrombocytopenia, leukopenia (including agranulocytosis); Hepatobiliary: Abnormal liver function; Metabolism and nutrition: Hyperkalemia, electrolyte disturbances; Musculoskeletal: Cramps; Nervous: Dizziness ; Psychiatric: Confusion, altered libido; Reproductive and mammary glands: Breast pain, menstrual disorders; Skin and subcutaneous tissues: Toxic epidermal necrolysis, Stevens-Johnson syndrome, alopecia, hirsutism, rash, pruritus, urticaria, drug rash syndrome with eosinophilia and symptoms systemic syndrome; Renal and urinary: Acute renal failure; Other side effects: Gynecomastia in men may be related to the use of Spironolacton. The progression of gynecomastia is related to the dose and duration of treatment, usually reverting to pre-discontinuation. Male gynecomastia can be present in some cases but is very rare. When experiencing side effects of Domever, patients should immediately notify their doctor to receive appropriate advice.
4. Be careful when using Domever
Some notes for patients to remember before and while using Domever:
Need to regularly monitor fluids and electrolytes when taking Domever, especially in the elderly, patients with severe liver and kidney failure. ; The risk of hyperkalemia may occur in patients with impaired renal function or excessive use of potassium, which can lead to cardiac abnormalities and even death. If hyperkalemia develops, the patient should discontinue Domever. If necessary, further aggressive measures should be taken to return the serum potassium level to normal; Reversible hyperchloremic metabolic acidosis (often accompanied by hyperkalemia) may occur in patients with decompensated cirrhosis (although renal function remains normal); Concomitant use of Domever with other potassium-sparing diuretics, nonsteroidal anti-inflammatory drugs, ACE inhibitors, angiotensin II receptor antagonists, heparin, aldosterone blockers, low molecular weight heparin, or certain drugs cases of hyperkalemia, a diet rich in potassium or salt containing potassium, potassium supplements,... can lead to severe hyperkalemia; Spironolactone treatment may cause (reversible) uremia, especially if the patient has impaired renal function; Hyperkalemia can lead to death. Therefore, serum potassium should be monitored in patients with severe heart failure receiving spironolactone. The use of other potassium-sparing diuretics should be avoided. Also, avoid the use of potassium supplements in patients with serum potassium > 3.5 mEq/l. Potassium and creatinine should be monitored 1 week after initiating/increasing the dose of Spironolactone, monthly for the first 3 months, then quarterly for 1 year, then every 6 months. Discontinue or discontinue treatment with Domever if serum potassium > 5mEq/l or creatinine > 4 mg/dl; Use with caution potassium-sparing diuretics in hypertensive children with mild renal impairment (because of the increased risk of hyperkalemia); Spironolacton drug can be used for pregnant women with heart disease but should be cautious, consult a doctor before use; Spironolacton drug can be used for nursing mothers but should be cautious, consult a doctor before use; Domever has side effects including fatigue and dizziness, so caution should be exercised when driving or operating machinery.
5. Domever drug interactions
Some drug interactions of Domever include:
Concurrent use of Domever with drugs that cause hyperkalemia will lead to severe hyperkalemia; The Spironolactone component of Domever increases the half-life of digoxin, increases serum digoxin concentrations, and interferes with serum digoxin quantification. In patients receiving 2 drugs concurrently, response to digoxin should be monitored rather than serum digoxin levels (unless digoxin quantification has been shown to be unaffected by spironolactone). If digoxin dose adjustment is necessary, the patient should be carefully monitored to recognize the increased/decreased effects of digoxin; The component Spironolactone increases the effectiveness of antihypertensive drugs. Therefore, it is necessary to reduce the dose of these drugs if treated with Domever; Because ACE inhibitors can decrease aldosterone production, ACE inhibitors should not be routinely used with spironolactone, especially in patients with marked renal impairment; Carbenoxolone can cause sodium retention, reducing the effectiveness of Spironolactone. Therefore, the simultaneous use of these two drugs should be avoided; Non-steroidal anti-inflammatory drugs such as indomethacin , aspirin and mefenamic can reduce the diuretic effect of diuretics (due to their ability to inhibit prostaglandin synthesis in the kidney), thereby reducing the diuretic effect of Spironolactone; Spironolactone reduces the vascular response to noradrenaline. Caution should be exercised in patients receiving local or general anesthesia during treatment with Spironolactone; In the quantitative determination of fluorine, the spironolactone composition may interfere with the estimation of compounds with similar fluorescence properties; Spironolactone also increases the metabolism of antipyrin. During the use of Domever, the patient should follow all instructions of the doctor on how to use, dose, note when taking the drug, ... This ensures a better treatment effect and reduces the risk of risk. experience unusual side effects.
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