This is an aldosterone antagonist, a potassium-sparing diuretic of mild to moderate potency.

Indications: oedema and ascitis in cirrhosis of the liver, nephrotic syndrome, congestive heart failure; primary hyper aldosteronism; malignant ascitis.

Cautions: breast feeding; pregnancy; hepatic and renal impairment.

Contra-indications: Hyperkalemia; hypernatremia; Addison’s disease.

Side Effects: gastrointestinal disturbances, gynecomastia, menstrual irregularity, impotence; lethargy; headache; confusion; rashes; hepatotoxicity; ostoemalacia.

Dose: 100-200 mg daily increased to 400 mg if required, Child, 3 mg/kg daily in divided doses.