{"id":59339,"date":"2024-02-28T05:53:18","date_gmt":"2024-02-28T05:53:18","guid":{"rendered":"https:\/\/medsname.com\/silectone\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"silectone","status":"publish","type":"product","link":"https:\/\/medsbase.com\/nl\/silectone\/","title":{"rendered":"Silectone"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">&#9889; Quick Answer &mdash; What is Silectone?<\/h3>\n<p style=\"margin:0;\"><strong>Silectone<\/strong> is een <strong>25 \/ 50 mg spironolactone tablet<\/strong> van Sun Pharma \u2014 een <strong>mineralocorticoid receptor antagonist (aldosterone antagonist)<\/strong> dat inwerkt op de <strong>mineralocorticoid receptor (MR) in the principal cells of the cortical collecting duct<\/strong>. Spironolactone was introduced by G.D. Searle in 1959 &mdash; designed as a synthetic steroid to antagonise aldosterone&rsquo;s distal-tubule effect on sodium retention and potassium excretion. The first MR antagonist; remains the reference agent despite the availability of the more selective eplerenone. Half-life 1.4 hours (parent); 16-24 hours (active metabolites canrenone and 7-\u03b1-thiomethylspirolactone); onset 24-48 hours (needs time for receptor antagonism to manifest at the tissue level); peak effect 2-3 days; duration 2-3 days after discontinuation. Primary indication: <strong>heart failure with reduced ejection fraction (HF-REF), primary aldosteronism, resistant hypertension, cirrhotic ascites, adjunct treatment for hirsutism and PCOS<\/strong>. Standaard dosering: <strong>Resistente hypertensie<\/strong> (BP not controlled on ACEi\/ARB + CCB + thiazide): 25-50 mg once daily &mdash; PATHWAY-2 evidence. Spironolactone beats bisoprolol and doxazosin as the fourth agent in resistant HTN. <strong>Geen eerstelijns antihypertensivum.<\/strong> <strong>Primary aldosteronism (Conn&rsquo;s):<\/strong> 50-400 mg\/day until potassium and BP normalise, then maintenance 25-100 mg. Key contraindications: see full list below. Monitor electrolytes, creatinine, and glucose. <strong>Niet combineren met lithium<\/strong> (thiazide-\/lusdiuretica kunnen lithiumtoxiciteit veroorzaken). <strong>Gebruik tijdens zwangerschap is afhankelijk van het specifieke geval<\/strong> (zie zwangerschapsopmerking). Voor de meeste hypertensieve pati\u00ebnten werken diuretica het beste als het <strong>tweede of derde middel<\/strong> \u2014 meestal gecombineerd met een ARB, ACE-remmer of calciumkanaalblokker in plaats van alleen gebruikt te worden.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Wat u krijgt bij MedsBase:<\/strong> WHO-GMP gecertificeerde fabrikant \u00b7 Discrete verpakking \u00b7 Wereldwijde verzending \u00b7 1.400+ geverifieerde <a href=\"https:\/\/medsbase.com\/nl\/reviews\/\">klantbeoordelingen<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Elke bestelling is gedekt door onze <a href=\"https:\/\/medsbase.com\/nl\/medsbase-re-shipment-assurance-policy\/\"><strong>Reshipment Assurance Policy<\/strong><\/a> \u2014 als uw pakket niet binnen 20 werkdagen arriveert, sturen wij het opnieuw.<\/p>\n<h3>Waarom bestellen bij MedsBase<\/h3>\n<p>Onze generieke medicijnen zijn afkomstig van WHO-GMP gecertificeerde fabrikanten en worden wereldwijd verzonden in discrete, eenvoudige verpakkingen \u2014 geen medicijnnaam op de buitenkant van het pakket. Betalingen met kaart worden verwerkt via een gereguleerde processor (betalingsoverzichten vermelden een gereguleerde kaartbetalingprocessor \u2014 nooit \u201cMedsBase\u201d of een medicijnnaam). Crypto en SEPA bankoverschrijvingen worden ook geaccepteerd. Elke bestelling wordt ondersteund door ons Reshipment Assurance Policy.<\/p>\n<h2 class=\"wp-block-heading\">What Is Silectone?<\/h2>\n<p>Silectone is an oral 25 \/ 50 mg spironolactone tablet from Sun Pharma, supplied in 30-180 tablets. Spironolactone was introduced by G.D. Searle in 1959 &mdash; designed as a synthetic steroid to antagonise aldosterone&rsquo;s distal-tubule effect on sodium retention and potassium excretion. The first MR antagonist; remains the reference agent despite the availability of the more selective eplerenone.<\/p>\n<h2 class=\"wp-block-heading\">How Spironolactone Works<\/h2>\n<p>Spironolactone inhibits the <strong>mineralocorticoid receptor (MR) in the principal cells of the cortical collecting duct<\/strong>. De downstream-effecten:<\/p>\n<ul>\n<li><strong>Blocks aldosterone at the mineralocorticoid receptor<\/strong> in principal cells of the cortical collecting duct<\/li>\n<li><strong>Reduced sodium reabsorption, reduced potassium secretion<\/strong> \u2014 milde natriurese met kaliumretentie (kaliumsparend)<\/li>\n<li><strong>Anti-fibrotic and anti-remodelling effect in myocardium<\/strong> &mdash; aldosterone drives cardiac fibrosis independent of its salt-retaining effect; blocking the receptor reduces fibrosis. This is the main mechanism of the HF-REF mortality benefit (RALES).<\/li>\n<li><strong>Anti-androgen activity<\/strong> &mdash; cross-reactivity with androgen and progesterone receptors produces gynaecomastia and menstrual irregularity as class side effects; same activity gives its off-label role in hirsutism and PCOS.<\/li>\n<li><strong>Delayed onset\/offset<\/strong> (24-72 hours each direction) &mdash; receptor pharmacology plus long-acting active metabolites (canrenone)<\/li>\n<li><strong>Effective at resistant hypertension<\/strong> (PATHWAY-2) &mdash; acts on the subpopulation of hypertensives with covert aldosterone excess<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Goedgekeurde en evidence-based toepassingen<\/h2>\n<ul>\n<li><strong>Heart failure with reduced ejection fraction (HF-REF), primary aldosteronism, resistant hypertension, cirrhotic ascites, adjunct treatment for hirsutism and PCOS<\/strong> \u2014 primaire indicatie<\/li>\n<li><strong>Heart failure with reduced ejection fraction (EF &le;35%)<\/strong> &mdash; RALES evidence, 25-50 mg daily<\/li>\n<li><strong>Primary aldosteronism (Conn&rsquo;s syndrome)<\/strong> &mdash; definitive medical therapy for bilateral adrenal hyperplasia; bridging therapy for unilateral adenoma pre-surgery<\/li>\n<li><strong>Resistente hypertensie<\/strong> &mdash; PATHWAY-2 evidence; fourth-line agent after ACEi\/ARB + CCB + thiazide<\/li>\n<li><strong>Cirrotische ascites<\/strong> &mdash; first-line diuretic in cirrhosis (loop diuretics added if response inadequate)<\/li>\n<li><strong>Hirsutism, PCOS-related acne, female-pattern hair loss<\/strong> &mdash; off-label anti-androgen therapy<\/li>\n<li><strong>Post-MI with LV dysfunction<\/strong> &mdash; eplerenone is preferred (EPHESUS trial specific)<\/li>\n<\/ul>\n<p><strong>Belangrijke klinische onderzoeksresultaten:<\/strong> <strong>RALES (1999)<\/strong> &mdash; landmark trial of spironolactone 25-50 mg in severe HF-REF; 30% reduction in all-cause mortality. Established aldosterone antagonism as standard HF-REF therapy. <strong>EPHESUS<\/strong> en <strong>EMPHASIS-HF<\/strong> extended to eplerenone. <strong>PATHWAY-2 (2015)<\/strong> &mdash; spironolactone 25-50 mg was the most effective fourth agent for resistant hypertension vs bisoprolol or doxazosin. <strong>TOPCAT<\/strong> &mdash; modest benefit in HF with preserved ejection fraction (HF-PEF); signal stronger in Americas arm than Russia arm (controversial).<\/p>\n<h2 class=\"wp-block-heading\">Silectone Dosage<\/h2>\n<p><strong>Heart dose:<\/strong> <strong>Resistente hypertensie<\/strong> (BP not controlled on ACEi\/ARB + CCB + thiazide): 25-50 mg once daily &mdash; PATHWAY-2 evidence. Spironolactone beats bisoprolol and doxazosin as the fourth agent in resistant HTN. <strong>Geen eerstelijns antihypertensivum.<\/strong> <strong>Primary aldosteronism (Conn&rsquo;s):<\/strong> 50-400 mg\/day until potassium and BP normalise, then maintenance 25-100 mg.<\/p>\n<p><strong>Andere indicaties:<\/strong> <strong>Heart failure with reduced ejection fraction (EF &le;35%):<\/strong> 12.5-25 mg once daily; target 25-50 mg if tolerated (RALES trial). <strong>Cirrotisch ascites:<\/strong> 50-400 mg\/day, usually with furosemide 20-160 mg (1:2.5 ratio); target 0.5 kg\/day weight loss. <strong>Hirsutism \/ PCOS \/ acne (female patients):<\/strong> 50-200 mg\/day &mdash; suppresses androgen-driven hair growth and acne over 3-6 months (off-label but well-established).<\/p>\n<p><strong>Toediening:<\/strong> eenmaal daags (of tweemaal daags voor hoge doses lisdiuretica bij HF), 's ochtends. Avonddosering veroorzaakt nycturie en moet waar mogelijk worden vermeden. Neem op hetzelfde tijdstip elke dag. Voedsel heeft geen significant effect op de absorptie van deze diuretica.<\/p>\n<p><strong>Controleschema:<\/strong><\/p>\n<ul>\n<li><strong>Uitgangswaarden:<\/strong> ureum, elektrolyten (met name kalium en natrium), creatinine, eGFR, glucose, serumuraat. Thuis- of kliniekbloeddruk en dagelijkse gewichtsmeting voor HF-pati\u00ebnten.<\/li>\n<li><strong>1-2 weken na start of dosisaanpassing:<\/strong> herhaal U&amp;E en creatinine. Verwacht milde elektrolytverschuivingen; onderzoek substanti\u00eble veranderingen.<\/li>\n<li><strong>4-6 weken:<\/strong> Bloeddrukcontrole en volledig metabool panel.<\/li>\n<li><strong>Doorlopend:<\/strong> jaarlijks U&amp;E, uraat, glucose en lipidenpanel eenmaal stabiel. Vaker bij CKD, HF of bij combinatietherapie.<\/li>\n<li><strong>Stop of verlaag de dosis bij:<\/strong> sodium &lt;130 with symptoms, potassium &gt;5.5, creatinine rise &gt;30%, new gout, severe dehydration symptoms.<\/li>\n<\/ul>\n<p><strong>Stopzetting:<\/strong> geen onttrekkingssyndroom maar abrupt stoppen kan rebound volumebehoud veroorzaken bij HF-pati\u00ebnten op chronische hoge doses lisdiuretica \u2014 afbouwen waar mogelijk en gewicht monitoren.<\/p>\n<ul>\n<li><strong>Non-selective steroid receptor activity<\/strong> causes gynaecomastia (5-10%), mastalgia, and menstrual irregularity via androgen and progesterone receptor effects. Eplerenone is selective for MR and avoids these; switch if gynaecomastia develops.<\/li>\n<li><strong>Delayed onset:<\/strong> effect takes 2-3 days to manifest and 2-3 days to wear off; dose adjustments should allow this lag.<\/li>\n<li><strong>Hyperkalaemia is the dose-limiting toxicity<\/strong>, particularly when combined with ACEi\/ARB (standard in HF and HTN). Monitor potassium and creatinine at baseline, 1 week, 1 month, and every 3-4 months.<\/li>\n<li><strong>Contraception considerations:<\/strong> spironolactone is teratogenic (feminisation of male fetus) &mdash; women on spironolactone for acne\/hirsutism must use reliable contraception.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Bijwerkingen<\/h2>\n<p><strong>Vaak (&gt;1%):<\/strong><\/p>\n<ul>\n<li><strong>Hyperkali\u00ebmie<\/strong> &mdash; dose-limiting; severe in CKD or with ACEi\/ARB combinations<\/li>\n<li><strong>Gynaecomastia and mastalgia in men<\/strong> (5-10% at 25-50 mg; up to 50% at high doses &gt;150 mg)<\/li>\n<li><strong>Menstrual irregularity in women<\/strong><\/li>\n<li><strong>Erectile dysfunction and reduced libido in some men<\/strong><\/li>\n<li><strong>Milde maag-darmklachten<\/strong><\/li>\n<li><strong>Metabole acidose<\/strong> (reduced distal H+ secretion) &mdash; usually mild<\/li>\n<li><strong>Stevens-Johnson-syndroom<\/strong> &mdash; rare hypersensitivity reaction<\/li>\n<li><strong>Creatininetoename<\/strong> &mdash; modest rise (10-20%) is expected on initiation; investigate if &gt;30%<\/li>\n<\/ul>\n<p><strong>Zeldzaam maar klinisch belangrijk:<\/strong><\/p>\n<ul>\n<li><strong>Ernstige hyponatri\u00ebmie<\/strong> \u2014 vooral bij ouderen met zoutarme di\u00ebten, SIADH-gevoelige toestanden of in combinatie met SSRI's. Kan zich uiten als verwardheid, vallen of epileptische aanvallen.<\/li>\n<li><strong>Pancreatitis<\/strong> \u2014 zeldzaam bijwerking van thiazide-\/loopklasse; stop direct bij bovenbuikpijn met verhoogd lipase<\/li>\n<li><strong>Trombocytopenie, leukopenie, agranulocytose<\/strong> \u2014 zeldzame overgevoeligheidsreacties (komt vaker voor bij thiaziden dan bij lisdiuretica)<\/li>\n<li><strong>Acute bijziendheid en geslotenhoekglaucoom<\/strong> \u2014 zeldzame sulfonamide-klasse reactie binnen uren tot dagen na start; stop onmiddellijk bij plotselinge oogpijn of verandering in gezichtsvermogen<\/li>\n<li><strong>Syndroom van Stevens-Johnson \/ toxische epidermale necrolyse<\/strong> \u2014 extreem zeldzaam maar gerapporteerd<\/li>\n<li><strong>Ernstige hyperkali\u00ebmie<\/strong> with cardiac arrhythmia &mdash; most common in CKD or with ACEi\/ARB combination<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contra-indicaties<\/h2>\n<ul>\n<li><strong>Hyperkali\u00ebmie &gt;5,5 mmol\/L bij aanvang<\/strong> &mdash; check before starting<\/li>\n<li><strong>Ernstige nierfunctiestoornis<\/strong> (eGFR &lt;30) &mdash; unacceptable hyperkalaemia risk<\/li>\n<li><strong>Ziekte van Addison<\/strong> (primary adrenal insufficiency)<\/li>\n<li><strong>Zwangerschap<\/strong> &mdash; teratogenic (anti-androgen effect feminises male fetuses)<\/li>\n<li><strong>Gelijktijdige kaliumsupplementen<\/strong> &mdash; do not combine without monitoring<\/li>\n<li><strong>Concurrent other potassium-sparing diuretics<\/strong> (amiloride, triamterene, eplerenone)<\/li>\n<li><strong>Anurie<\/strong><\/li>\n<\/ul>\n<p><strong>Zwangerschap:<\/strong> <strong>absoluut gecontra-indiceerd<\/strong> &mdash; anti-androgen activity causes feminisation of male fetuses.<\/p>\n<p><strong>Borstvoeding:<\/strong> over het algemeen acceptabel bij lage doses; hoge doses kunnen de lactatie onderdrukken (vooral thiaziden). Alternatieve antihypertensiva (propranolol, nifedipine) hebben de voorkeur waar mogelijk.<\/p>\n<h2 class=\"wp-block-heading\">Geneesmiddelinteracties<\/h2>\n<ul>\n<li><strong>Lithium - KRITISCHE INTERACTIE.<\/strong> Spironolactone has modest effect on lithium clearance compared with thiazides and loops, but monitor levels if combination is unavoidable.<\/li>\n<li><strong>NSAID's<\/strong> - verminderen het diuretisch effect (via prostaglandineremming) en verhogen aanzienlijk het risico op acuut nierfalen in combinatie met ACE-remmers\/ARB's (de \u201ctriple whammy\u201d). Gebruik bij voorkeur paracetamol voor chronische pijn.<\/li>\n<li><strong>ACE-remmers en ARB's<\/strong> &mdash; additive hyperkalaemia risk &mdash; monitor potassium closely, especially in CKD. Standard in HF-REF (ACEi\/ARB + spironolactone) with careful monitoring; dangerous in patients with baseline K &gt;5.0 or eGFR &lt;30.<\/li>\n<li><strong>Kaliumsupplementen en kaliumsparende diuretica<\/strong> &mdash; do not combine; additive hyperkalaemia.<\/li>\n<li><strong>Digoxine<\/strong> - hypokali\u00ebmie versterkt digoxinetoxiciteit (loop- en thiazidediuretica); spironolacton vermindert direct de digoxineklaring. Controleer digoxinespiegels en kalium bij starten of wijzigen van diureticum.<\/li>\n<li><strong>Orale corticostero\u00efden, amfotericine B, stimulerende laxeermiddelen<\/strong> - additieve hypokali\u00ebmie (loop\/thiazide) of gemaskeerde kaliumbehoefte (spironolacton).<\/li>\n<li><strong>Orale antidiabetica, insuline<\/strong> - thiaziden en (in mindere mate) lisdiuretica verslechteren de glucosetolerantie; mogelijk dosisaanpassing vereist.<\/li>\n<li><strong>Cholestyramine \/ colestipol<\/strong> \u2014 vermindert de absorptie van thiaziden en lisdiuretica met 40-85%. Houd een doseringsinterval van 4 uur aan.<\/li>\n<li><strong>Sterke CYP3A4-remmers<\/strong> (clarithromycin, ritonavir, itraconazole) &mdash; raise canrenone metabolite levels; increase hyperkalaemia risk.<\/li>\n<li><strong>Alcohol<\/strong> \u2014 additieve orthostatische hypotensie.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Where Silectone Fits in the Diuretic Class<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Klasse<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Vertegenwoordigers<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Typisch gebruik<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Thiazide<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/nl\/aquazide\/\">HCTZ<\/a>, chlorthalidone<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Eerstelijns bij HTN, calciumstenen, nefrogene DI<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Thiazide-achtige<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/nl\/natrilix-sr\/\">Indapamide<\/a>, metolazone<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HTN (ouderen, HYVET-bewijs), sequenti\u00eble nefronblokkade<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Lisdiuretica (kortwerkend)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/nl\/lasix\/\">Furosemide<\/a>, bumetanide<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Acuut longoedeem, CHF, ascites, hypercalci\u00ebmie<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Lisdiureticum (langwerkend)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/nl\/dytor\/\">Torasemide<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Chronisch CHF, HTN (alleen lisdiureticum met HTN-evidentie), CKD-oedeem<\/td>\n<\/tr>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Aldosteronantagonist<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/nl\/aldactone\/\">Spironolacton<\/a>, eplerenon<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HF-REF (RALES), resistente HTN (PATHWAY-2), Conn-syndroom, cirrotische ascites<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Andere kaliumsparende middelen<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Amiloride, triamtereen (meestal in combinaties)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Preventie van hypokali\u00ebmie bij toevoeging aan lisdiureticum\/thiazide<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Carbonic anhydrase<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Acetazolamide<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Hoogteziekte, glaucoom, metabole alkalose<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Opslag<\/h2>\n<p>Store Silectone below 25&deg;C in the original blister pack. Keep out of reach of children.<\/p>\n<h2 id=\"faqs\">Veelgestelde vragen<\/h2>\n<h3 class=\"wp-block-heading\">When should I take Silectone &mdash; morning or evening?<\/h3>\n<p><strong>'s Ochtends<\/strong> in bijna alle gevallen. Het diuretisch effect veroorzaakt een verhoogde urineproductie gedurende 2-8 uur na inname. Inname 's avonds veroorzaakt nocturie en verstoort de slaap. Pati\u00ebnten die tweemaal daags lisdiuretica gebruiken, nemen deze meestal bij het ontbijt en vroeg in de middag (niet voor het slapen).<\/p>\n<h3 class=\"wp-block-heading\">Is Silectone a first-line blood-pressure drug?<\/h3>\n<p><strong>No &mdash; spironolactone is a fourth-line antihypertensive.<\/strong> It is the preferred add-on when BP remains uncontrolled on a three-drug combination of ACE inhibitor\/ARB + calcium-channel blocker + thiazide (PATHWAY-2 trial evidence). It also has specific first-line roles in <strong>primair aldosteronisme<\/strong>, <strong>heart failure with reduced ejection fraction<\/strong>, en <strong>cirrhotic ascites<\/strong>.<\/p>\n<h3 class=\"wp-block-heading\">Will Silectone affect my potassium?<\/h3>\n<p>Yes &mdash; spironolactone <strong>raises<\/strong> potassium (it is potassium-sparing). Hyperkalaemia (&gt;5.5 mmol\/L) is the main safety concern, especially when combined with ACE inhibitors or ARBs (which is the standard heart-failure combination). Check baseline potassium before starting, then at 1 week, 1 month, and every 3-4 months thereafter. Stop Silectone if potassium rises above 5.5 and investigate.<\/p>\n<h3 class=\"wp-block-heading\">I have gout &mdash; can I take Silectone?<\/h3>\n<p>Yes &mdash; spironolactone is <strong>urate-neutral to mildly lowering<\/strong> and does not precipitate gout. It is a reasonable diuretic choice in gout patients.<\/p>\n<h3 class=\"wp-block-heading\">I&rsquo;m diabetic &mdash; is Silectone safe?<\/h3>\n<p>Yes. Spironolactone is <strong>metabolically neutral<\/strong> on glucose and lipids. It has specific evidence in diabetic HF patients (the RALES population included 26% diabetics) and does not worsen diabetic control.<\/p>\n<h3 class=\"wp-block-heading\">Can I take ibuprofen with Silectone?<\/h3>\n<p>Incidenteel kortdurend gebruik is meestal geen probleem. Chronisch dagelijks gebruik van NSAID's (ibuprofen, diclofenac, naproxen) <strong>vermindert het diuretische en antihypertensieve effect<\/strong> of Silectone (prostaglandin blockade) and substantially raise the AKI risk when combined with an ACE inhibitor or ARB &mdash; the &#8220;triple whammy.&#8221; Use paracetamol preferentially for chronic pain.<\/p>\n<h3 class=\"wp-block-heading\">Zal ik 's nachts meer moeten plassen?<\/h3>\n<p>Usually no, if you take Silectone in the morning. The diuretic effect peaks 2-8 hours after dosing and has mostly worn off by evening. Nocturia is a common complaint when patients switch to evening dosing; switch back to morning dosing and nocturia resolves within 1-3 days.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Silectone in pregnancy?<\/h3>\n<p><strong>Nee \u2014 absoluut gecontra-indiceerd.<\/strong> Spironolactone&rsquo;s anti-androgen activity causes feminisation of male fetuses. Women of childbearing potential on spironolactone (for any indication, including acne and hirsutism) must use reliable contraception. For women planning pregnancy, switch to an alternative pre-conception.<\/p>\n<h3 class=\"wp-block-heading\">Wat als ik een dosis vergeet?<\/h3>\n<p>Neem het in zodra u eraan denkt, tenzij het bijna tijd is voor uw volgende dosis \u2014 sla in dat geval de gemiste dosis over. Neem geen dubbele dosis. Een enkele gemiste dosis heeft geen significant effect op de langetermijnregulatie van bloeddruk of vochtbalans.<\/p>\n<h3 class=\"wp-block-heading\">Where can I buy Silectone online?<\/h3>\n<p>You can buy Silectone (25 \/ 50 mg spironolactone, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.<\/p>\n<h2 class=\"wp-block-heading\">Gerelateerde antihypertensiva &amp; diuretica op MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/aquazide\/\">Aquazide \u2014 Hydrochloorthiazide (HCTZ) thiazide<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/dytor\/\">Dytor \u2014 Torasemide (lisdiureticum, meer voorspelbare biologische beschikbaarheid)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/lasix\/\">Lasix \u2014 Furosemide 40 mg (lisdiureticum)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/losar\/\">Losar \u2014 Losartan (ARB-partner voor diureticum)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/natrilix-sr\/\">Natrilix SR \u2014 Indapamide 1,5 mg SR (thiazide-achtig)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/ramcor\/\">Ramcor \u2014 Ramipril (ACE-remmer partner voor diureticum)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/high-blood-pressure-medication\/\"><strong>Bekijk alle hoge bloeddruk medicijnen<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 Medisch disclaimer.<\/strong> Deze pagina is alleen voor informatieve doeleinden en vervangt geen medisch advies van een gekwalificeerde zorgverlener. Hypertensie, hartfalen en aritmie\u00ebn vereisen diagnose, monitoring en doseringsindividualisatie door een arts \u2014 gebruik b\u00e8tablokkers altijd onder medische begeleiding.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Gerelateerde alternatieven<\/h3>\n<p>Andere producten in <strong>Chronische aandoeningen<\/strong> die klanten ook bekijken:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/lanoxin\/\">Lanoxin<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/neomercazole\/\">Neomercazole<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/ramgee\/\">Ramgee<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/carvejohn\/\">Carvejohn<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/gabapin\/\">Gabapin<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Silectone is Sun Pharma&#8217;s spironolactone 25\/50 mg tablets \u2014 mineralocorticoid receptor antagonist. Standard doses in heart failure (12.5-25 mg, target 25-50 mg per RALES), resistant hypertension (25-50 mg per PATHWAY-2), cirrhotic ascites (50-400 mg), and PCOS\/hirsutism (50-200 mg). Potassium-sparing diuretic with delayed onset (24-72 hours via active metabolite canrenone). Monitor potassium closely.<\/p>","protected":false},"featured_media":59340,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[4679,4680],"class_list":{"0":"post-59339","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-silectone","11":"product_tag-spironolactone","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product\/59339","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/comments?post=59339"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media\/59340"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media?parent=59339"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_brand?post=59339"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_cat?post=59339"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_tag?post=59339"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}