---

Risk Factors:

Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Anuria severe or progressive renal failure. Hyperkalaemia; Addison's disease diabetes diabetic nephropathy. Moderate to severe renal impairment in children.

---

Indications:

Hypertension congestive cardiac failure hepatic cirrhosis malignant ascites nephrotic syndrome primary aldosteronism.

---

Adverse Effects:

Gynaecomastia GI upset rash drowsiness headache confusion malaise benign breast neoplasm blood dyscrasias hepatic impairment electrolyte disturbances leg
cramps ataxia dizziness changes in libido confusion menstrual disorders breast pain skin reaction acute renal failure alterations in voice pitch.

---

Don’t Use:

Precautions: Renal or hepatic impairment. Long term use in young patients. Hyponatraemia porphyria. Predisposition to acidosis. Monitor fluid electrolytes and BUN.