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- Discussion: 
- for primary hyperaldosteronism, HTN, CHF, Cirrhosis; 
- also used for diuretic induced hypokalemia when oral supplements or other potassium sparing agents are inappropriate; 
- diruetic of choice for cirrhotic edema and ascites; 
- Adult: Edema: 
- 25-200 mg/day administered in single or divided doses;

- if diuresis remains inadequate, add 2nd diuretic agent w/ action more proximal in the renal tubule; 
- 50-100mg/day initially; adjust dose after 2 weeks; 
- add 2nd diuretic agent w/ action on proximal renal tubule if HTN persists; 
- or... 25-100mg/24hr PO in divided doses; 
- max dose: 400mg/day for primary hyperaldosteronism; 
- may take upto 3-4 days for diuretic effect; 
- Contraindicated with anuria, hyperkalemia, renal impairment

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