Aldactone (200 mg
potassium canrenoate i.v.) was given in a single dose as the sole
drug to 30 patients with
congestive heart failure (CHF). Of these patients 21 were unresponsive to routine treatment. Clinical improvement was observed in 18 of 30 patients (60%) within 6 h after
Aldactone injection. Good
diuretic effect (urine volume over 500 ml/6 h) was achieved in 14 patients, including 7 cases who responded dramatically (diuresis 700-1500 ml in 6 h). Plasma
aldosterone concentrations before the injection of
Aldactone were variable in individual patients. An analysis of their
diuretic response to the
Aldactone injection within 6 h showed that responders had significantly higher initial plasma
aldosterone level (312 +/- 108 pg/ml) than non-responders (152 +/- 31 pg/ml) (p less than 0.02). The same tendency was observed if good or poor clinical effects were considered.
Aldactone caused a slight increase in plasma
potassium level (0.20 mEq/1) (p less than 0.025).
Aldactone given in a single dose i.v. to patients with CHF is a potent
drug and can produce a dramatic response in some individuals who are refractory to routine
therapy. The beneficial effects of
Aldactone could be seen within the first 6 h especially in patients with secondary
aldosteronism.