Veroshpiron - instructions for use, analogs, reviews and release forms (tablets 25 mg, capsules 50 mg and 100 mg) drugs for the treatment of hypertension and diuretic effect in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Veroshpiron. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Veroshpiron in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Veroshpiron in the presence of existing structural analogues. Use for the treatment of hypertension and diuretic effect in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Veroshpiron - a potassium-sparing diuretic, a competitive antagonist of aldosterone.

In the distal sections of the nephron, Veroshpiron inhibits the retention of sodium and water by aldosterone and suppresses the potassium-releasing effect of aldosterone, reduces the synthesis of permeases in the aldosterone-dependent region of the collecting tubules and distal tubules. By binding to aldosterone receptors, increases the excretion of sodium, chlorine and water ions in the urine, reduces the excretion of potassium and urea ions, reduces the acidity of urine.

The hypotensive effect is due to the diuretic effect. Diuretic effect is manifested on the 2nd-5th day of treatment.

Composition

Spironolactone + auxiliary substances.

Pharmacokinetics

After oral administration, it is quickly and completely absorbed from the digestive tract. Bioavailability is about 100%, and eating increases it to 100%. Spironolactone poorly penetrates organs and tissues, while spironolactone itself and its metabolites penetrate the placental barrier, and canrenone into breast milk. In the process of biotransformation, active sulfur-containing metabolites 7-alpha-thiomethylspinonolactone and canrenone form in the liver. It is mainly excreted by the kidneys (50% in the form of metabolites, 10% in unchanged form) and partially through the intestine.

Indications

• essential hypertension (as part of combination therapy);
• edematous syndrome with chronic heart failure (can be used in the form of monotherapy and in combination with standard therapy);
• the conditions at which secondary hyperaldosteronism can be detected, incl. cirrhosis of the liver, accompanied by ascites and / or edema, nephrotic syndrome and other conditions accompanied by edema;
• hypokalemia / hypomagnesemia (as an aid for its prevention during treatment with diuretics and when other methods of correction of the potassium level can not be used);
• primary hyperaldosteronism (Conn's syndrome) - for a short preoperative course of treatment;
• to establish the diagnosis of primary hyperaldosteronism.

Forms of release

Tablets 25 mg.

Capsules 50 mg and 100 mg.

Instructions for use and dosage

In essential hypertension, the daily dose for adults is usually 50-100 mg once and can be increased to 200 mg, while increasing the dose should be gradual, 1 every 2 weeks. To achieve an adequate response to therapy, the drug should be taken at least 2 weeks. If necessary, adjust the dose.

With idiopathic hyperaldosteronism, the drug is prescribed in a dose of 100-400 mg per day.

With expressed hyperaldosteronism and hypokalemia, the daily dose is 300 mg (maximum 400 mg) for 2-3 doses, with the improvement of the condition, the dose is gradually reduced to 25 mg per day.

With hypokalemia and / or hypomagnesemia caused by diuretic therapy, Veroshpiron is prescribed at a dose of 25-100 mg per day, once or in several doses. The maximum daily dose is 400 mg if oral potassium preparations or other methods of replenishing its deficiency are ineffective.

When diagnosing and treating primary hyperaldosteronism as a diagnostic tool for a short diagnostic test, Veroshpiron is prescribed for 4 days 400 mg per day, distributing the daily dose for several doses per day. With an increase in the concentration of potassium in the blood at the time of taking the drug and lowering it after cancellation it can be assumed that there is a primary hyperaldosteronism. With a long diagnostic test, the drug is administered at the same dose for 3-4 weeks. When the correction of hypokalemia and arterial hypertension is achieved, it is possible to assume the presence of primary hyperaldosteronism.

Once the diagnosis of hyperaldosteronism is established using more accurate diagnostic methods, as a short course of preoperative therapy for primary hyperaldosteronism, Veroshpiron should be taken at a daily dose of 100-400 mg, dividing it by 1-4 admission during the entire period of preparation for a surgical operation. If the operation is not indicated, Veroshpiron is used for prolonged maintenance therapy, while the lowest effective dose that is selected individually for each patient is used.

In the treatment of edema against the background of nephrotic syndrome, the daily dose for adults is usually 100-200 mg. The effect of spironolactone on the main pathological process was not revealed and therefore the use of this drug is recommended only in cases when other types of therapy are ineffective.

With edematous syndrome against a background of chronic heart failure, the drug is prescribed daily for 5 days at 100-200 mg per day in 2-3 doses, in combination with a "loop" or thiazide diuretic. Depending on the effect, the daily dose is reduced to 25 mg.The maintenance dose is selected individually. The maximum daily dose is 200 mg.

When edema is accompanied by cirrhosis of the liver, the daily dose of Veroshpiron for adults is usually 100 mg if the ratio of sodium and potassium ions (Na + / K +) in urine exceeds 1.0. If the ratio is less than 1.0, the daily dose is usually 200-400 mg. The maintenance dose is selected individually.

With edema in children, the initial dose is 1-3.3 mg / kg body weight or 30-90 mg / m2 per day in 1-4 doses. After 5 days, dose adjustment is performed and, if necessary, it is increased 3 times as compared with the original dose.

Side effect

• nausea, vomiting;
• diarrhea;
• ulceration and bleeding from the gastrointestinal tract;
• gastritis;
• intestinal colic;
• abdominal pain;
• constipation;
• ataxia;
• retardation;
• dizziness;
• headache;
• drowsiness;
• confusion of consciousness;
• agranulocytosis, thrombocytopenia, megaloblastosis;
• hyperuricemia, hypercreatininaemia, increased urea concentration, hyperkalemia, hyponatremia;
• coarse voice;
• in men - gynecomastia (the probability of development depends on the dose, the duration of treatment and is usually reversible and after the removal of Veroshpiron disappears, only in rare cases the breast remains slightly enlarged);
• decreased potency and erection;
• in women - menstrual irregularities;
• dysmenorrhea;
• amenorrhea;
• metrorrhagia in menopause;
• hirsutism;
• pain in the area of ​​the mammary glands;
• hives;
• drug fever;
• itching;
• alopecia;
• acute renal insufficiency;
• muscular spasm;
• cramps calf muscles.

Contraindications

• Addison's disease;
• hyperkalemia;
• hyponatremia;
• renal failure of severe degree (SC less than 10 ml / min);
• anuria;
• lactose intolerance, lactase deficiency, glucose / galactose absorption disorder syndrome;
• pregnancy;
• lactation period (breastfeeding);
• children under 3 years;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

The use of Veroshpiron is contraindicated in pregnancy and lactation.

special instructions

When using Veroshpiron it is possible to temporarily increase the level of urea Nitrogen in the blood serum, especially with reduced kidney function and hyperkalemia. It is also possible to develop reversible hyperchloremic metabolic acidosis.

When appointing Veroshpiron to patients with impaired renal and hepatic function, elderly patients need regular monitoring of serum electrolytes and kidney function.

It is considered among the townspeople that Veroshpiron is able to reduce weight, but weight loss caused by the drug can be correlated only with the amount of excess weight lost with a liquid and not more than that. It has nothing to do with diets or real weight loss.

Reception Veroshpirona makes it difficult to determine the concentration of digoxin, cortisol and adrenaline in the blood.

Despite the absence of direct effects on carbohydrate metabolism, the presence of diabetes, especially with diabetic nephropathy, requires special care when prescribing Veroshpiron because of the possibility of developing hyperkalemia.

In the treatment of non-steroidal anti-inflammatory drugs against the background of the administration of Veroshpiron, kidney function and the level of blood electrolytes should be monitored.

During treatment Veroshpironom alcohol consumption is contraindicated, you should avoid eating foods rich in potassium.

During treatment, alcohol consumption is contraindicated.

Impact on the ability to drive vehicles and manage mechanisms

In the initial period of treatment it is forbidden to drive a car and engage in activities that require an increased concentration of attention and speed of psychomotor reactions.The duration of restrictions is set individually.

Drug Interactions

Veroshpiron reduces the effect of anticoagulants, indirect anticoagulants (heparin, coumarin derivatives, indanedione) and toxicity of cardiac glycosides (as the normalization of the level of potassium in the blood prevents the development of toxicity).

Enhances the metabolism of phenazole.

Reduces the sensitivity of blood vessels to norepinephrine (requires caution when conducting anesthesia).

Increases T1 / 2 digoxin, so possible intoxication with digoxin.

Increases the toxic effect of lithium due to a decrease in its clearance.

Accelerates the metabolism and excretion of carbenoksolona.

Carbenoxolone promotes sodium retention by spironolactone.

Glucocorticosteroids (GCS) and diuretics (benzothiazine derivatives, furosemide, ethacrynic acid) enhance and accelerate diuretic and natriuretic effects.

Strengthens the action of diuretic and hypotensive drugs.

SCS increases the diuretic and natauric effect in hypoalbuminemia and / or hyponatremia.

The risk of hyperkalemia increases with the use of Veroshpiron withpotassium preparations, potassium supplements and potassium-sparing diuretics, ACE inhibitors (acidosis), angiotensin 2 antagonists, aldosterone blockers, indomethacin, cyclosporin.

Salicylates, Indomethacin reduce the diuretic effect.

Ammonium chloride, colestyramine contribute to the development of hyperkalemic metabolic acidosis.

Fludrocortisone causes a paradoxical increase in tubular secretion of potassium.

Reduces the effect of mitotane.

Strengthens the effect of tryptorelin, buserelin, gonadorelin.

Analogues of the drug Veroshpiron

Structural analogs for the active substance:

• Aldactone;
• Vero-Spironolactone;
• Verospilactone;
• Spiriks;
• Spironaxan;
• Spironol;
• Spironolactone;
• Spironolactone (Unilan);
• Urakton.

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