"Veroshpiron" is a fast-acting diuretic that removes excess fluid from the body. This allows you to relieve swelling and normalize blood pressure. There are not many side effects and if the instructions are followed they are rare. The drug must be taken strictly according to the instructions, observing the daily and single dosage. Therapy lasts no more than 20 days in a row.
Veroshpiron tablets: main characteristics
"Veroshpiron" refers to diuretic drugs; its effects are an antagonist of the adrenal hormone aldosterone. Available in the form of capsules and tablets of identical composition.
The active ingredient is spironolactone. Each tablet contains 25 mg, and capsules contain dosages of 50 mg and 100 mg. Spironolactone stimulates water excretion, reduces potassium loss and the formation of permease enzymes. The most pronounced effect occurs 7 hours after taking the drug, it continues for 24 hours.
Due to regular exposure to spironolactone, a decrease in blood pressure is observed, which is associated with a diuretic effect. A decrease in blood pressure is observed 2-5 weeks after the start of therapy.
The medicine is sold in pharmacies only with a prescription. It is necessary to agree with the doctor, who determines the duration of the course and dosage. The drug is stored at room temperature (maximum 30 degrees).
Veroshpiron, 25 mg, tablets, 20 pcs.
Inside.
For essential hypertension:
The daily dose for adults is usually 50–100 mg once and can be increased to 200 mg, and the dose should be increased gradually, once every 2 weeks.
To achieve an adequate response to therapy, the drug must be taken for at least 2 weeks. If necessary, adjust the dose.
For idiopathic hyperaldosteronism
: 100–400 mg/day.
With severe hyperaldosteronism and hypokalemia
: 300 mg/day (maximum 400 mg) in 2–3 doses; as the condition improves, the dose is gradually reduced to 25 mg/day (for tablets).
Hypokalemia/hypomagnesemia
: for hypokalemia and/or hypomagnesemia caused by diuretic therapy - 25–100 mg/day, once or in several doses. The maximum daily dose is 400 mg if oral potassium supplements or other methods of replenishing the deficiency are ineffective.
Diagnosis and treatment of primary hyperaldosteronism
As a diagnostic tool in a short diagnostic test
: 400 mg/day, divided into several doses per day, for 4 days. If the concentration of potassium in the blood increases while taking the drug and decreases after its discontinuation, the presence of primary hyperaldosteronism can be assumed.
As a diagnostic tool in a long-term diagnostic test
: at the same dose for 3–4 weeks. When correction of hypokalemia and arterial hypertension is achieved, the presence of primary hyperaldosteronism can be assumed.
Short course of preoperative therapy for primary hyperaldosteronism
: after the diagnosis of hyperaldosteronism is established using more accurate diagnostic methods, Veroshpiron should be taken at a dose of 100–400 mg/day, divided into 1–4 doses per day during the entire period of preparation for surgery. If surgery is not indicated, then Veroshpiron is used for long-term maintenance therapy, using the lowest effective dose, which is selected individually for each patient.
Edema due to nephrotic syndrome
: daily dose for adults is usually 100–200 mg/day. No effect of spironolactone on the underlying pathological process has been identified, and therefore the use of this drug is recommended only in cases where other types of therapy are ineffective.
With edema syndrome against the background of chronic heart failure
: 100–200 mg/day in 2–3 divided doses daily, for 5 days, 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 dose is 200 mg/day.
Edema due to liver cirrhosis
: if the ratio of sodium and potassium ions (Na+/K+) in the urine exceeds 1, then the daily dose for adults is 100 mg. If the ratio is less than 1, then the daily dose for adults is usually 200–400 mg. The maintenance dose is selected individually.
Edema in children
: the initial dose in children over 3 years of age is 1–3.3 mg/kg or 30–90 mg/m2/day in 1–4 doses. After 5 days, the dose is adjusted and, if necessary, increased by 3 times compared to the original.
What does Veroshpiron help with?
The drug is taken as an additional remedy for the treatment of such pathologies:
- essential hypertension (high blood pressure);
- swelling due to CHF;
- ascites;
- nephrotic syndrome;
- cirrhosis of the liver;
- prevention of potassium and magnesium deficiency;
- Conn's syndrome (treatment on the eve of surgery);
- diagnostic tool (to confirm the disease “Primary hyperaldosteronism”).
Verospiron
Orally, after meals, 1 or 2 times a day. Taking the daily dose or the first part of the daily dose of the drug is recommended in the morning.
Adults
Essential hypertension
Additional therapy in the treatment of arterial hypertension in case of insufficient effectiveness of previously used antihypertensive drugs
The initial dose of spironolactone when used simultaneously with other antihypertensive drugs is 25 mg/day. If after 4 weeks the blood pressure does not reach the target values, the dose of the drug can be increased by 2 times.
In hypertensive patients receiving medications that may cause hyperkalemia (eg, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers), serum potassium and creatinine levels should be assessed before initiating spironolactone. Veroshpiron should not be used in patients whose serum potassium content exceeds 5.0 mmol/l and whose serum creatinine concentration exceeds 220 µmol/l.
Frequent monitoring of potassium and creatinine levels in the blood is required for 3 months after starting spironolactone.
Congestive heart failure
Edema due to congestive heart failure or nephrotic syndrome
The initial dose is 100 mg and can vary from 25 to 200 mg/day; the drug can be taken in 1-2 doses. When taking higher doses, Veroshpiron can be used in conjunction with a diuretic that acts in the proximal renal tubule. In this case, the dose of spironolactone should be adjusted.
Adjunctive therapy in the treatment of severe heart failure (NYHA class II1-IV and ejection fraction ≤35%)
It has been established that if the potassium content in the blood serum does not exceed 5.0 mmol/l, and the concentration of creatinine in the blood serum does not exceed 220 μmol/l, against the background of basic standard therapy, the dose of spironolactone at the beginning of use should be 25 mg/day.
In patients with good tolerance of the drug at a dose of 25 mg/day, according to clinical indications, the dose can be increased to 50 mg/day. For patients with poor tolerance to therapy with Veroshpiron at a dose of 25 mg/day, the dose of the drug can be reduced to 25 mg once every 2 days.
Ascites and edema due to liver cirrhosis
If the ratio of sodium and potassium ions in the urine exceeds 1.0, then the daily dose of the drug should be 100 mg. If the specified ratio is less than 1.0, then the dose of the drug should be in the range from 200 to 400 mg/day.
The maintenance dose should be determined individually for each patient.
Hypokalemia
The drug is prescribed at a dose of 25-100 mg/day if the use of potassium supplements or other potassium-sparing methods is insufficient.
Primary hyperaldosteronism
For diagnostic purposes
1) Long-term test: spironolactone is taken 400 mg/day for 3-4 weeks. When correction of hypokalemia and arterial hypertension is achieved, the presence of primary hyperaldosteronism can be assumed.
2) Short test: spironolactone is taken 400 mg/day for 4 days. If the potassium content in the blood serum increases while taking spironolactone and decreases after its discontinuation, the presence of primary hyperaldosteronism can be assumed.
Treatment
In preparation for surgical treatment, spironolactone is used in doses of 100 to 400 mg/day. If surgery is not indicated, spironolactone can be used for long-term maintenance therapy at the lowest effective dose. In this case, the initial dose of the drug may be reduced every 14 days until the lowest effective dose is reached.
To reduce the severity of side effects with long-term use, Veroshpiron is recommended to be used in combination with other diuretics.
Special patient groups
Children and teenagers under 18 years of age
The initial dose of the drug is 1-3 mg/kg body weight per day in 1-4 doses. When conducting maintenance therapy or when used simultaneously with other diuretics, the dose of Veroshpiron should be reduced to 1-2 mg/kg body weight.
When used in children under 3 years of age, a suspension can be used. To prepare a suspension, tablets should be crushed and mixed with liquid or pasty food. The suspension should be used immediately, immediately after preparation.
Elderly patients (over 65 years old)
It is recommended to start treatment with the drug with the lowest dose and gradually increase it until the maximum desired effect is achieved. Caution should be exercised in patients with severe renal or hepatic impairment, which may affect the metabolism and excretion of spironolactone. In addition, when using the drug in elderly patients, the risk of developing hyperkalemia should be taken into account (see section "Special Instructions").
Contraindications for use
Taking the drug is prohibited in the presence of the following violations:
- anuria;
- severe renal failure;
- sodium deficiency;
- excess potassium;
- Addison's pathology.
During pregnancy and during breastfeeding (any period), Veroshpiron is also not taken. The drug should be used with caution in elderly people and patients with the following diseases:
- diabetes mellitus of both types;
- acidosis;
- excess calcium;
- installation of AV block;
- disturbances of the monthly cycle;
- chronic kidney and liver diseases;
- local or general anesthesia;
- diabetic nephropathy.
Side effects
In some cases, taking a medication can lead to side effects from different organ systems:
- gastritis;
- constipation;
- abdominal pain, colic;
- liver disorders;
- vomit;
- headache;
- dizziness;
- confusion;
- increased drowsiness;
- muscle spasm;
- allergies (rash, hives, itching);
- alopecia;
- problems with potency;
- acidosis.
Instructions for use of "Veroshpiron"
Capsules and tablets are used according to general rules. The dosage is prescribed depending on the patient’s disease:
- For essential hypertension, take 50 or 100 mg once. Gradually this amount can be increased to 200 mg.
- For idiopathic hyperaldosteronism, the amount is set in the range from 100 to 400 mg per day.
- If hyperaldosteronism is severe, potassium deficiency is observed, take 300 g per day (the amount is divided by 2-3 times).
- If there is a deficiency of magnesium and potassium associated with diuretics, take no more than 100 mg per day. The reception takes place once or 2-3 times.
- To diagnose a pathology called “Primary hyperaldosteronism,” the following norm has been established: 400 mg per day for 4 days in a row. This amount is divided into 2-3 doses.
- In the presence of edema (including with CHF), the daily dose is up to 200 mg.
- Swelling in cirrhosis: 100 mg or from 200 to 400 mg (depending on the ratio of the concentration of sodium and potassium cations).
- Swelling in children: the amount is calculated based on the ratio of 1-3 mg per kg of weight. The dose is adjusted after taking it for 5 consecutive days.
Tablets or capsules should be taken after meals. The course of therapy lasts up to 20 days. Then they take a break for at least 6 months, and if necessary, resume treatment again.
Important!
If the course lasts for 2 months or more, acute renal failure may develop. In case of overdose, vomiting, skin rash, and diarrhea are observed. Therefore, it is necessary to strictly follow the dosage as recommended by the doctor and instructions.
Veroshpilakton (Veroshpiron) tablets 25 mg No. 20
A country
Russia
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Active substance
Spironolactone
Compound
Active substance: Spironolactone.
pharmachologic effect
It has a diuretic, potassium-sparing, hypotensive effect. Inhibits the reabsorption of sodium ions through the apical membrane of renal epithelial cells and increases the excretion of sodium, chlorine and water ions in the urine. It has a potassium-sparing effect: it inhibits the aldosterone-regulated exchange of sodium ions for potassium ions, reduces the secretion and excretion of potassium, magnesium, urea and increases their concentration in the blood. Increases excretion. Reduces urine acidity. The diuretic effect appears on the 2-5th day and persists for 2-3 days after stopping use. Antihypertensive activity is due to an increase in the excretion of sodium ions and a decrease in the volume of circulating blood and extracellular fluid; appears in the 2-3rd week of treatment. Increases the activity of glucuronyl transferase, increases the amount of conjugated bilirubin in the urine, reduces the risk of arrhythmias. When taken orally, it is completely absorbed. It is quickly and intensively biotransformed in the liver with the formation of several active metabolites. Almost completely binds to blood plasma proteins. Excreted in urine, partially excreted in bile and feces.
Indications for use
Primary hyperaldosteronism, aldosterone-producing adrenal adenoma, edema syndrome against the background of secondary hyperaldosteronism in chronic heart failure, liver cirrhosis (with ascites or edema), nephrotic syndrome; arterial hypertension due to secondary hyperaldosteronism, some forms of essential; hypokalemia, incl. during therapy with saluretics and digitalis preparations, edema and nephropathy in pregnant women, edematous syndrome in newborns, infectious-allergic bronchial asthma (especially complicated by right heart failure), myopathy, myasthenia gravis, parkinsonism, polycystic ovary syndrome (prevention and treatment), hirsutism (treatment), premenstrual syndrome, premature puberty in young men, bronchopulmonary dysplasia.
Interaction
Steroidal anti-inflammatory drugs and diuretics (benzothiadiazine derivatives, furosemide, ethacrynic acid, etc.) enhance and accelerate the diuretic and natriuretic effects, ACE inhibitors (because they inhibit the release of aldosterone), indomethacin, cyclosporine, other potassium-sparing diuretics, potassium preparations (in including potassium chloride) and potassium supplements - increase the risk of developing hyperkalemia (especially against the background of renal failure). Sympathomimetic drugs reduce antihypertensive properties, NSAIDs (indomethacin and acetylsalicylic acid) - diuretic, natriuretic and antihypertensive activity and increase the risk of developing renal failure. Potentiates the effect of diuretic and antihypertensive drugs, enhances the toxic effects of lithium preparations, prevents the development of hypokalemia when prescribing furosemide and other diuretics that cause it, reduces the effect of cardiac glycosides, anticoagulants (coumarin derivatives, indandione, heparin), the vasoconstrictor effect of adrenaline and inhibits the antiulcer agent - carbenoxolone (accelerates biotransformation and excretion).
Side effect
Hyperkalemia, hyponatremia, increased blood concentrations of urea, creatinine, uric acid, disturbances of water-salt metabolism and acid-base balance (metabolic hyperchloremic acidosis or alkalosis); nausea, vomiting, dyspeptic symptoms, abdominal pain, intestinal motility disorders, diarrhea or constipation, intestinal colic, gastritis, ulceration and bleeding in the gastrointestinal tract; headache, dizziness, ataxia, drowsiness, mental disorders; muscle spasms; gynecomastia, erectile dysfunction, virilization in women (deepening of the voice, hirsutism and other androgenic effects), menstrual disorders, incl. dysmenorrhea, amenorrhea, metrorrhagia during menopause, etc., breast tenderness, breast carcinoma; megaloblastosis, agranulocytosis, thrombocytopenia, photosensitivity; allergic reactions - maculo-, papulo-, and erythematous rashes, urticaria, drug fever, itching, etc.
Contraindications
Hypersensitivity, hyperkalemia, azotemia, anuria, renal failure (acute, chronic, with significant damage to excretory function, including chronic nephritis in the nephrotic stage).
Overdose
Symptoms: nausea, vomiting, diarrhea; severe hyperkalemia (paresthesia, muscle weakness, arrhythmias), hyponatremia (dry mouth, thirst, drowsiness, etc.); hypercalcemia, increased urea levels in the blood. Treatment: maintaining vital functions, immediate removal of stomach contents; in case of hyperkalemia - rapid intravenous administration of a 20-50% glucose solution and insulin - 0.25-0.5 U/g glucose (repeat if necessary).
special instructions
Restrictions on use: Liver dysfunction, diabetes mellitus (especially diabetic nephropathy), predisposition to metabolic acidosis, hyponatremia, hypercalcemia, menstrual irregularities accompanied by enlarged mammary glands, the first 3 weeks of pregnancy, breastfeeding. Prescribed with caution in case of incomplete atrioventricular block, decompensated cirrhosis of the liver, surgical intervention, against the background of drugs that cause gynecomastia, local and general anesthetics, the elderly. When combined with cardiac glycosides, diuretics and antihypertensive drugs, doses should be reduced. During therapy, it is necessary to carefully monitor the content of electrolytes, the level of nitrogen, urea and creatinine in the blood, blood pressure, and avoid introducing excess amounts of potassium into the body.
Dispensing conditions in pharmacies
On prescription
