Veroshpiron spironolactone instructions for use. When is Veroshpiron prescribed and to whom is it contraindicated? Advise or dissuade: what conclusions do patients make

Veroshpiron is a potassium-sparing diuretic, a diuretic used against edema. The active ingredient is spironolactone.

It is prescribed for edema in heart failure, hypokalemia, hypomangiemia, and other conditions of the body accompanied by edema.

According to the instructions, the drug is a competitive antagonist of the mineralocorticoid aldosterone, a special hormone that is produced by the adrenal cortex. Spironolactone has an effect that is opposite to that of the hormone aldosterone.

Veroshpiron produces a pronounced diuretic effect, while it does not significantly affect the renal circulation and the functioning of the renal tubules, does not disturb the acid-base state in the body.

Due to the diuretic effect, which occurs 2-5 days after the start of use, hypotensive (reducing blood pressure) the effect of the drug.

The active substance of the tablets is metabolized mainly in the liver cells (hepatocytes) with the formation of active intermediate substances that are excreted from the body with the urine by the kidneys and in a small amount with the feces.

The half-life (the time after which half of the entire dose of the drug taken is excreted) is 12.5 hours. The half-life increases with cirrhosis of the liver (replacement of hepatocytes with fibrous connective tissue) and heart failure, while the active substance Veroshpiron is retained in the blood and tissues of the body.

Available in the form of tablets of 0.025 g active substance in each. In 1 pack of 20 and 100 tablets.

Indications for use

What helps Veroshpiron? The drug is prescribed in the following cases:

• with edema associated with heart disease (chronic heart failure), endocrine system(Conn's disease, polycystic ovaries, hirsutism);
• with arterial hypertension;
• with ascites associated with cirrhosis of the liver;
• with cerebral edema and other diseases that are accompanied by edema;
• with severe burns;
• with paroxysmal paralysis associated with calcium deficiency;
• with myasthenia gravis (as a remedy for auxiliary treatment).

In gynecology, it is prescribed to reduce androgen levels in women with PCOS (polycystic ovary syndrome). The drug can cause bleeding, disrupt the menstrual cycle. Veroshpiron is often recommended to be taken in conjunction with contraceptives in order to normalize menstrual cycle, reduce hirsutism.

Instructions for use Veroshpiron, dosage

Tablets are taken orally as a whole, preferably in the morning, after taking them, they are washed down with a sufficient amount of liquid. Adult patients are prescribed in the following dosage:

• With nephrotic syndrome, the daily dose is from 100 to 200 mg.
• With edematous syndrome, take from 100 mg / day. up to 200 mg / day. three times a day.

The drug is prescribed daily for 5 days, then the daily dose is gradually reduced and adjusted to 1 tablet of Veroshpiron 25 mg or increased to 400 mg in 4 divided doses.

• With increased blood pressure prescribe 50-100 mg of the drug per day, once, or in 4 doses, for 2 weeks. The drug can be combined with antihypertensive drugs.
• With hypokalemia, take 25-100 mg at a time or up to 400 mg in several doses.
• In primary hyperaldosteronism, 100, 200 or 400 mg per day are prescribed in 4 doses before surgery and 25-50 mg for long-term treatment.
• With polycystic ovary syndrome and hirsutism, the use is reduced to 100 mg of the drug twice a day.

Children are prescribed 1-3.3 mg per kg of weight, and this amount is taken either fractionally (4 doses) or once. After 4 days of treatment, the dose is adjusted, while it is possible to increase it three times.

According to the instructions, when a clinical effect is achieved, the dosage is reduced to 1 tablet of Veroshpiron 25 mg per day, after which 1 tablet is taken 4 times a day / every 4 days.

Also, tablets are used during various diagnostic tests aimed at determining the functional activity of the kidneys and the level of aldosterone in the blood. In these cases, the drug is taken as a single dose of 100-200 mg.

Side effects

According to the instructions for use, the appointment of Veroshpiron may be accompanied by the following side effects:

• dyspeptic disorders, pain in the abdominal region;
• sleep disturbances, lethargy, dizziness;
• changes in laboratory tests of blood and other body fluids;
• endocrine disruptions (in women - coarsening of the voice, metrorrhagia, amenorrhea or dysmenorrhea, in men - gynecomastia, as well as a decrease in libido and potency);
• muscle spasms.

Everything side effects are reversible and disappear after discontinuation of the drug, so if they develop, you should stop taking the tablets and consult a doctor.

Contraindications

It is contraindicated to prescribe Veroshpiron in the following cases:

• hyperkalemia and hypernatremia;
• severe form of renal failure;
• pregnancy and lactation;
• intolerance to the components of the drug, including lactose;
• Addison's disease.

Overdose

Overdose symptoms are nausea, vomiting, dizziness, decreased blood pressure, diarrhea, skin rash, hyperkalemia (paresthesia, muscle weakness, arrhythmias), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increased urea concentration.

Treatment is gastric lavage, symptomatic treatment dehydration and arterial hypotension.

In case of hyperkalemia, it is important to normalize the water-electrolyte metabolism with the help of potassium-releasing diuretics, rapid parenteral administration of a dextrose solution (5-20% solutions) with insulin at the rate of 0.25-0.5 IU per 1 g of dextrose. In severe cases, hemodialysis is performed.

Analogues Veroshpiron, price in pharmacies

If necessary, you can replace Veroshpiron with an analogue according to the ATC code - these are drugs:

1. aldactone,
2. Veroshpilakton,
3. spirix,
4. Renial,
5. epitor,
6. Spironol
7. Spironolactone,
8. Uracton.

When choosing analogues, it is important to understand that the instructions for use Veroshpiron, price and reviews of drugs similar action do not apply. It is important to consult a doctor and not to make an independent replacement of the drug.

Price in Russian pharmacies: Veroshpiron 25 mg tablets 20 pcs. - from 74 to 90 rubles, 50 mg 30 pcs. - from 179 to 193 rubles.

Keep out of the reach of children at temperatures up to 30 degrees Celsius. Leave in pharmacies by prescription.

Veroshpiron is one of the drugs that belongs to potassium-sparing drugs. The article will reveal questions on the topic of what Veroshpiron is, its instructions for use, price, reviews and analogues of this tool.

Release form

According to Vidal's reference book, Veroshpiron is available in two main dosage forms, including capsules and tablets. In Latin, this drug is prescribed as Verospironum. Therefore, when buying a drug, you should pay attention to this substance.

The tablet form of Veroshpiron has a white or almost white color. On one side you can find a chamfer that allows you to divide the dose in two. Their shape is flat or round, you can also note the presence of markings with the name of the drug on English language. The presented dosage for Veroshpiron tablets contains 25 mg of the main active ingredient. One package contains 20 tablets.

The form of Veroshpiron capsules is presented in packages with two dosages. This:

1. Hard gelatin capsule with white body and yellow cap. Inside the capsule, you can find a granular fine-grained substance with a white color. The mass of the active substance is 50 mg. One package contains blisters in the amount of three pieces with capsules in an amount equal to 30.
2. Orange hard gelatin capsule with a yellow cap. Fine-grained granular mixture has a white tint. The 100 mg capsule is available in a pack of 30.

In injections, this drug is not produced. Veroshpiron does not have the form of candles.

Veroshpiron indications for use

When prescribing this remedy, many patients ask the question of what Veroshpiron helps with.

Veroshpiron is used for the following symptoms:

• the development of edematous syndrome, which is formed in response to chronic heart failure, as the main component of therapy or a combination with other drugs;
• formation as a component of complex treatment;
• prophylactic administration against the background of a hypokalemic state arising from long-term treatment means from the diuretic group;
• the formation of Conn's syndrome due to primary hyperaldosteronism;
• conditions associated with secondary hyperaldosteronism with edema formed due to cirrhotic changes in the liver, ascites and nephrotic syndrome with facial edema;
• conducting control diagnostic tests to identify primary hyperaldosteronism;
• elimination of intracranial hypertension.

The drug does not have a positive effect in the treatment of cystitis or infection.

Contraindications

According to the annotation, the drug should not be taken under the following conditions, as the risk of complications or side effects increases, among them:

• the age of the child, not exceeding three years;
• the state of pregnancy or breastfeeding;
• anuric conditions associated with a violation of the outflow of urine or its complete absence;
• lactose intolerance or lactase deficiency;
• conditions associated with disorders in galactose digestibility or insufficient digestion of glucose;
• renal failure in a severe form of the course with impaired functioning;
• hyponatremic or hyperkalemic state;
• the presence of hypersensitivity to any constituent component.

Caution should be observed when:

• advanced age of the patient;
• the presence of metabolic acidosis;
• manifestations associated with diabetic nephropathy or diabetes varying degrees of severity;
• unstable hypertension;
• hypercalcemic state;
• conditions associated with atrioventricular blockade;
• postoperative conditions;
• complex symptomatic appointments when general or local anesthesia is performed;
• violations in menstrual function, PMS and polycystic;
• conditions associated with gynecomastia during therapy medicines causing such manifestations;
• pathological changes in the size of the mammary glands;
• cirrhotic changes in liver cells;
• manifestations of liver failure.

In such cases, you can reduce the desired course or Veroshpiron should be used constantly, but at a lower dose.

Side effects

The development of side effects while taking Veroshpiron is a fairly common manifestation. They can occur when the permissible dosage is exceeded, violations in the rule of admission, as well as a condition associated with the presence of contraindications for use.

The most common signs of side effects from Veroshpiron are:

1. Violations in neurological processes with headache, dizziness, ataxia, impaired consciousness, etc.
2. On the part of the digestive tract, there is nausea, periodically aggravated vomiting, pain in the abdominal region, which has a different intensity, an increased risk of organ failure.
3. The hematopoietic system is affected with inhibition of the production of the platelet link, megaloblasts. In some cases, these conditions are associated with agranulocytosis.
4. The pathological process also affects the organs of the endocrine system, which is expressed in women by disturbances in the functioning of the ovaries with a malfunction of the menstrual function, in reproductive age this can manifest itself as gynecological pathology with amenorrhea, and in menopause it is manifested by menorrhagia.
5. Men may experience the problem of gynecomastia.
6. The immune system is affected with the development of allergic conditions with itching, urticaria and erythematous rashes.
7. The kidneys disrupt their work with a clinic of insufficiency of an acute or chronic course.
8. The manifestation of muscle spasm, convulsive syndrome in the calf muscles is typical when muscles are involved in the manifestation of side effects.
9. V rare cases against the background of long-term use of Veroshpiron, it can develop excessive hair growth, in foci where such manifestations are not typical. In women, hair loss due to increased testosterone against the background of taking Veroshpiron, it slows down or completely stops.

Important! Properly selected dose helps to maintain the effect for a long time.

How to take Veroshpiron?

Veroshpiron, due to the release forms, are taken orally. It is recommended to comply with the prescribed dosage, not exceeding it, along with the application, it is necessary to consume a sufficient amount of liquid, mainly, it should be pure water.

Important! It is forbidden to divide a tablet or capsule, violation of integrity leads to a decrease in the effect of taking.

The use of Veroshpiron is recommended to be carried out in the first half of the day, since use in the evening can disrupt lifestyle and sleep due to awakenings with the urge to urinate. This is largely due to the fact that Veroshpiron begins to act quickly after application.

Reception of Veroshpiron should be divided by hours, it is better if it is morning, and it is preferable to carry out the use at the same time intervals. If the use was missed, but the break does not exceed a 4-hour interval, then the missed dose should be drunk as soon as possible. If more than 4 hours have passed, then the missed dose of Veroshpiron is skipped and no reimbursement is made, since the next dose is carried out in the prescribed dosage. The effect of use begins to appear quickly, therefore, in a short period of time, the doctor can give recommendations on how much Veroshpiron should be taken.

When treating Veroshpiron, restrictions are imposed on the use of salt-containing foods, as well as foods that are rich in potassium. These include the use of tomatoes, dates, oranges, etc. At the same time, alcohol should be completely excluded.

Veroshpiron instructions for use of tablets and capsules

The dose of Veroshpiron for children and adults must be selected individually, the dosage is determined depending on the severity of the patient, the severity of the edematous syndrome, as well as blood pressure indicators.

Among the main indications, the dosage is:

• in the case of the development of edematous syndrome against the background of nephrotic edema, it is necessary to use from 100 to 200 mg of Veroshpiron daily;
• heart failure with edematous syndrome involves three times the use of Veroshpiron from 100 to 200 mg. The duration of the loading dose is up to 5 days. Subsequently, the dosage is reduced to maintain the condition, while the dose of Veroshpiron is reduced to 25 mg;
• with edema associated with cirrhosis of the liver, the dosage should be selected taking into account the level of ions. With a ratio of sodium and potassium of more than one, 100 mg daily is sufficient. In the event that it is less than one, then the dose is 200-300 mg daily;
• with idiopathic hyperaldosteronism, the dosage can range from 100 to 400 mg, depending on the level of hormones;
• with severe hyperaldosteronism with hypokalemia, it can be increased to 400 mg, with the use of up to 3 times a day.

Arterial hypertension involves the use of Veroshpiron at a dosage of 50 to 100 mg daily. The dosage can be increased up to 200 mg, but this must be done with extreme caution, as electrolyte levels can change rapidly. The duration of therapy will be up to 2 weeks.

According to experts, Veroshpiron is a more suitable remedy in the presence of pathology of the heart, as it helps to preserve potassium in the body, which is necessary in this case. The cardiologist can individually select the dose, if necessary, take a break in treatment or prescribe a continuous intake.

In some cases, cats and dogs with edematous syndrome can be treated with Veroshpiron, the dosage is selected by the veterinarian. Quite often it is also replaced with Spironolactone.

Overdose

The manifestation of an overdose is associated with an excess of the permissible dosage or the presence of hypersensitivity to the components. Among the main signs of an overdose are:

• development of nausea and vomiting;
• diarrhea;
• skin rashes of a polymorphic nature;
• disruption of work nervous system with confusion and headaches;
• development of increased drowsiness;
• from the side of the eyes - this is blurred vision;
• with uncontrolled intake, the formation of dehydration is possible.

In the event that the appearance of these symptoms is characteristic, it is necessary to immediately stop using Veroshpiron. If the last use was carried out no later than 2-3 hours, procedures are carried out to prevent the absorption of the incoming substance. For this, procedures are used to wash the stomach, as well as symptomatic treatment that prevents the development of overdose symptoms.

Pregnancy and lactation

Veroshpiron is contraindicated for women diagnosed with pregnancy, as well as during lactation.

Due to a possible encounter with breast milk to the child, with an urgent need to take Veroshpiron, it is required to stop breast-feeding for this period. In addition, the withdrawal period of the drug should be taken into account, since even after stopping the use of the drug, its residual amounts remain in the blood and body.

Application in childhood

The use of Veroshpiron is contraindicated for patients whose age is less than three years. Nevertheless, Veroshpiron is rarely used for children, but the tablets are used in an individually selected dose.

The main indication is the presence of edematous syndrome. The dosage is selected exclusively by a specialist, treatment should be carried out in a hospital, since the risk of complications and side effects is much higher due to the patient's low body weight. The remedy is absolutely contraindicated for babies.

Because of the impossibility oral intake a whole tablet or capsule, it is required to crush the Substance, which will be equal to a single dose. The ground substance is soluble in water or mixture.

As an initial dosage, Veroshpiron is used in a volume of 3-4 mg per kilogram of body weight. The amount received is divided up to four doses.

This dosage is used for 5 days. Subsequently, it is possible to gradually increase the dosage.

In addition, you should adhere to a strict interval in the reception. In the event that vomiting occurred earlier than half an hour from the moment of use, then it will be necessary to reuse the previously prescribed dosage.

drug interaction

In the event that the patient is prescribed Veroshpiron, but he regularly uses other drugs, it is necessary to take into account the possible development drug interaction, which in some cases leads to undesirable consequences. Among the main groups of drugs, the joint interaction with Veroshpiron should be considered:

1. The combination together with anticoagulants reduces the degree of their effectiveness. Simultaneous administration with a group of cardiac glycosides leads to a decrease in the toxic effect of the latter.
2. There is a decrease in the toxic reaction to the norepinephrine group. This is especially expressed when combined with Verapamil.
3. Mitotan in combination with Veroshpiron has a lesser effect.
4. Joint appointment with antihypertensive (especially), hypothiazide drugs, in particular, Diakarb or Diuver leads to an increased manifestation of the effect.
5. Lithium-containing drugs increase the toxic effect on the body when combined with Veroshpiron.
6. The combination, together with drugs that contribute to the preservation of potassium in the body, as well as contain this microelement, leads to possible development hyperkalemic state.
7. Salicylates lead to a decrease in the severity of the diuretic effect.
8. Colestyramine and ammonium chloride lead to possible acidosis.
9. Non-steroidal anti-inflammatory drugs lead to possible hyperkalemic complications.

In the event that Veroshpiron does not show an effect, or causes side effects, it should be canceled.

Analogues

Veroshpiron can be replaced with other drugs that have a similar diuretic mechanism of action:

1. Inspra. A tool similar to Veroshpiron has a similar composition, but its feature is the minimum amount adverse reactions on the body. It is used for males, in cases where the use of veroshpiron is contraindicated. When it is taken, gynecomastia does not develop. Unlike Veroshpiron, the price increases significantly, but in some cases, taking Inspra is an extreme measure. In addition, it has less effect on a woman's ovaries.
2. Aldactone, a substitute that is part of the group of diuretics of the potassium-sparing group. Due to the absorption of sodium and potassium, the edematous syndrome manifests itself to a lesser extent or completely disappears. There is also a decrease in the acidity of urine. The effect of treatment is manifested by 3-5 days from the start of administration. It shows good compatibility with other drugs that cause side effects in combination with Veroshpiron.

In addition, this group includes Verospilactone, Spironolactone, etc. These drugs, according to the classification, are also included in the group of potassium-sparing diuretics.

Veroshpiron is one of the drugs, which, in some cases, can reduce body weight. This goal can have serious consequences for the further health of the patient, since the use of Veroshpiron pursues another effect.

When using Veroshpiron, sodium and potassium ionic components are removed, which draw out a large amount of water. Which in the future may require the use of Panangin. As a result, body weight decreases due to gradual dehydration, rather than splitting and burning fat cells.

After the treatment is stopped, body weight resumes due to the accumulation of water in the body.

The use of Veroshpiron for the purpose of losing weight can be dangerous not only because of possible dehydration, but also the manifestation of a convulsive syndrome, impaired functioning of cardio-vascular system and other biological processes.

When a large amount of water is removed from the body, there is also a violation in the functioning of liver cells, the occurrence of diarrhea, vomiting and abdominal pain, as well as changes in the menstrual cycle.

Holiday conditions

Veroshpiron can be purchased at a pharmacy without a doctor's prescription.

Storage conditions

This medication is valid for 5 years from the date of issue. Opened packaging is recommended to be stored for no more than a year at home.

Price

The medicine can cost from 60 to 200 rubles. This parameter will depend on the type of pharmacy network, as well as the dosage and volume of packaging that the patient needs.

Veroshpiron is a potassium-sparing diuretic. The active ingredient is Spironolactone.

Potassium-sparing diuretic, a competitive aldosterone antagonist, affects the distal convoluted renal tubules. In connection with the blockade of aldosterone receptors, urinary excretion of sodium, chlorine and water ions increases, the release of potassium and hydrogen ions decreases.

Being an aldosterone antagonist, it prevents the replacement of sodium with potassium in the distal renal tubules and reduces the excretion of potassium. The drug can be used as monotherapy or in combination with other diuretics acting on the proximal renal tubules.

The hypotensive effect of Veroshpiron tablets is due to their diuretic effect.

The drug is well absorbed in the digestive tract, characterized by high bioavailability, about 90% of the drug binds to plasma proteins. In the process of biotransformation of the active substance, active metabolites are formed, which are excreted mainly in the urine, in a small amount - in the feces.

The elimination half-life averages 12.5 hours. It crosses the placenta and is also excreted in breast milk.

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Price in pharmacies

Information about the price of Veroshpiron in Russian pharmacies is taken from the data of online pharmacies and may differ slightly from the price in your region.

You can buy the drug in pharmacies in Moscow at a price: Veroshpiron 25 mg 20 tablets - from 74 to 97 rubles, the price of 50 mg capsules is 30 pcs. - from 176 to 195 rubles.

Conditions for dispensing from pharmacies - by prescription.

Keep out of the reach of children at a temperature not exceeding 30°C. Shelf life - 5 years.

The list of analogues is presented below.

What helps Veroshpiron?

The drug Veroshpiron is prescribed in the following cases:

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

Instructions for use Veroshpiron 25 \ 50 mg, doses and rules

The tablets are taken orally as a whole, preferably in the morning, with a sufficient amount of liquid.

Essential hypertension - for adults, the dose is 50-100 mg per day (may be increased to 200 mg, over several days) in a single dose. To achieve a clinically tangible effect, the course of such treatment should be at least 2 weeks.

Idiopathic aldosteronism - 100-400 mg per day for a long time.

Severe hyperaldosteronism - 300 mg per day (maximum dose up to 400 mg is allowed) in 2-3 doses. The instruction recommends that when the condition improves and the level of potassium ions is restored, the transition to a maintenance dose is 1 tablet of Veroshpiron 25 mg per day.

Hypokalemia - 25-100 mg (depending on the degree of decrease in the level of potassium ions) once or in several doses. It is used when other drugs are ineffective to restore the level of potassium ions in the blood.

Edema in nephrotic syndrome - 100-200 mg per day as an adjuvant, since the drug does not affect the course of the underlying pathological process.

Chronic heart failure - 100-200 mg per day in 2-3 doses, the course is up to 5 days. The drug is used in combination with other diuretics (loop or thiazide diuretics). Upon reaching a clinically significant effect, the daily dose may be reduced to 1 tablet of Veroshpiron 25 mg. The maintenance dose is set individually.

With edematous syndrome, take from 100 mg / day to 200 mg per day \ 3 times a day. According to the instructions for use, Veroshpiron is prescribed daily for 5 days, then the daily dose is gradually reduced and adjusted to 25 mg or increased to 400 mg in 4 divided doses.

In primary hyperaldosteronism, Veroshpiron is prescribed at 100, 200 or 400 mg per day in 4 doses before surgery and 25-50 mg for long-term treatment.

With PCOS syndrome and hirsutism, the standard dosage of Veroshpiron is 100 mg 2 times a day.

For children, Veroshpiron is prescribed at 1-3.3 mg / kg (30-90 mg / kg per day), taken once or in 4 doses. On the 5th day, the dose can be adjusted and, if necessary, increased by 3 times. Upon reaching the effect, the dose is reduced to 0.025 g per day, and later take 1 tablet 4 times a day every 3 days.

Also, the drug is used during various diagnostic tests aimed at determining the functional activity of the kidneys and the level of aldosterone in the blood. In these cases, Veroshpiron is taken as a single dose of 100-200 mg.

Important information

While taking Veroshpiron, it is necessary to limit the intake of potassium into the body and monitor kidney function and blood condition.

Caution is taken with blockades of the conduction of the heart muscle, with surgical interventions, taking hormonal medicines, anesthetics, in old age.

Use during pregnancy and lactation

Not to be taken by pregnant and lactating women. According to strict indications, the use is allowed in the second and third trimester of pregnancy to eliminate edema, if the intended benefit to the mother is higher than the risk to the fetus.

Application features

Before using the drug, read the sections of the instructions for use on contraindications, possible side effects and other important information.

Side effects of Veroshpiron

Instructions for use warns of the possibility of development side effects drug Veroshpiron:

• From the peripheral and central nervous system: lethargy, headaches and dizziness, ataxia, lethargy, drowsiness, confusion;
• From the digestive tract: diarrhea, gastritis, nausea and vomiting, the appearance of ulcers and bleeding in the digestive tract, constipation, abdominal pain, impaired liver function;
• On the part of the hematopoietic organs: thrombocytopenia, agranulocytosis and megaloblastosis;
• From the side of metabolism: hypercreatininemia, metabolic hyperchloremic acidosis, alkalosis, hyperuricemia, increased urea concentration, hyponatremia, hyperkalemia;
• On the part of the endocrine system: gynecomastia in men (the phenomenon is reversible, disappears quickly when the drug is discontinued, in isolated cases the mammary gland may be slightly enlarged), coarsening of the voice, decreased erection and potency; in women: dysmenorrhea, menstrual irregularities, pain in the mammary glands, hirsutism, metrorrhagia in menopause, amenorrhea;
• Allergic reactions: itching, drug fever, rash, urticaria, maculopapular and erythematous rash (rarely);
• Dermatological disorders: hypertrichosis, alopecia;
• From the excretory system: acute kidney failure;
• From the musculoskeletal system: cramps of the calf muscles, muscle spasm.

Contraindications

It is contraindicated to use Veroshpiron with the following diseases or states:

• hypersensitivity to any of the components of the drug;
• Addison's disease;
• hyperkalemia;
• hyponatremia;
• severe renal failure (Cl creatinine<10 мл/мин), анурия;
• pregnancy and lactation period;
• children's age up to 3 years;
• lactase deficiency, lactose intolerance, glucose-galactose malabsorption.

With caution: hypercalcemia, metabolic acidosis, AV blockade (hyperkalemia contributes to its increase), diabetes mellitus (with confirmed or suspected chronic renal failure), diabetic nephropathy, surgical interventions (during anesthesia), taking drugs that cause gynecomastia, local and general anesthesia, old age, menstrual disorders, breast enlargement, liver failure, liver cirrhosis.

Overdose

Overdose symptoms - nausea, vomiting, dizziness, diarrhea, skin rash, hyperkalemia (paresthesia, myasthenia gravis, arrhythmias), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increased urea concentration.

Recommended gastric lavage, symptomatic therapy of dehydration and lowering blood pressure. With hyperkalemia - rapid administration of dextrose (5-20% solutions) and insulin at the rate of 0.25-0.5 IU per 1 g of dextrose, repeated if necessary.

List of analogues Veroshpiron

If necessary, replace the drug, there are two options - choosing another drug with the same active ingredient or a drug with a similar effect, but with a different active substance. Drugs with a similar effect are united by the coincidence of the ATX code.

Analogues Veroshpiron, list of drugs:

1. Renial,
2. Epitor.

ATX code matches:

• aldactone,
• Veroshpilakton,
• spirix,
• Spironol
• Uracton.

When choosing a replacement, it is important to understand that the price, instructions for use and reviews for Veroshpiron do not apply to analogues. Before replacing, you must obtain the approval of the attending physician and do not replace the drug yourself.

Reviews of cardiologists about Veroshpiron confirm the effectiveness of the drug, but it is advised to use it in moderation and as prescribed by the doctor, since the drug has side effects and contraindications. Diuretic tablets fully cope with the function assigned to them, and also effectively help with edema. In gynecology, the drug has been successfully used in PCOS.

Special Information for Healthcare Professionals

Interactions

Reduces the effectiveness of anticoagulants, indirect anticoagulants and the toxicity of cardiac glycosides.

The drug enhances the metabolism of phenazole, triptorelin, buserelin, gonadorelin, reduces the sensitivity of blood vessels to norepinephrine.

Veroshpiron enhances the toxic effect of lithium due to a decrease in its clearance, accelerates the metabolism and excretion of carbenoxolone, the latter, in turn, contributes to sodium retention.

GCS and diuretics mutually reinforce and accelerate the diuretic and natriuretic effects.

When taking Veroshpiron with potassium preparations, potassium supplements and potassium-sparing diuretics, ACE inhibitors (acidosis), angiotensin II antagonists, aldosterone blockers, indomethacin, cyclosporine, the risk of developing hyperkalemia increases.

special instructions

During treatment with Veroshpiron, a transient increase in the content of urea nitrogen in the blood is possible, especially when the drug is used with reduced kidney function and hyperkalemia, as well as the development of moderate reversible hyperchloremic metabolic acidosis. In this regard, in patients with kidney and liver diseases and in the elderly, it is necessary to systematically monitor blood serum electrolytes and indicators of kidney function.

The use of the drug makes it difficult to determine the content of digoxin in the blood serum, cortisol and adrenaline in the blood plasma.

Veroshpiron®

International non-proprietary name

Spironolactone

Dosage form

Capsules 50 mg, 100 mg

Compound

One 50mg or 100mg capsule contains

active substance- spironolactone 50 mg or 100 mg

Excipients: sodium lauryl sulfate, magnesium stearate, corn starch, lactose monohydrate.

The composition of the capsule shell 50 mg

cap: quinoline yellow (E 104), titanium dioxide (E 171), gelatin, frame: titanium dioxide (E 171), gelatin.

The composition of the capsule shell 100 mg

cap: "sunset" yellow (E 110), titanium dioxide (E 171), gelatin,

frame: sunset yellow (E 110), quinoline yellow (E 104), titanium dioxide (E 171), gelatin

Description

Capsules with an opaque yellow cap and a white opaque body, size "3" (for a dosage of 50 mg). Capsules with an opaque orange cap and a yellow opaque body, size "0" (for a dosage of 100 mg). The contents of the capsules are a fine-grained granular powdery mixture of white color.

Pharmacotherapeutic group

Diuretics. Potassium-sparing diuretics. Aldosterone antagonists. Spironolactone.

ATX code C03D A01

Pharmacological properties

Pharmacokinetics

Absorption of spironolactone from the gastrointestinal tract is rapid and complete. To a large extent, it binds to plasma proteins (approximately 90%). Spironolactone undergoes rapid metabolism. Its active metabolites are 7α-thiomethylspironolactone and canrenone. Although the half-life of spironolactone itself is short (1.3 hours), the half-life of its active metabolites is longer (2.8 to 11.2 hours). Metabolites are excreted mainly in the urine; a small part is excreted in the feces. Spironolactone and its metabolites cross the placenta and are excreted in breast milk.

After taking 100 mg of spironolactone daily for 15 days, the time to peak plasma concentration (tmax), peak plasma concentration (Cmax) and elimination half-life (t1/2) of spironolactone were: 2.6 hours, 80 ng/mL and , approximately 1.4 hours, respectively. For 7α-thiomethylspironolactone and canrenone, these figures were 3.2 and 4.3 hours, respectively; 391 ng/ml and 181 ng/ml; 13.8 and 16.5 hours.

The effect on the kidneys of a single dose of spironolactone peaks after 7 hours and persists for at least 24 hours.

Pharmacodynamics

Spironolactone is a competitive aldosterone antagonist. It acts in the distal tubules of the nephron, inhibiting the retention of sodium and water ions, as well as the excretion of potassium ions - the effects of aldosterone. Not only does it increase Na+ and Cl- excretion and decrease urinary K+ excretion, it also reduces H+ excretion. As a consequence of its diuretic effect, it has a hypotensive effect.

Indications for use

Congestive heart failure (in cases where the patient does not respond to treatment with other diuretics or there is a need to potentiate their effects)

- essential arterial hypertension (mainly in cases of hypokalemia, usually in combination with other antihypertensive drugs)

Cirrhosis of the liver with edema and/or ascites

Treatment of primary hyperaldosteronism

Edema due to nephrotic syndrome

Treatment of hypokalemia when no other therapy is available

Prevention of hypokalemia in patients receiving cardiac glycosides (in cases where other approaches are considered inappropriate or inappropriate)

Dosage and administration

Veroshpiron® is prescribed in one or two divided doses after meals. It is recommended to take the daily dose or the first part of the daily dose in the morning.

Primary hyperaldosteronism

In cases of diagnosed primary hyperaldosteronism, the drug may be prescribed in preparation for surgery at a dose of 100-400 mg. In patients in whom surgery is not planned, the drug can be used as long-term maintenance therapy at the lowest effective dosage, determined individually. In the situation described, it is permissible to reduce the initial dose every 14 days until the minimum effective dose is reached. In cases of long-term use, it is recommended to use in combination with diuretics of other groups to reduce side effects.

Edema (congestive heart failure, nephrotic syndrome)

Adults: the initial daily dose is 100 mg (25-200 mg) and is administered in one or two divided doses.

In the case of higher doses, Veroshpiron® can be taken in combination with other groups of diuretics that act in the more proximal parts of the renal tubules. In this case, the dosage of Veroshpiron® should be adjusted.

Cirrhosis of the liver with ascites or edema

If the Na + / K + ratio in the urine is greater than 1, the initial daily and maximum daily doses are 100 mg. If this ratio is less than 1, the initial daily dose is 200 mg, the maximum is 400 mg / day. The maintenance dose should be determined individually.

Essential arterial hypertension

The initial daily dose, administered in one or two doses, is 50-100 mg and is taken in combination with other antihypertensive drugs. Therapy should be continued for two weeks, since by the end of this period the maximum antihypertensive effect is achieved. Then the dose should be adjusted individually depending on the effect achieved.

hypokalemia

In patients who do not have enough nutritional supplements with K + or other methods of potassium replacement therapy, the drug is taken in a daily dose of 25-100 mg.

Elderly patients

It is recommended to start treatment with lower doses followed by a gradual increase until the maximum effect is achieved. Should be taken into account if there are hepatic and renal disorders, since they affect the metabolism of the drug and its excretion.

Side effects

Often (˃ 1/10)

- hyperkalemia (in patients with renal insufficiency and those receiving potassium supplements)

Arrhythmia (in patients with renal insufficiency and those receiving potassium supplements)

Decreased libido, erectile dysfunction, gynecomastia (in men), breast tenderness, breast enlargement, menstrual irregularities (in women)

Often (˃ 1/100, <1/10)

- hyperkalemia (in elderly patients, diabetics and those receiving ACE inhibitors)

Nausea, vomiting

Infertility (in case of using high doses (450 mg per day)

Infrequently (˃ 1/1000, <1/100)

- headache, confusion, drowsiness, asthenia, fatigue, dizziness, muscle spasms, ataxia, calf muscle cramps

Rarely (˃ 1/10000, <1/1000)

- hypersensitivity

Hyponatremia, dehydration, porphyria

Gastritis, ulcer, stomach bleeding, stomach pain, diarrhea, constipation

Rash, urticaria, hyperemia

Rarely (<1/10000)

- thrombocytopenia, agranulocytosis, eosinophilia, megaloblastosis

hirsutism

Paralysis, paraplegia

Hepatitis

Alopecia, eczema, erythema annulare, lupus-like skin lesions, maculopapular and erythematous rashes, drug fever, pruritus

Osteomalacia

Acute renal failure

Increased serum urea, hypercreatininemia

unknown frequency

Hyperchloraemic acidosis or alkalosis

unwanted hypotension

Undesirable effects usually stop after the drug is discontinued.

Contraindications

Hypersensitivity to the active substance or to any of the excipients

Anuria, acute renal failure, chronic renal failure, severe violation of the nitrogen excretion function of the kidneys (glomerular filtration rate< 10 мл/мин)

Hyperkalemia, hyponatremia, hypercalcemia

Pregnancy and lactation

Addison's disease

Children and adolescents up to 18 years of age

Patients with rare congenital forms of lactose intolerance: Lapp lactase deficiency, glucose-galactose malabsorption

Drug Interactions

Concomitant use of Veroshpiron® and other potassium-sparing diuretics, ACE inhibitors, angiotensin-II receptor antagonists, aldosterone blockers, potassium preparations can lead to severe hyperkalemia.

When combined with:

- dother diuretics- increased diuresis

- cholestyramine, ammonium chloride- increased risk of hyperkalemia and hyperchloremic metabolic acidosis

- immunosuppressants(tacrolimus and cyclosporine) - increased risk of hyperkalemia

- antihypertensive drugs(especially ganglioblockers) - development of the expressed hypotension is possible. Thus, it may be necessary to reduce the dose of antihypertensive drugs when adding Veroshpiron® to the treatment regimen.

- aalcohol, barbiturates or drugs May potentiate orthostatic hypotension caused by spironolactone

- pressor amines (norepinephrine)- Veroshpiron® reduces their effect, this should be taken into account when performing local or general anesthesia using these drugs

H steroidal anti-inflammatory drugs (NSAIDs), in particular acetylsalicylic acid, indomethacin and mefenamic acid- increased risk of hyperkalemia with a concomitant decrease in the diuretic, natriuretic and antihypertensive effects of Veroshpiron®

- glucocorticosteroids, ACTH- paradoxical increase in potassium excretion

- digoxin- spironolactone is able to increase the half-life of digoxin, which can lead to an increase in its content in the blood serum and the development of glycoside intoxication

- lithium- Lithium preparations should not be administered simultaneously with diuretics, as they reduce the renal clearance of lithium and may increase the risk of intoxication

- carbenoxolone May cause sodium retention and thus reduce the effectiveness of spironolactone

- carbamazepine- when taken simultaneously with spironolactone, it can cause the development of clinically significant hyponatremia

- coumarin derivatives- their effect is weakened

- triptorelin, buserelin, gonadorelin- their effects are enhanced

Impact on laboratory results - influence on the process of determining the concentration of digoxin by radioimmunoassay methods can be expected.

special instructions

Veroshpiron® should be used with extreme caution in patients with diseases that may cause the development of acidosis and / or hyperkalemia. The drug may increase the risk of hyperkalemia in patients with diabetic nephropathy.

Therapy with Veroshpiron® can cause a transient increase in serum urea nitrogen, especially in patients with pre-existing renal dysfunction and hyperkalemia. Veroshpiron® can cause the development of reversible hyperchloremic metabolic acidosis. Thus, in patients with impaired renal and hepatic function, as well as in elderly patients, biochemical parameters of renal function, as well as electrolyte balance, should be regularly examined.

Therapy with Veroshpiron® may interfere with the determination of serum digoxin, plasma cortisol and epinephrine.

During treatment with Veroshpiron®, alcohol intake is prohibited.

The composition of the dosage form includes lactose. The drug should not be administered to patients with rare congenital forms of lactose intolerance: Lapp lactase deficiency, glucose-galactose malabsorption.

Pregnancy and lactation

The drug is contraindicated during pregnancy and during breastfeeding. If necessary, the appointment of the drug should stop breastfeeding.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

At the beginning of treatment, driving and dangerous machinery should be abandoned for a period of time, the duration of which is determined individually. In the future, this limitation should be approached differently in each individual patient.

Overdose

Symptoms: drowsiness / lethargy, confusion, impaired water and electrolyte balance.

Treatment: symptomatic, no specific antidote. Water-electrolyte and acid-base balance should be maintained by prescribing potassium-releasing diuretics, parenteral administration of glucose with insulin, and in severe cases, hemodialysis.

Release form and packaging

10 capsules in a blister pack made of PVC film and aluminum foil.

3 contour packs, together with instructions for medical use in the state and Russian languages, are put into a cardboard box.

Storage conditions

Store at temperatures between 15 0C and 30 0C.

Keep out of the reach of children!

Shelf life

Do not use after the expiration date of the drug

Terms of dispensing from pharmacies

On prescription

Name and country of the manufacturing organization

OJSC "Gedeon Richter",

1103 Budapest, st. Dömröi, 19-21, Hungary

Name and country of the marketing authorization holder

OJSC "Gedeon Richter", Hungary

Address of the organization accepting claims from consumers on the quality of products in the territory of the Republic of Kazakhstan:

Veroshpiron is a diuretic drug that is used to eliminate various edema. The drug belongs to the group of potassium-sparing diuretics. The active substance is spironolactone, after which the drug is named on the international pharmacological market - Spironolactone.

Veroshpiron is available in the following dosage forms:

• Tablets containing a substance of 25 mg;
• Capsules gelatin hard 50 and 100 mg.

Pharmacological properties of Veroshpiron

According to the instructions, Veroshpiron is a competitive antagonist of the mineralocorticoid aldosterone, a special hormone that is produced by the adrenal cortex. The drug produces a pronounced diuretic effect, while it does not significantly affect the renal circulation and the functioning of the renal tubules, does not violate the acid-base state in the body.

After oral administration, the drug is completely and rapidly absorbed from the gastrointestinal tract. The bioavailability of Veroshpiron, according to the instructions, reaches almost 100 percent, and food intake makes this figure maximum. The highest content of the drug in the blood is 80 ng / ml, subject to a daily dose of 100 mg for two weeks. After the next intake in the morning, Cmax is observed after 2-6 hours.

The drug binds to blood proteins by 98 percent. The active ingredient spironolactone penetrates into tissues and organs poorly, however, it has the ability to penetrate the placental barrier in its original form and in the form of metabolites. Also, drugs are found in the breast milk of the mother.

The half-life of Veroshpiron, according to the instructions, is 13-24 hours. For the most part, the drug is excreted in the urine - 50% of the dose taken in the form of metabolites and unchanged - 10%. Minor excretion is through the intestines. Canrenone (an active metabolite of spironolactone) leaves the body in two stages: within 2-3 hours after ingestion - half and within 12-96 - in the rest of the amount.

In heart failure and cirrhosis of the liver, the half-life of Veroshpiron increases without signs of cumulation, the risk of which is higher with hyperkalemia and renal failure.

Indications for use

Indications for Veroshpiron are the following diseases:

• Ascites associated with liver cirrhosis;
• Edema caused by diseases of the heart and endocrine system: chronic heart failure, hirsutism, Conn's disease, polycystic ovaries;
• Arterial hypertension;
• Severe burns;
• swelling of the brain;
• Diseases accompanied by edema of various origins;
• myasthenia;
• Paroxysmal paralysis associated with calcium deficiency.

Method of application and dosage

The indications for Veroshpiron described above are only guidelines, therefore, treatment with this drug is prescribed only by a doctor.

With cirrhosis of the liver, the dosage of the drug is 0.1, 0.2 or 0.4 g per day and depends directly on the stage and characteristics of the course of the disease.

In nephrotic syndrome, the use of Veroshpiron implies doses of 0.1 to 0.2 g per day. For the treatment of edematous syndrome, it is recommended to take a medicine of 100-200 mg in three doses. According to the instructions, Veroshpiron should be taken every day for 5 days, after which the daily dosage is gradually reduced to 25 mg or increased to 400 mg in 4 doses.

To reduce high blood pressure, doses of the drug range from 50 to 100 mg per day, while the drug is taken either 1 time per day or in 4 doses. The course of treatment lasts 2 weeks. Reviews of Veroshpiron confirm that the drug is allowed to be combined with antihypertensive drugs.

With hypokalemia, the use of Veroshpiron is indicated in an amount of 25-100 mg at a time or up to 400 mg per day, divided into several doses.

Doses of the drug for primary hyperaldosteronism are 0.1, 0.2 or 0.4 mg per day, divided into 4 doses - before surgery and 25-50 mg - with long-term treatment.

To eliminate the syndrome of polycystic ovaries and hirsutism, the dose of Veroshpiron is 100 mg 2 times a day.

Children are prescribed 1-3.3 mg per kg of weight, and this amount is taken either fractionally (4 doses) or once. After 4 days of treatment, the dose is adjusted, while it is possible to increase it three times. When a clinical effect is achieved, the dosage is reduced to 25 mg per day, after which drugs are taken 1 tablet 4 times a day every 4 days.

Side effects

According to reviews of Veroshpiron, the following disorders in the body are possible:

• From the peripheral and central nervous system: lethargy, headaches and dizziness, ataxia, lethargy, drowsiness, confusion;
• From the digestive tract: diarrhea, gastritis, nausea and vomiting, the appearance of ulcers and bleeding in the digestive tract, constipation, abdominal pain, impaired liver function;
• On the part of the hematopoietic organs: thrombocytopenia, agranulocytosis and megaloblastosis;
• From the side of metabolism: hypercreatininemia, metabolic hyperchloremic acidosis, alkalosis, hyperuricemia, increased urea concentration, hyponatremia, hyperkalemia;
• On the part of the endocrine system: gynecomastia in men (the phenomenon is reversible, disappears quickly when the drug is discontinued, in isolated cases the mammary gland may be slightly enlarged), coarsening of the voice, decreased erection and potency; in women: dysmenorrhea, menstrual disorders, pain in the mammary glands, hirsutism, metrorrhagia in menopause, amenorrhea;
• Allergic reactions: itching, drug fever, rash, urticaria, maculopapular and erythematous rash (rarely);
• Dermatological disorders: hypertrichosis, alopecia;
• From the excretory system: acute renal failure;
• From the musculoskeletal system: cramps of the calf muscles, muscle spasm.

Overdose with Veroshpiron

Very rarely, reviews of Veroshpiron indicate cases of drug overdose. However, in such situations, you need to flush the stomach, drink plenty of fluids, as well as caffeine in order to increase blood pressure. Patients with hyperkalemia are prescribed insulin and dextrose.

Contraindications to the use of Veroshpiron

Contraindications to Veroshpiron are:

• Impaired kidney function;
• Hypersensitivity to any component;
• Diabetes mellitus with complications;
• Addison's disease;
• Increased levels of calcium and potassium in the blood;
• Pregnancy;
• Liver failure;
• Gynecological diseases.

Veroshpiron is carefully prescribed for conduction blockades in the heart muscle, taking hormonal drugs, surgical interventions, as well as for elderly patients.

During treatment with this drug, you should limit the intake of potassium into the body, as well as monitor the condition of the blood and kidney function.

Terms and conditions of storage