Veroshpilakton instructions for use
- Veroshpilakton instructions for use
ATX Code C03DA01
Pharmacotherapeutic group : potassium-sparing diuretics.
Dosage form : tablets.
Product : round flat tablets of white or cream color, with a facet and risk on the one hand, contour squares, cardboard pack.
A drug that exerts a diuretic effect by removing an increased amount of sodium and water with a simultaneous retention in the body of potassium and magnesium.
Active substance :
Auxiliary components :
- silicon dioxide colloidal;
- potato starch;
- magnesium stearate;
Spironolactone, an active ingredient of the drug, is a potassium-sparing diuretic. It is included in the group of specific long-acting aldosterone antagonists. This substance in the distal sections of the nephron prevents sodium and water retention, suppresses the potassium-releasing effect of aldosterone and reduces the synthesis of permeases. Binding to aldesterone receptors increases the excretion of sodium and chlorine ions in the urine, reduces the excretion of urea and potassium ions, reduces the acidity of urine.
The maximum therapeutic effect after taking the drug is observed after 7 hours. The duration of the action is about 24 hours. The presence of a diuretic effect causes the hypotensive effect of the drug. Diuretic effect is manifested after 2-5 days of treatment.
After ingestion, the active ingredient is rapidly and almost completely absorbed into their digestive tract, becoming active metabolites containing 80% sulfur and 20% canrenone. The maximum concentration in the blood plasma reaches in 2-4 hours. The connection with plasma proteins is 90%.
With daily use of 100 mg of spironolactone per day for 15 days, the maximum concentration of the component reaches 80 mg / day. Despite the fact that the drug is very poorly adsorbed in tissues and organs, its metabolites are able to penetrate the placental barrier, and the vanrenone is found in breast milk. The volume of distribution is 0.05 l / kg. The half-life of the active ingredient is 13-24 hours, C 1/2 of its metabolites - 15 hours.
Veroshpilakton is excreted by the kidneys, 10% - unchanged, 50% - in the form of metabolites. A small part comes out of the body along with the calves.
In patients with cirrhosis of the liver or heart failure, the half-life is prolonged, but there are no signs of cumulation in this situation.
Indications for use
- Essential hypertension (as a drug combination therapy);
- Pathological conditions characterized by secondary hyperaldosteronism (nephrotic syndrome, cirrhosis accompanied by edema or ascites and other conditions characterized by edema formation);
- Chronic heart failure (edematous syndrome);
- Connes syndrome (as a drug recommended for a short course of preoperative therapy);
- Hypokalemia or hypomagnesemia (as an auxiliary drug);
- When diagnosing "primary hyperaldosteronism".
- Individual intolerance to the components of the drug;
- Severe form of renal failure (if creatinine clearance does not exceed 10ml / min);
- Addison's disease;
- Pregnancy and lactation;
- Children's age (up to 3 years);
Veroshpilakton is recommended to be used with extreme caution in patients suffering from hypercalcemia, diabetes mellitus, developed against a background of chronic renal failure, with diabetic nephropathy, the use of drugs that promote the development of gynecomastia, atrioventricular blockade, and surgical interventions. Before general and local anesthesia, with menstrual disorders, liver failure, and also in senile age.
Dosing and Administration
In the treatment of essential hypertension - a single daily dose - 50-100 mg. According to medical indications, it can be gradually increased to 200 mg (1 time in 2 weeks). The recommended course of treatment is at least two weeks. If necessary, dose adjustment is possible.
Idiopathic hyperaldosteronism is 100-400 mg / day.
Hypokalemia and pronounced hyperaldosteronism - 300 mg / day. The maximum daily dose is 400 mg divided into 2-3 doses. After improving the patient's condition, the dosage is gradually reduced to 25 mg / day.
Hypokalemia / hyponatremia (effect of diuretic therapy) 25-100 mg / day, once, or divided into several receptions. The maximum daily dose is 400 mg (recommended for ineffectiveness of oral potassium preparations).
As a diagnostic tool for 4 days, 400 mg per day, divided into several receptions. In the case of an increase in the concentration of potassium in the blood when taking the drug and lowering after withdrawal, the question arises of the development of primary hyperaldosteronism.
As a preparation of preoperative therapy with primary hyperaldosteronism - 100-400 mg / day, dividing into 1-4 reception.
With swelling, which is a consequence of nephrotic syndrome - 100-200 mg / day.
With edematic syndrome, which is a consequence of chronic heart failure - for 5 days, 100-200 mg per day, in a complex with a thiazide or loop diuretic. According to medical indications, the daily dose can be reduced to 25 mg. The maximum dose is 200 mg / day.
In the treatment of edema that occur on the background of liver cirrhosis, 100-200 mg of the drug per day (depending on the ratio of potassium and sodium ions) is prescribed.
Treatment of edema in children is carried out for 5 days, in the calculation of 1-3.3 mg of the drug per 1 kg of body weight. The dosage is then adjusted and, if necessary, increased.
From the side of the central nervous system : dizziness, drowsiness, headache, ataxia, retardation, confusion, lethargy, muscle spasms.
On the part of the digestive tract : nausea, vomiting, impaired liver function, constipation, diarrhea, abdominal pain, intestinal colic, gastritis .
From the hematopoietic system : thrombocytopenia, leukopenia.
From the skin: urticaria , skin itching, erythematous or macular rash, hypertrichosis, alopecia.
On the part of the endocrine system : a decrease in erection and potency, gynecomastia, menstrual irregularity, voice coarsening, hirsutism, soreness in the mammary glands.
From the urinary system : acute renal failure.
Other disorders: spasms of gastrocnemius muscles, violation of water-salt metabolism, hypercreatininaemia, violation of acid-base balance, hyperuricemia.
Veroshpilakton reduces the toxicity of glycosides and the therapeutic effect of indirect anticoagulants.
With simultaneous use, the toxic effect of lithium, the metabolism of phenazole and carbenoxolone is increased, the sensitivity to noepinephrine decreases, and the half-life of digoxin is increased.
When interacting with glucocorticosteroids and diuretics, the diuretic and natriuretic effect is intensified and accelerated, and when interacting with NSAIDs, it decreases. The effect of antihypertensive drugs is increasing.
When using Veroshpilakton with potassium supplements, potassium-sparing diuretics, aldosterone blockers, angiotensin antagonists, the risk of hypercalcemia increases. Indomethacin and salicylates help to reduce the diuretic effect. Simultaneous application with colestyramine and ammonium chloride may lead to the development of hyperkalemic metabolic acidosis.
Veroshpilakton reduces the effect of using mitotane, enhances the action of buserelin, triptorelin and gonadorelin.
When an overdose of the drug may develop nausea, vomiting, dizziness, arrhythmia, muscle weakness (the effect of hyperkalemia), diarrhea, thirst, drowsiness, thirst, dry mouth. Possible skin rash, dehydration, increased urea concentration.
Refers to prescription drugs.
Store in a dry place, protected from light, out of reach of children, at a temperature not exceeding 25 ° C.
Shelf life of the drug is 3 years from the date of issue. After the expiration date indicated on the package, the drug should not be used.
The average price in pharmacies in Moscow
- Potassium canrenoate;