Veroshpilakton instructions for use
- Veroshpilakton instructions for use
ATX C03DA01 code
Pharmacotherapeutic group : potassium-sparing diuretics.
Dosage form : tablets.
Release form : round flat tablets of white or cream color, with a facet and risk on the one hand, planimetric cell packing, cardboard pack.
A drug that has a diuretic effect due to the elimination of an increased amount of sodium and water while simultaneously delaying potassium and magnesium in the body.
Active substance :
Auxiliary components :
- colloidal silicon dioxide;
- potato starch;
- magnesium stearate;
Spironolactone, an active component of the drug, is a potassium-sparing diuretic. It is included in the group of specific aldosterone antagonists of prolonged action. This substance in the distal nephron prevents the retention of sodium and water, inhibits the potassium-excreting effect of aldosterone and reduces the synthesis of permeases. By binding to aldesterone receptors, it increases the excretion of sodium and chlorine ions with urine, reduces the excretion of urea and potassium ions, and reduces the acidity of urine.
The maximum therapeutic effect after taking the drug is observed after 7 hours. Duration of action - about 24 hours. The presence of a diuretic effect causes the hypotensive effect of the drug. The diuretic effect appears after 2-5 days of treatment.
After ingestion, the active component is quickly and almost completely absorbed from the digestive tract, becoming active metabolites containing 80% sulfur and 20% canrenone. The maximum concentration in the blood plasma reaches in 2-4 hours. Communication 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 vannone is found in breast milk. The volume of distribution is 0.05 l / kg. The half-life of the active component is 13-24 hours, C 1/2 of its metabolites is 15 hours.
Veroshpilakton is excreted by the kidneys, 10% - unchanged, 50% - as metabolites. A small part comes out of the body along with feces.
In patients with cirrhosis of the liver or heart failure, the elimination half-life increases, however, there are no signs of cumulation in this situation.
Indications for use
- Essential hypertension (as a combination therapy drug);
- Pathological conditions characterized by secondary hyperaldosteronism (nephrotic syndrome, cirrhosis of the liver , accompanied by edema or ascites and other conditions that are characterized by the formation of edema);
- Chronic heart failure (edematous syndrome);
- Conn's syndrome (as a drug recommended for a short course of preoperative therapy);
- Hypokalemia or Hypomagnemia (as an adjunct drug);
- When making a diagnosis of "primary hyperaldosteronism."
- Individual intolerance to the components of the drug;
- Severe 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 on the background of chronic renal failure, diabetic nephropathy, medication, promoting the development of gynecomastia, atrioventricular block, surgical interventions. Before carrying out general and local anesthesia, in violation of the menstrual cycle, liver failure, as well as in old age.
Dosage and administration
In the treatment of essential hypertension - a single daily dose of 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 - 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 (a consequence of diuretic therapy) 25-100 mg / day, once, or divided into several doses. The maximum daily dose is 400 mg (recommended with the ineffectiveness of oral potassium preparations).
As a diagnostic tool for 4 days at 400 mg per day, divided into several doses. In the case of increasing the concentration of potassium in the blood while taking the drug and decrease after the cancellation, the question arises about the development of primary hyperaldosteronism.
As a drug preoperative therapy in primary hyperaldosteronism - 100-400 mg / day, divided into 1-4 doses.
For edema resulting from nephrotic syndrome - 100-200 mg / day.
With edematous syndrome, which is a consequence of chronic heart failure - for 5 days, 100-200 mg per day, in the complex with a thiazide or loop diuretic. According to medical indications, the daily dose may be reduced to 25 mg. The maximum dose is 200 mg / day.
In the treatment of edema that occurred on the background of cirrhosis of the liver, 100-200 mg of the drug is administered per day (depending on the ratio of potassium and sodium ions).
Treatment of edema in children is carried out for 5 days, at the rate of 1-3.3 mg of the drug per 1 kg of body weight. Then the dosage is adjusted, and, if necessary, increased.
From the side of the central nervous system : dizziness, drowsiness, headache, ataxia, lethargy, confusion, lethargy, muscle spasms.
On the part of the digestive tract : nausea, vomiting, abnormal liver function, constipation, diarrhea, abdominal pain, intestinal colic, gastritis .
From the hematopoietic system : thrombocytopenia, leukopenia.
On the part of the skin: urticaria , pruritus, erythematous or macular rash, hypertrichosis, alopecia.
On the part of the endocrine system : reduction of erection and potency, gynecomastia, menstrual disorders, coarsening of the voice, hirsuitism, tenderness in the area of the mammary glands.
On the part of the urinary system : acute renal failure.
Other disorders: convulsions of calf muscles, impaired water-salt metabolism, hypercreatininemia, impaired acid-base balance, hyperuricemia.
Veroshpilakton reduces the toxicity of glycosides and the therapeutic effect of indirect anticoagulants.
With simultaneous use increases the toxic effect of lithium, the metabolism of phenazole and carbenoxolone, reduced sensitivity to noepinephrine, increases the half-life of digoxin.
When interacting with glucocorticosteroids and diuretics, the diuretic and natriuretic effect is enhanced and accelerated, and when interacting with NSAIDs it decreases. The effect of antihypertensive drugs is enhanced.
When using Veroshpilakton with potassium supplements, potassium-sparing diuretics, aldosterone blockers, angiotensin antagonists increases the risk of hypercalcemia. Indomethacin and salicylates help reduce the diuretic effect. Simultaneous use with Kolestiramine and ammonium chloride can lead to the development of hyperkalemic metabolic acidosis.
Veroshpilakton reduces the effect of the use of mitotane, enhances the effect of buserelin, triptorelin and gonadorelin.
With an overdose of the drug may develop nausea, vomiting, dizziness, arrhythmia, muscle weakness (a consequence of hyperkalemia), diarrhea, thirst, drowsiness, thirst, dry mouth are observed. You may experience skin rash, dehydration, an increase in the concentration of urea.
Refers to prescription drugs.
Store in a dry, protected from light, out of reach of children at a temperature not exceeding 25 C.
The shelf life of the drug for 3 years from the date of issue. After the expiration date indicated on the package, the drug is not allowed to use.
Average price in Moscow pharmacies
- Potassium canrenoate;