Veroshpiron instruction manual
Veroshpiron tablets are a representative of the pharmacological group of medicines - potassium-sparing diuretics. The use of these tablets increases the diuresis (the volume of urine output from the body during the day), while the potassium ions from the body are not withdrawn. They are used to remove excess fluid from the body primarily for various cardiovascular diseases.
Form of issue and composition
Veroshpiron tablets are available in tablets and capsules. One tablet contains 25 mg of active ingredient - spironolactone. Also, the tablet contains auxiliary substances:
- Magnesium stearate - 2 mg.
- Silicon dioxide - 1.2 mg.
- Talc - 5.8 mg.
- Lactose monohydrate is 146 mg.
- Corn starch - 70 mg.
Capsules are available in 2 doses of 50 and 100 mg of spironolactone and contain such auxiliary substances as:
- Magnesium stearate - 2.5 / 5 mg in capsules of 50 and 100 mg of spironolactone.
- Sodium lauryl sulfate - 2,5 / 5 mg.
- Corn starch is 42.5 / 85 mg.
- Lactose monohydrate 127.5 / 255 mg
The capsule cover also contains titanium dioxide (E171) - 2/2%, quinoline yellow dye (E104) - 0.48 / 0%, yellow dye "Sunset sunset" (E110) - 0 / 0.04%, gelatin - up to 100 %. Tablets and capsules are packaged in a blister pack of 10. A cardboard pack contains 20 tablets or 10 and 30 capsules of each dosage.
The active substance of the drug is spironolactone. It is a potassium-sparing diuretic (diuretic). The mechanism of action of spironolactone is the blockade of the receptors of the convoluted tubules of kidney nephrons to the hormone adldosterone. This leads to an increase in the amount of urinary excretion of sodium, chlorine and water ions, without excretion of potassium and hydrogen ions. An increase in diuresis usually does not develop immediately, but after 2-5 days after the start of the drug.
Spironolactone, which is a part of the Veroshpiron tablets, is well absorbed from the lumen of the small intestine. It penetrates well through the placenta into the developing fetus during pregnancy and into breast milk during lactation. The active substance of the tablets Veroshpiron is metabolized predominantly in the liver cells (hepatocytes) with the formation of active intermediates, which are excreted from the body with urine by the kidneys and in an insignificant amount with feces. Half-life (the time through which half of the entire dose of the drug taken out) is 12.5 hours. The elimination half-life increases with liver cirrhosis (replacement of hepatocytes with fibrotic connective tissue) and heart failure, while the active substance spironolactone is retained in the blood and tissues of the body.
Indications for use
The use of Veroshpiron tablets is indicated in a number of pathological conditions of the body, characterized by a delay in the body of water and sodium ions, as well as a decrease in the level of potassium ions, these include:
- Essential hypertension is a prolonged increase in systemic arterial pressure associated with fluid retention and sodium salts in the vascular bed.
- Idiopathic hyperaldosteronemia is an increase in the level of the aldosterone hormone in the body (produced by atrial cells), which leads to fluid retention in the body and frequent development of edema of tissues.
- Congestive heart failure - a decrease in the functional activity of the heart, a decrease in the minute stroke volume leads to the development of edema, fluid retention and sodium salts in the body.
- Cirrhosis - replacement of liver cells with fibrotic connective tissue, with the development of blood stasis in the portal vein system, liver failure, water retention and edema. Also, with cirrhosis, secondary aldosteronism develops-an increase in the level of the aldosterone hormone due to a decrease in its metabolism in the liver to intermediate metabolic products.
- Primary hyperaldosteronism - the drug is applied a short course during preoperative preparation and after surgery.
- Hypokalemia is a decrease in the level of potassium in the blood. Veroshpiron tablets are used in the complex therapy of this condition.
Also, the use of the drug is indicated when it is necessary to achieve a long diuretic effect while maintaining the level of potassium ions in the body.
Contraindications for use
The use of tablets Veroshpiron is contraindicated in certain pathological and physiological conditions of the body, which include:
- Individual intolerance or hypersensitivity to spironolactone or excipients of the drug.
- Acute renal failure, which is accompanied by significant oliguria (a decrease in daily diuresis) or anuria (complete absence of urine output).
- Addison's disease.
- Hyperkalemia is an increase in the level of potassium ions in the blood.
- Hypokalemia - a decrease in the concentration of sodium ions in the body.
- Pregnancy at any time.
- Children up to 3 years.
Before using the drug, you need to make sure there are no contraindications. To accurately determine the level of potassium and sodium ions in the blood, a laboratory test is carried out (biochemical analysis for electrolytes).
Dosage and Administration
Veroshpiron tablets are taken internally as a whole, preferably in the morning, after intake with a sufficient amount of liquid. Dosage and duration of the course of application of the drug depend on the main pathology:
- Essential hypertension - for adults, the dose is 50-100 mg per day (can be increased to 200 mg, for several days) at one time. To achieve a clinically noticeable effect, the course of such treatment should be at least 2 weeks.
- Idiopathic aldosteronism is 100-400 mg per day for a long time.
- Expressed hyperaldosteronism - 300 mg per day (maximum dose of 400 mg is allowed) in 2-3 divided doses. When the condition is improved and the level of potassium ions is restored, they pass to a maintenance dose of 25 mg (1 tablet) per day.
- Hypokalemia - 25-100 mg (depending on the degree of decrease in the level of potassium ions) once or in several ways. It is used with ineffectiveness of other drugs to restore the level of potassium ions in the blood.
- Edema in nephrotic syndrome - 100-200 mg per day as an auxiliary, since spironolactone does not affect the course of the main pathological process.
- Chronic heart failure - 100-200 mg per day in 2-3 divided doses, course up to 5 days. The drug is used in combination with other diuretics (loop or thiazide diuretics). When a clinically significant effect is achieved, the daily dose can be reduced to 25 mg. The maintenance dose is set individually.
- Edema on the background of liver cirrhosis - the daily dose varies from 100 to 400 mg, depending on the ratio of sodium and potassium ions in urine (determined laboratory). The subsequent maintenance dose is set individually, depending on the severity of the clinical effect.
- Preparation for surgical intervention for secondary hyperaldosteronism and postoperative period - the dose is 100-400 mg per day, selected by the doctor individually.
- Edema in children - the initial dose for age over 3 years is 1-3 mg per kg of body weight of the child per day. After a few days, the dose can be increased, no more than 3 times the original value.
Veroshpiron tablets are also 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 once in a dose of 100-200 mg.
The use of Veroshpiron tablets can lead to the development of side effects and negative reactions from various body systems:
- The digestive system - nausea, vomiting, diarrhea, the development of ulcers and erosions in the gastrointestinal tract, bleeding from them, gastritis (inflammation of the stomach), periodic abdominal pain, propensity to constipation, impaired functional activity of the liver.
- The hematopoietic system - agranulocytosis (the practical absence of certain types of leukocytes in the blood), thrombocytopenia (decrease in the number of platelets), megaloblastic (appearance in the peripheral blood of young immature forms of its cells).
- Central nervous system - headache, dizziness, drowsiness, up to lethargy, confusion, spasm of striated muscles (sometimes cramps of calf muscles) and ataxia (staggering gait).
- Endocrine system - gynecomastia (enlargement of the mammary glands), impaired erectile function and potency in men, in women - pain in the mammary glands, menstrual cycle disorder, amenorrhea (absence of menstruation), hirsutism (increased body fatigue of the male type).
- Skin - alopecia (hair loss) or vice versa hypertrichosis (increased hairiness).
- The urinary system is the development of acute renal failure.
- Allergic reactions - skin rash and itching, urticaria (rash and swelling of the skin that have an external resemblance to nettle burn), angioedema Quincke (significant swelling of the skin and subcutaneous tissue in the face or external genital area), anaphylactic shock (severe allergic reaction with Development of multiple organ failure and progressive lowering of blood pressure).
All side effects are reversible and disappear after drug withdrawal, so in case of their development, taking Veroshpiron tablets should be stopped and consult a doctor.
Reception of the drug can be prescribed only after his appointment as a doctor, after choosing the dosage and conducted laboratory tests. There are a number of special instructions that are taken into account before the start of treatment, they include:
- After starting taking the drug, a temporary increase in residual nitrogen in the blood can occur, after a short period of time, this laboratory indicator is normalized (with renal failure normalization lasts a little longer).
- Veroshpiron tablets do not directly affect the blood sugar level, however, with diabetes they are used with caution.
- When taking the drug should avoid eating a rich potassium (dried apricots, raisins, bananas).
- With care, tablets Veroshpiron are used for renal or hepatic insufficiency.
- With long-term administration, parallel use of non-steroidal anti-inflammatory drugs, periodic laboratory monitoring of blood system parameters, functional activity of the kidneys and liver.
- Veroshpiron tablets do not have a direct effect on the speed of psychomotor reactions and concentration of attention. However, in connection with the possible development of side effects, it is recommended to refuse from activities requiring increased attention.
In pharmacies, Veroshpiron tablets are dispensed only on prescription. It is not recommended to use them alone, adjust dosage or duration of treatment.
In case of exceeding the recommended therapeutic dose, symptoms of overdose develop in the form of nausea, vomiting, abdominal pain, hyperkalaemia (characterized by a violation of the rhythm of contractions of the heart, seizures), hyponatremia (manifested by dry mouth), dehydration (dehydration). In case of overdosage, gastric, intestinal and pathogenetic washing is performed, aimed at the restoration of fluid and salts in the body (intravenous drip of saline solutions).
According to the active substance, analogues of Veroshpiron tablets are - Spironolactone, Renial, Eplitor.
Terms and conditions of storage
The shelf life of Veroshpiron tablets and capsules is 5 years. The drug should be stored in a dry, dark place inaccessible to children at an air temperature of no more than + 30 ° C.
The average cost of Veroshpiron tablets in Moscow pharmacies varies depending on the dosage of the drug:
- 50 mg - 162-166 rubles.
- 100 mg - 240-262 rubles.