Veroshpiron application instructions
Veroshpiron tablets are representative of the pharmacological group of drugs - potassium-saving diuretics. The use of these tablets helps to increase diuresis (the volume of urine excreted from the body during the day), while potassium ions are not excreted from the body. They are used to remove excess fluid from the body primarily for various cardiovascular diseases.
Release form and composition
Veroshpiron tablets are available in tablets and capsules. One tablet contains 25 mg of active ingredient - spironolactone. Also included in the tablet excipients:
- Magnesium stearate - 2 mg.
- Silicon dioxide - 1.2 mg.
- Talc - 5.8 mg.
- Lactose monohydrate - 146 mg.
- Corn starch - 70 mg.
Capsules are available in 2 dosages - 50 and 100 mg of spironolactone and contain such excipients:
- Magnesium stearate - 2.5 / 5 mg in capsules of 50 and 100 mg of spironolactone.
- Sodium lauryl sulfate - 2.5 / 5 mg.
- Corn starch - 42.5 / 85 mg.
- Lactose monohydrate - 127.5 / 255 mg
The capsule lid also contains titanium dioxide (E171) - 2/2%, quinoline yellow dye (E104) - 0.48 / 0%, yellow dye “Sunset” (E110) - 0 / 0.04%, gelatin - up to 100 % Tablets and capsules are packaged in a blister of 10 pieces. A carton pack contains 20 tablets or 10 and 30 capsules of each dosage.
The active ingredient of the drug is spironolactone. It is a potassium-sparing diuretic (diuretic). The mechanism of action of spironolactone is to block the receptors of the convoluted tubule of the renal nephrons to the hormone adldosterone. This leads to an increase in the amount of urine excretion of sodium ions, chlorine and water, without excretion of potassium ions and hydrogen. An increase in diuresis usually develops not immediately, but 2-5 days after the start of the use of the drug.
Spironolactone, which is part of Veroshpiron tablets, is well absorbed from the lumen of the small intestine. It penetrates well through the placenta into the body of a developing fetus during pregnancy and into breast milk during lactation. The active ingredient of the tablets Veroshpiron is metabolized mainly in the liver cells (hepatocytes) with the formation of active intermediate substances, which are excreted in the urine by the kidneys and in small quantities with feces. The half-life (the time after which half of the entire dose of the taken drug is eliminated) is 12.5 hours. The elimination half-life is increased in case of liver cirrhosis (replacement of hepatocytes by fibrotic connective tissue) and heart failure, while the active ingredient spironolactone is retained in the blood and tissues of the body.
Indications for use
The use of tablets Veroshpiron shown 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 - a prolonged increase in systemic arterial pressure associated with fluid retention and sodium salts in the bloodstream.
- Idiopathic hyperaldosteronemia - an increase in the level of the hormone aldosterone in the body (produced by atrial cells), which leads to fluid retention in the body and the frequent development of tissue edema.
- 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.
- Liver cirrhosis is the 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, in liver cirrhosis, secondary aldosteronism develops - an increase in the level of the hormone aldosterone due to a decrease in its metabolism in the liver to intermediate metabolic products.
- Primary hyper aldosteronism - the drug is used in a short course during preoperative preparation and after surgery.
- Hypokalemia - a decrease in the level of potassium in the blood. Veroshpiron tablets are used in the treatment of this condition.
Also, the use of the drug is indicated when it is necessary to achieve a prolonged diuretic effect with preservation of the level of potassium ions in the body.
The use of Veroshpiron tablets 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 (reduced daily diuresis) or anuria (complete absence of urine).
- 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.
- Breast feeding.
- Children's age up to 3 years.
Before using the drug, make sure that there are no contraindications. For accurate determination of the level of potassium and sodium ions in the blood, it is carried out a laboratory study (biochemical analysis of electrolytes).
Dosing and Administration
Veroshpiron tablets are taken whole inside, preferably in the morning, after taking them wash down with a sufficient amount of liquid. The dosage and duration of the course of the drug depends on the underlying pathology:
- Essential hypertension - for adults, the dose is 50-100 mg per day (can be increased to 200 mg in a few days) in one step. To achieve a clinically tangible effect, the course of such treatment must be at least 2 weeks.
- Idiopathic aldosteronism - 100-400 mg per day for a long time.
- Pronounced hyperaldosteronism - 300 mg per day (the maximum dose is allowed up to 400 mg) in 2-3 doses. With the improvement of the state and the restoration of the level of potassium ions, switch 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 doses. Used with the 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 adjuvant, since in this case spironolactone does not affect the course of the main 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). At achievement of clinically significant effect, the daily dose can be reduced to 25 mg. Maintenance dose is set individually.
- Edema on the background of cirrhosis of the liver - the daily dose varies from 100 to 400 mg, depending on the ratio in the urine of sodium and potassium ions (determined by laboratory). Subsequent maintenance dose is determined individually, depending on the severity of the clinical effect.
- Preparing for surgery for secondary hyperaldosteronism and the postoperative period - the dose is 100-400 mg per day, chosen by the doctor individually.
- Edema in children - the initial dose for the 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, not 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 in a single 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, development of ulcers and erosions in the gastrointestinal tract, bleeding from them, gastritis (inflammation of the stomach), recurrent pain in the abdomen, a tendency to constipation, impaired functional activity of the liver.
- The hematopoietic system is agranulocytosis (the practical absence of certain types of leukocytes in the blood), thrombocytopenia (a decrease in the number of platelets), megaloblastosis (the 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 of the leg) and ataxia (staggering gait).
- The endocrine system - gynecomastia (breast enlargement), impaired erectile function and potency in men, in women - pain in the mammary glands, impaired menstrual cycle, amenorrhea (absence of menstruation), hirsutism (increased body hairiness of the male type).
- Skin - alopecia (hair loss) or, on the contrary, hypertrichosis (increased hairiness).
- Urinary system - the development of acute renal failure.
- Allergic reactions - rash and itching of the skin, urticaria (rash and swelling of the skin that have an external resemblance to a nettle burn), angioedema Quincke (significant swelling of the skin and subcutaneous tissue in the face or genital organs) development of multiple organ failure and progressive lowering of blood pressure).
All side effects are reversible and disappear after discontinuation of the drug, therefore, if they develop, taking Veroshpiron tablets should be stopped and consult a doctor.
Reception drug can be appointed only after his appointment by a doctor, after the selection of the dosage and laboratory tests. There are a number of special instructions that are taken into account before the start of treatment, these include:
- After starting the drug, a temporary increase in the residual nitrogen in the blood is possible, after a short period of time, this laboratory figure normalizes (in case of kidney failure, normalization takes a little longer).
- Veroshpiron tablets do not have a direct effect on blood sugar levels, however, they are used with caution in diabetes mellitus.
- While taking the drug should avoid eating foods rich in potassium (dried apricots, raisins, bananas).
- With caution Veroshpiron tablets used in renal or hepatic failure.
- With long-term use, parallel use of nonsteroidal anti-inflammatory drugs, periodic laboratory monitoring of blood system parameters, functional activity of the kidneys and liver is carried out.
- Veroshpiron tablets do not have a direct effect on the speed of psychomotor reactions and concentration. However, due to the possible development of side effects, it is recommended to abandon activities requiring increased attention.
Pharmacies Veroshpiron tablets are dispensed only by prescription. It is not recommended to use them yourself, adjust the dosage or the duration of the course of treatment.
If the recommended therapeutic dose is exceeded, overdose symptoms develop in the form of nausea, vomiting, abdominal pain, hyperkalemia (characterized by a heart rhythm disturbance, cramps), hyponatremia (manifested by dry mouth), dehydration (dehydration). In case of overdose, gastric and intestinal lavage is performed and pathogenetic therapy is aimed at restoring body fluids and salts (intravenous drip of saline).
According to the active substance analogues Veroshpiron tablets are - Spironolactone, Renial, Epitor.
Terms and conditions of storage
The shelf life of tablets and capsules Veroshpiron is 5 years. The drug should be stored in a dry, dark place inaccessible to children at an air temperature not higher than + 30 ° C.
The average cost of Veroshpiron tablets in pharmacies in Moscow varies depending on the dosage of the drug:
- 50 mg - 162-166 rubles.
- 100 mg - 240-262 rubles.