Veroshpilactone, capsules 100 mg 30 pcs

Spironolactone is an aldosterone antagonist that competitively binds to aldosterone receptors in the distal renal tubules.

Aldosterone acts as a potassium-saving diuretic by increasing the amount of sodium and water excreted from the body while delaying potassium and magnesium excretion.

The diuretic effect usually develops on days 2-5 of treatment and persists for 2-3 days after discontinuation of the drug.

Indications

Active ingredient

Composition

1 tablet contains:

Active substance:

Spironolactone 100 mg.

How to take, the dosage

The tablets are taken orally after meals.

Adults can take the daily dose in one or more doses.

Oedema against a background of chronic heart failure: The initial dose is 25 mg/day and the maximum dose is 100 mg/day. The maintenance dose is determined individually.

Oedema against liver cirrhosis: 100-400 mg/day (depending on potassium/sodium ratio). The maintenance dose is determined individually.

Peripheral edema against nephrotic syndrome: Daily dose is 100-200 mg/day.

Essential hypertension in adults: 50-100 mg/day. If necessary, the daily dose may be gradually increased to 200 mg/day over two weeks. The duration of treatment is at least 2 weeks.

Children:usually prescribed at a rate of 3 mg/kg body weight per day. The dose should be chosen based on the response and tolerability of the drug. The number of times a day is usually 1 to 2 times.

Diagnosis and treatment of primary hyperaldosteronism: can be used for initial diagnosis as an indirect indicator of primary hyperaldosteronism in patients on a normal diet. Long test:Adults – 400 mg/d for 3-4 weeks. Elimination of hypokalemia and arterial hypertension, indirectly in favor of the diagnosis of primary hyperaldosteronism.Short test:daily dose for adults – 400 mg for 4 days.

If, while taking spironolactone, serum potassium ion concentrations increase but fall when spironolactone is withdrawn, primary hyperaldosteronism should be considered as a possible diagnosis. Once the diagnosis of hyperaldosteronism has been made with more informative diagnostic tests, spironolactone can be taken in preparation for surgery at a dose of 100 to 400 mg/day.

In patients who are not going to have surgery, Verospilactone can be used as long-term maintenance therapy at the lowest effective dose that is adjusted for the patient individually.

Prevent hypokalemia during treatment with saluretics: 25-100 mg/d.

Missed dose:Take the missed dose as soon as possible. Do not take it if there is no time left before the next dose. Do not take a double dose.

Interaction

Pharmacodynamic interaction

Veroshpilactone decreases vascular sensitivity to noradrenaline. This should be considered when performing general and local anesthesia in patients taking Verospilactone.

The simultaneous use of potassium-saving diuretics with indomethacin or ACE inhibitors leads to hyperkalemia. In combination with other diuretics and hypotensive drugs Veroshpilactone increases their effect. Therefore, when adding Veroshpilactone to the treatment regimen, the dosage of such drugs should be reduced.

Pharmacokinetic interaction

Spironolactone has been shown to increase the T1/2 of digoxin. This may lead to increased blood concentrations of digoxin up to toxic, so if they are taken together, the dose should be reduced or the interval between digoxin doses should be increased.

Acetylsalicylic acid attenuates the diuretic effect of spironolactone by blocking the secretion of the main metabolite, canrenone, in the renal tubules. Indomethacin and mefanamic acid have been shown to inhibit the excretion of canrenone.

Spironolactone enhances the metabolism of antipyrine.

Contraindications

Hypersensitivity, Addison’s disease, acute or rapidly progressing renal failure, chronic renal failure with significant reduction in excretory function (creatinine Cl less than 10 ml/min), anuria, hyperkalemia, hyponatremia, hypercalcemia.

With caution:. Reduced excretory renal function, impaired liver function (increased sensitivity to changes in electrolyte balance), diabetes mellitus (especially diabetic nephropathy), predisposition to metabolic acidosis (the hyperkalemic effect of spironolactone increases in acidosis, spironolactone may contribute to acidosis), menstrual disorders and/or increased breast glands, AV blockade (possible enhancement due to the development of hyperkalemia).

Side effects

Nervous system and sensory organs:dizziness, drowsiness, lethargy, drowsiness, headache, ataxia, confusion.

Gastrointestinal organs:nausea, vomiting, diarrhea, cramps, intestinal colic, gastritis, ulceration and bleeding in the GI tract, liver function disorders.

Urogenital system disorders:Gynecomastia (usually reversible, in rare cases may persist after withdrawal of the drug), pain in the mammary glands, erectile dysfunction in men, reduced potency in men, menstrual cycle disorders or amenorrhea, menopausal metrorrhagia, hirsutism, voice changes in women.

Skin side: maculopapular or erythematous skin rashes, alopecia, hypertrichosis, pruritus, urticaria.

Others:calf cramps, benign breast neoplasms, breast pain, leukopenia (including agranulocytosis), thrombocytopenia, electrolyte imbalance, hyperkalemia, increased blood urea nitrogen, creatinine, osteomalacia, drug fever.

Overdose

Symptoms: Nausea, vomiting, drowsiness, confusion, skin rash, diarrhea. Possible electrolyte imbalance and dehydration of the body.

Treatment: Veroshpilactone should be stopped immediately, vomiting should be induced and the stomach flushed.

There is no specific antidote. Symptomatic treatment of dehydration, electrolyte imbalances and arterial hypotension should be given.

The elimination of hyperkalemia is achieved by rapid administration of glucose (20-50% solutions) and insulin at the rate of 0.25-0.5 units of insulin per 1 g of glucose.

Potassium withdrawal diuretics and ion exchange resins are used.

Similarities