Veroshpiron tablets - official instructions for use

Use of Veroshpiron in pediatrics

As a diuretic drug, it is used in pediatrics to treat various diseases.
The dosage of the medicine and the duration of therapy can be determined solely by the attending physician, adjusted for the child’s medical history and his current state of health. The age limit for taking Veroshpiron is above 3 years. In practice, the medicine is prescribed to infants exclusively under the supervision of doctors.

Veroshpiron is prescribed in the following doses:

1. Daily dose – from 1 to 3 mg per 1 kg of body weight, divided into 1-4 doses.
2. After 5 days, the dosage is changed. You can increase the prescribed dose by a maximum of 3 times.

The drug is taken twice a day with an interval of 10-12 hours.

Children under 6 years of age are advised to take this drug as a last resort. For greater convenience for the child, if necessary, grind the tablet into a powder mixture and add to milk or water.

Infants experience bouts of vomiting after taking Veroshpiron. If vomiting occurs within half an hour after taking it, then you need to take the medicine again. If the gag reflex worked after half an hour or was absent altogether, repeated use is not required.

At what pressure and how to take it?

The diuretic effect of Veroshpiron helps reduce high blood pressure, so this drug is often included in treatment regimens for hypertensive conditions.

For arterial hypertension

Veroshpiron is not considered mandatory for arterial hypertension, but it is often prescribed if standard treatment regimens for hypertension do not produce a positive result. Excess aldosterone is often the reason why conventional treatments fail, and this can be determined by urine and blood tests to measure the amount of the hormone.

Experienced specialists do not prescribe Veroshpiron at the initial stage of hypertension. First they try to cope with safer drugs.

Most often, Veroshpiron is prescribed for malignant or essential hypertension, when the pressure remains above 140/90 and does not fall when taking other medications or even rises even higher. In this case, it is added to an already used treatment regimen or prescribed as the only medication.

Depending on the blood pressure and the patient’s condition, the doctor selects the required dosage. But the initial dose should not be less than 100 mg per day. The hypotensive effect is achieved 5 days after the start of treatment, but a lasting result appears no earlier than 2 weeks, and in some patients later.

Normal and abnormal blood pressure

After a stable result appears, patients are prescribed maintenance treatment - 25 mg per day. This dosage can be taken for a long time if adverse reactions occur in the body. During the period of therapy, it is necessary to measure blood pressure twice a day to monitor whether Veroshpiron has a positive effect or not.

With intracranial pressure

Veroshpiron is rarely prescribed for intracranial pressure, since its diuretic effect has virtually no effect on the fluid level in the skull. The use of the drug is justified only in combination with other drugs that affect the cause of the disease.

Usually, for intracranial pressure, it is prescribed in small dosages of 25-100 mg per day. After 5-10 days, reduce the frequency of dosing - it is recommended to take 25 mg every other day. If the results are good, the doctor may prescribe 25 mg every 3-4 days.

Physiology of intracranial pressure

Despite the instructions limiting the use of the drug to children under 3 years of age, Veroshpiron is prescribed even to infants suffering from intracranial pressure. But its use in infancy should be under the supervision of a doctor and with regular blood tests.

Adverse drug reactions

Side effects can affect the functioning of various organs and systems:

1. Nervous system: headache, lethargy, dizziness, ataxia, confusion, drowsiness, lethargy.
2. Digestion: diarrhea, nausea, constipation, abdominal pain and colic, vomiting, bleeding in the intestines and stomach, gastritis, liver dysfunction.
3. Circulatory system: megaloblastosis, thrombocytopenia, agranulocytosis.
4. Endocrine system: in women, menstruation disorders are possible (dysmenorrhea, amenorrhea, metrorrhagia during menopause), breast tenderness, breast cancer, hirsutism; in men, gynecomastia is likely to develop.
5. Immune system: allergies in the form of drug fever, urticaria, itching, skin rashes.
6. Kidneys: acute renal failure.
7. Muscular system: spasms and cramps in the muscles.
8. Skin and hair: hypertrichosis, baldness.
9. Metabolism: increase in blood concentrations of urea, uric acid and creatinine, decrease in blood sodium concentration, hyperchloremic alkalosis, acidosis.

Side effects

Depending on the patient’s well-being, the following side effects sometimes occur:

bowel dysfunction (constipation or diarrhea);

exacerbation of gastritis, as well as various pains in the abdominal area;

• gastrointestinal bleeding;
• severe swelling in the legs;
• difficult liver function;
• severe renal failure with a significant increase in potassium levels;
• cramps of the calf and other muscles;
• various allergic reactions;
• dizziness and confusion;
• excess hair growth, baldness;
• problems with menstruation, pain in the mammary glands;
• decreased immunity and others.

After stopping the drug, most side effects gradually disappear.

• pain in the abdomen;
• bleeding from the gastrointestinal tract;
• vomiting reflex;
• nausea;
• problems with bowel movements;
• slow reaction;
• dizziness;
• increased fatigue;
• hoarseness of voice;
• headache;
• disruption of the menstrual cycle;
• pain in the mammary glands;
• itching and burning of the skin;
• decreased potency in men;
• hives.

• pain in the gastrointestinal tract;
• stomach bleeding;
• attacks of nausea;
• gagging;
• urinary disorders;
• lethargy;
• weakness;
• headaches;
• disruptions in the menstrual cycle;
• itching of the skin;
• pemphigus;
• vertigo.

Interaction with other drugs

Before starting therapy with Veroshpiron, you must notify your doctor about taking other medications to avoid complications of treatment. Veroshpiron has the following interactions with drugs:

• Anticoagulants – reduces their effectiveness.
• Cardiac glycosides – reduces toxicity.
• Norepinephrine - reduces the sensitivity of blood vessels to it.
• Mitotane - reduces its effectiveness.
• Diuretics and antihypertensive drugs – increases their effectiveness.
• Phenazol – enhances its absorption by the body.
• Preparations containing lithium – increases their toxicity.
• Carbenoxolone - accelerates its exit from the body, simultaneous use leads to sodium retention in the blood.
• Buserelin, Gonadorelin – increases efficiency.
• Salicylates - combined use reduces the diuretic effect.
• Potassium-sparing and potassium-containing drugs, aldosterone receptor antagonists, angiotensin II receptor blockers - combined use contributes to the development of hyperkalemia.
• Cholestyramine, ammonia - simultaneous use increases the risk of increasing the acid balance of the body.
• Antipyretics - simultaneous use may develop hyperkalemia.

Features of taking veroshpiron and possible side effects

Taking the drug is often accompanied by a number of side effects:

• nausea, vomiting, diarrhea, abdominal pain, constipation, liver problems

• lethargy, drowsiness, headache, confusion
• disturbances of water-salt metabolism and changes in some laboratory parameters
• deepening of the voice, menstrual irregularities, the appearance of breakthrough menstrual-like bleeding, pain in the mammary glands
• the occurrence of allergic reactions, itching
• renal dysfunction
• cramps of the calf muscles

While taking veroshpiron, the following is prohibited:

• drinking alcohol
• at the beginning of treatment - performing activities that require increased attention (for example, driving a vehicle)
• eating foods rich in potassium (bananas, oranges, grapefruits, prunes, tomatoes, apricots)

The dosage, duration, and phase of the menstrual cycle suitable for treatment with veroshpiron are determined by the doctor for each woman individually, depending on the type, severity of the disease and the body’s response to the drug. In order to prevent the occurrence of breakthrough bleeding and other menstrual irregularities, it is possible to take the drug simultaneously with oral contraceptives.

How does the medicine work?

The spironolactone molecule has a steroid core; its structure is similar to aldosterone. The main action of aldosterone is to regulate fluid, sodium and potassium in the body. Long-term increased production of this hormone leads to hypertension, metabolic disorders, and accelerated development of complications of vascular, heart, and kidney diseases. Receptors that can bind to aldosterone are found in the kidneys, blood vessels, intestines, heart, brain, and fatty tissue.

The active substance of Veroshpiron, spironolactone, is an aldosterone antagonist. It binds to the same receptors, thereby preventing the hormone from working. Blocking receptors with spironolactone in the distal renal nephrons leads to increased excretion of fluid, sodium and chlorine through the kidneys. Potassium is retained in the body due to the suppression of the potassium-removing effect of aldosterone. The higher the patient’s aldosterone level, the more effective Veroshpiron will work.

Removing excess fluid leads to relaxation of blood vessels and a decrease in pressure. According to reviews from patients who took the drug, its diuretic effect is mild, in strength and duration it is significantly inferior to loop diuretics - torasemide and furosemide, and does not appear immediately - usually after 3-5 days. But inhibition of calcium excretion begins after taking the first tablet.

Veroshpiron is a relatively weak but long-acting medicine. This is due to the fact that spironolactone metabolites are also active. For spironolactone, the half-life reaches 1 day, for its metabolites - 4 days, so the effect of Veroshpiron lasts for several days.

Composition and properties

"Veroshpiron" is a diuretic. In addition to being a diuretic, the drug has the property of lowering blood pressure. The drug is classified as an aldosterone antagonist. The main substance in the medicine is spironolactone. The substance determines the abilities of the drug. In addition to it, the composition includes substances, the descriptions of which are presented in the table.

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Medicine Inspra

This drug was developed relatively recently. Its effect on the body is similar to the drug "Veroshpiron". However, the drug "Inspra" has fewer side effects. This medication is often recommended for the treatment of men who are afraid of unpleasant consequences from therapy with the original remedy.

Therefore, if you are interested in an analogue of “Veroshpiron” (without gynecomastia), then pay attention to the medicine “Inspra”

However, you should not replace the drug yourself. The drug "Inspra" has a smaller list of indications. It is effective for heart failure and helps cope with the consequences of heart attacks. However, the medication is not prescribed for hypertension. Liver cirrhosis is also not an indication for use.

The medicine "Inspra" is rarely prescribed to patients, since the price of the medicine is 2500-2650 rubles.

What does Veroshpiron help with?

Indications for use of the drug include:

• primary hyperaldosteronism (Conn's syndrome) - for a short preoperative course of treatment;
• essential hypertension (as part of combination therapy);
• to establish the diagnosis of primary hyperaldosteronism;
• hypokalemia/hypomagnesemia (as an adjuvant for its prevention during treatment with diuretics and when it is impossible to use other methods of correcting potassium levels).

Why is Veroshpiron still prescribed? Doctors prescribe this medicine to patients if they have:

• conditions in which secondary hyperaldosteronism can be detected, incl. liver cirrhosis, accompanied by ascites and/or edema, nephrotic syndrome and other conditions accompanied by edema;
• edema syndrome in chronic heart failure (can be used as monotherapy and in combination with standard therapy).

Veroshpiron side effects

Adverse events associated with taking spironolactone are rare, but they include an extensive list of pathological conditions. Veroshpiron - side effects of use:

• vomit;
• diarrhea;
• nausea;
• gastritis;
• ulcerations in the gastrointestinal tract;
• constipation;
• intestinal colic;
• epigastric pain;
• liver function disorders;
• dizziness;
• ataxia;
• drowsiness;
• lethargy;
• confusion;
• lethargy;
• headache;
• thrombocytopenia;
• agranulocytosis;
• megaloblastosis;
• hypercreatininemia;
• hyperuricemia;
• alkalosis;
• hyponatremia;
• metabolic acidosis;
• hyperkalemia;
• deepening of the voice;
• gynecomastia;
• dysmenorrhea;
• cycle disorders;
• hirsutism;
• metrorrhagia;
• amenorrhea;
• itchy skin;
• hives;
• fever;
• hypertrichosis;
• renal failure;
• alopecia;
• convulsions;
• muscle spasms.

Side effects

• agranulocytosis, thrombocytopenia, megaloblastosis;
• alopecia;
• amenorrhea;
• ataxia;
• pain in the mammary glands;
• abdominal pain;
• gastritis;
• hyperuricemia, hypercreatininemia, increased urea concentration, hyperkalemia, hyponatremia;
• hirsutism;
• headache;
• dizziness;
• diarrhea;
• dysmenorrhea;
• constipation;
• lethargy;
• itching;
• ulcerations and bleeding from the gastrointestinal tract;
• intestinal colic;
• hives;
• drug fever;
• metrorrhagia during menopause;
• muscle spasm;
• deepening of the voice;
• acute renal failure;
• decreased potency and erection;
• drowsiness;
• confusion;
• cramps of the calf muscles;
• nausea, vomiting;
• in women - menstrual irregularities;
• in men - gynecomastia (the likelihood of development depends on the dose, duration of treatment and is usually reversible and disappears after discontinuation of Veroshpiron, only in rare cases the mammary gland remains slightly enlarged).

Instructions for use of Veroshpiron: method and dosage

• For essential hypertension, the daily dose for adults is 50-100 mg once and can be increased to 200 mg. The dosage is increased gradually - once every 2 weeks. The minimum duration of treatment is 2 weeks.
• For idiopathic hyperaldosteronism, the dosage of the drug is 100-400 mg/day.
• For severe hyperaldosteronism and hypokalemia, the daily dose is 300 mg (maximum 400 mg) in 2-3 doses. After the condition improves, the dose is gradually reduced to 25 mg/day.
• For hypokalemia and/or hypomagnesemia, Veroshpiron is prescribed at a dose of 25-100 mg/day, once or in several doses. The maximum daily dose should not exceed 400 mg.
• When diagnosing and treating primary hyperaldosteronism, Veroshpiron is prescribed as a diagnostic agent for a short diagnostic test at 400 mg/day for 4 days. The daily dosage is evenly distributed into several doses throughout the day. If the concentration of potassium in the blood increases while taking the drug and decreases after its discontinuation, the presence of primary hyperaldosteronism can be assumed.
• For a long-term diagnostic test, the drug is prescribed at a dosage of 400 mg/day (3-4 times a day) for 3-4 weeks. When correction of hypokalemia and arterial hypertension is achieved, the presence of primary hyperaldosteronism can be assumed.
• After confirming the diagnosis of hyperaldosteronism, a dosage of 100-400 mg is prescribed as a short course of preoperative therapy, divided into 1-4 doses throughout the entire period of preparation for surgery.
• If surgery is not indicated, then it is used for long-term maintenance therapy, using the lowest effective dose, which is selected individually for each patient.
• When treating edema due to nephrotic syndrome, the daily dose for adults is usually 100-200 mg.
• In case of edema syndrome against the background of chronic heart failure, the drug is prescribed daily for 5 days, 100-200 mg/day in 2-3 doses, in combination with a loop or thiazide diuretic. In some cases, the daily dose is reduced to 25 mg. The maintenance dose is selected individually. The maximum daily dose is 200 mg.
• For edema due to liver cirrhosis, the daily dose of Veroshpiron for adults is usually 100 mg if the ratio of sodium and potassium ions (Na+/K+) in the urine exceeds 1.0. If the ratio is less than 1.0, then the daily dose is usually 200-400 mg. The maintenance dose is selected individually.
• For edema in children, the initial dose is 1-3.3 mg/kg body weight or 30-90 mg/m2/day in 1-4 doses. After 5 days, the dose is adjusted. If necessary, it is increased 3 times.

Release form and dosage

Veroshpiron can be purchased in tablets (containing 25 mg of spironolactone) and capsules (dosage 50 and 100 mg).
How much does the medicine cost:

• the price of a package containing 20 tablets is about 90 rubles,
• 30 capsules of 50 mg will cost 185 rubles,
• 30 capsules 100 mg - 295 rubles.

Recommended dosage instructions for use:

In reviews of Veroshpiron, there are often cases of its uncontrolled use as a diuretic. Taking this drug on your own for swelling of the face, for weight loss, or for hair loss is strictly prohibited. Even in small dosages, Veroshpiron is far from being as harmless a drug as is commonly believed. Taking it on your own initiative, without prior examination and supervision by a doctor, will not only not bring any benefit, but may also worsen the situation.

Indications

The medicine "Veroshpiron" (instructions, analogues are given below) is prescribed to patients who have been diagnosed with complex cases of hypertension. The drug has a strong diuretic effect, which helps get rid of swelling. The release form of the medicine is tablets or capsules with a gelatin body. The main active ingredient is spironolactone.

The medication in question is prescribed for the treatment of the following diseases:

1. Hypertension complicated by hypokalemia.
2. Kidney failure, accompanied by swelling and the presence of protein in the urine.
3. With secondary idiomatic hyperaldosteronism.
4. If a diagnosis of liver cirrhosis is made with resulting accumulations of transudate in the abdominal cavity and edema.
5. In case of a critical decrease in the level of potassium in the body.
6. For tissue swelling due to chronic heart problems.

Analogs and prices for medicines

The cost of the drug Veroshpiron in the form of tablets in Russian pharmacy chains is about 70 rubles per package and more. Capsules may cost a little more. Their cost starts from 140 rubles or more, however, there is more drug in the package. You can purchase medicine only upon presentation of a doctor's prescription.

Veroshpiron has analogues that are cheaper and more expensive than their own cost. Among them are three main medicines:

• Spironolactone (analogue of the main component in tablets, package cost - from 40 rubles),
• Inspra (active component – ​​Eplerenone, price – about 2500 rubles, an analogue is used when it is impossible to use products with spirolactone),
• Veroshpilactone (a complete analogue of the product, price - from 50 rubles per pack of tablets or capsules).

You cannot purchase any analogues of the product yourself, regardless of the reasons. In addition, all of them are also sold from pharmacy chains only upon presentation of a doctor’s prescription.

Caution when it is better to refrain from taking the drug

Even if there are indications for taking Veroshpiron, but the patient has an excess of potassium, sodium deficiency, kidney problems, allergies, then you should stop using it. This diuretic is not prescribed during breastfeeding (if this is not possible, then the baby will have to be transferred to IV). The question of the advisability of its use by a pregnant woman is decided by the doctor.

Contraindications also include:

• diabetes;
• adrenal insufficiency;
• Addison's disease;
• reduction or complete cessation of urination;
• first trimester of pregnancy;
• liver failure;
• disturbance of acid-base balance in the body (metabolic acidosis).

Particular caution should be exercised when prescribing Veroshpiron to elderly people, women with dysmenorrhea, as well as during local anesthesia and general anesthesia

Contraindications for use

Veroshpiron should be used with extreme caution at low blood pressure. Patients with hypotension should always consult a doctor, as this drug is intended for hypertensive patients. Pay attention to the composition of the tablets or capsules: whether you are sensitive to any of the components. People suffering from severe renal failure, pregnant women, nursing mothers, children under three years of age and those who are lactose intolerant should not use the medicine. People with liver failure, diabetes mellitus, menstrual irregularities, and the elderly should definitely consult with their doctor.

You should take medicine very carefully in case of complex diseases in the heart muscle

Directions for use and dosage

Drinking alcoholic beverages is not compatible with taking Veroshpiron. Therefore, it is recommended to abstain from drinking alcohol during treatment.

During the appointment, you should refrain from driving vehicles and working with mechanisms that require fixation of attention.

As stated above, the drug Veroshpiron in the form of capsules or tablets is taken orally with plenty of liquid.

1. In case of heart failure or swelling, Veroshpiron is prescribed to be taken for 5 days, 100-200 mg per day, i.e. 2-3 doses of the drug. It must be combined with a thiazide diuretic (medium strength diuretics). The maximum dose per day reaches 200 mg.
2. In cases of nephrotic syndrome, the daily dose is 100-200 mg. Studies have not revealed the effect of the functional substance of Veroshpiron - spironolactone - on defective functioning in the body, therefore Veroshpiron is prescribed only in cases where other therapies have not proven their effectiveness.
3. In cases of primary hypertension, Veroshpiron is taken in an amount of 50-100 mg at a time, in the future it is possible to gradually increase the dosage to 200 mg. The dosage used should be increased every two weeks. To determine the effectiveness of therapy, it is recommended to use the drug for at least 2 weeks.
4. If there is a lack of potassium in the blood, the drug is prescribed at a dosage of 25-100 mg 2-3 times, depending on the concentration of potassium in the patient’s body.
5. In cases of diagnostics that determine the level of kidney activity and the production of the hormone aldesterone, the drug Veroshpiron is taken once at a dosage of 100-200 mg.
6. For swelling due to liver cirrhosis, the drug is prescribed in a dose of 100-400 mg, depending on the concentration of potassium and sodium ions. Further therapy is prescribed individually.
7. Preparation for surgical operations and the rehabilitation period for hyperaldosteronism are prescribed 100-400 mg per day.
8. In cases of edema in children, the drug is prescribed at the rate of 1-3 mg of active substance per 1 kg of weight of a child over 3 years old.

In case of an overdose of Veroshpiron, the following symptoms may be observed:

• Abdominal pain, nausea, vomiting.
• Lethargy, drowsiness.
• Dehydration.
• Dry mouth.
• Hyperkalemia, which is accompanied by tachycardia and convulsions.
• Skin rash.

When the prescribed dose has been exceeded, the stomach must be rinsed, causing an attack of vomiting and immediately consult a doctor.

Composition, release form and mechanism of action

The active ingredient of the drug is spironolactone. Auxiliary ingredients: silicon, magnesium, talc, lactose, corn starch. Available in flat, round tablets, with a bevel, a specific odor and the inscription of the name of the drug in Latin letters on one side. Packed in cardboard or propylene boxes.

Capsules – 50 and 100 mg, elastic gelatin, cap – yellowish, not transparent. The body is light and impenetrable. The contents of the capsules look like white granular powder.

The diuretic drug "Veroshpiron" is produced in tablets, each of which contains 25 mg of the active ingredient - spironolactone. The medicine is packaged in cardboard packages of 20 or 100 tablets. The additional components are:

• food additive E171;
• colloidal silicon dioxide;
• dyes;
• food emulsifier E572;
• corn starch;
• talc;
• milk sugar;
• gelatin.

• disruptions in kidney function;
• diabetes;
• individual intolerance to certain substances in the composition of the drug;
• adrenocortical insufficiency;
• increased accumulation of calcium and potassium in the blood plasma;
• disturbances in liver function;
• pregnancy period;
• diseases of the reproductive system.

Prescribe a diuretic with care in the following situations:

• heart block;
• surgical interventions;
• use of hormonal medications;
• old age.

Special instructions for the use of the drug Veroshpiron

During treatment with Veroshpiron, a transient increase in urea nitrogen in the blood is possible, especially if the drug is used with reduced renal function and hyperkalemia, as well as the development of moderate reversible hyperchloremic metabolic acidosis

In this regard, in patients with kidney and liver diseases and in the elderly, it is necessary to systematically monitor serum electrolytes and indicators of renal function. The use of Veroshpiron makes it difficult to determine the content of digoxin in the blood serum, cortisol and adrenaline in the blood plasma. Although the drug does not have a direct effect on carbohydrate metabolism, when used in patients with diabetes mellitus, especially with diabetic nephropathy, special care must be taken due to the risk of hyperkalemia. Patients receiving Veroshpiron should not be additionally prescribed potassium supplements or a diet high in potassium, as this may cause hyperkalemia. Also, Veroshpiron should not be prescribed in combination with other drugs that cause potassium retention.

The risk of developing hyperkalemia is increased in patients with insufficient renal function. During the initial period of use of the drug, the duration of which is determined individually, it is prohibited to drive vehicles and perform other work that requires speed of physical and mental reactions. In the future, the possibility of their implementation is determined individually. It is prohibited to drink alcohol while taking Veroshpiron. It is advisable to use Veroshpiron in combination with other diuretics, limiting the use of table salt and liquid; if necessary, maintain bed rest. For children under 6 years of age, the drug is prescribed in tablet form.

Veroshpiron - contraindications

There are diseases for which spironolactone is absolutely prohibited, and conditions where it can be used with caution. In the first case, Veroshpiron should be replaced - the effect of the medication will only cause harm. Direct contraindications for use:

• hyperkalemia;
• Addison's disease;
• severe renal failure;
• hyponatremia;
• lactose intolerance;
• anuria;
• syndrome of impaired absorption of glucose or galactose;
• pregnancy;
• lactase deficiency;
• age up to 3 years;
• lactation;
• hypersensitivity to any ingredient of the drug.

In other situations, only the doctor decides how appropriate it is to prescribe Veroshpiron - indications for use may include the following diseases that require careful use of a diuretic:

• metabolic acidosis;
• hypercalcemia;
• diabetes;
• AV block;
• menstruation disorders;
• liver failure;
• diabetic nephropathy;
• pathological enlargement of the mammary glands;
• cirrhosis of the liver;
• elderly age.

How to take it correctly

In order to obtain the effect described in the instructions for use from taking Veroshpiron and avoid its side effects, the following rules must be followed during treatment:

Possible side effects

In addition to the fact that spironolactone is an aldosterone antagonist, it also affects other receptors: it partially blocks androgen and corticosteroid receptors, and binds to progesterone receptors. Often this effect of Veroshpiron is undesirable and provokes side effects.

Among the side effects described in the instructions, the most dangerous are:

1. Hyperkalemia. The risk of development is estimated by various studies at 2-12%. Severe hyperkalemia (potassium level greater than 6) takes time to develop, so it can be prevented by periodic blood testing. If the patient does not have a potassium deficiency, it is not advisable to combine Veroshpiron with potassium supplements, NSAIDs, or group analogues of spironolactone.
2. Hypertrophy of the mammary glands in men may be accompanied by pain. This side effect is dose-dependent: it occurs more often with long-term use of Veroshpiron in high dosages. The incidence is 10% (compared to 1% in the placebo group). More often, hypertrophy is reversible, that is, it disappears after stopping the medication.
3. Changes in hormonal levels in men can be accompanied by impotence and deterioration of erection. Reviews of the drug note that these disturbances are temporary.
4. In women, menstrual irregularities, male-pattern hair growth on the face and chest, and chest pain are possible.
5. Some studies have shown an increase in the risk of breast cancer, but a connection with taking Veroshpiron could not be established.
6. The effect on hormones can lead to alopecia, including in women.
7. The drug may cause allergic reactions. They are usually limited to rash and itching. Angioedema was not recorded.
8. If kidney function is impaired, an increase in blood urea and acidosis are possible. These side effects are usually temporary and reversible.

Data on the frequency of side effects are not given in the instructions for use. According to the results of the study (1663 patients participated for 2 years), 82% of patients taking Veroshpiron and 79% of those in the placebo group complained of health problems.

pharmachologic effect

• Veroshpiron realizes its diuretic and hypotensive effect due to a special interaction with aldosterone (a hormone secreted by the adrenal cortex), which consists in blocking the functions of the hormone by binding to its receptors.
• The main purpose of the drug is to remove fluid from the body, that is, to have a diuretic effect. The peculiarity of Veroshpiron, which distinguishes it from other diuretic drugs, is that it does not remove potassium from the body, but promotes its accumulation. Belongs to the group of potassium-sparing diuretics. However, this drug removes sodium and chlorine in the same way as other diuretics.
• Due to the diuretic effect, which occurs 2-5 days after the start of use, the hypotensive (lowering blood pressure) effect of the drug is also achieved.
• Acting in the skin, hair follicles, sebaceous and sweat glands, Veroshpiron reduces the rate of processing of testosterone (male sex hormone).
• The active substance is completely absorbed from the gastrointestinal tract, binds to blood proteins, turns into metabolites (which penetrate the placental barrier and breast milk), and is partially excreted in the urine (60%) and partially in the feces (40%).

Pharmacological properties of Veroshpiron

According to the instructions, Veroshpiron is a competitive antagonist of the mineralocorticoid aldosterone, a special hormone produced by the adrenal cortex. The medicine produces a pronounced diuretic effect, but does not significantly affect renal blood circulation and the functioning of the renal tubules, and does not disrupt the acid-base state in the body.

After oral administration, the medicine is completely and quickly absorbed from the gastrointestinal tract. The bioavailability of Veroshpiron, according to the instructions, reaches almost 100 percent, and food intake makes this figure maximum. The highest content of the drug in the blood is 80 ng/ml, subject to daily use of a dose of 100 mg for two weeks. After the next dose in the morning, Cmax is observed after 2-6 hours.

The drug binds to blood proteins by 98 percent. The active component spironolactone penetrates tissues and organs poorly, however, it has the ability to penetrate the placental barrier in its original form and in the form of metabolites. The drug is also found in mother's breast milk.

The half-life of Veroshpiron, according to the instructions, is 13-24 hours. For the most part, the drug is excreted in the urine - 50% of the dose taken in the form of metabolites and unchanged - 10%. Minor excretion occurs through the intestines. Canrenone (the active metabolite of spironolactone) leaves the body in two stages: within 2-3 hours after administration - half and within 12-96 - the remaining amount.

In heart failure and liver cirrhosis, the half-life of Veroshpiron increases without signs of accumulation, the risk of which is higher with hyperkalemia and renal failure.

Instructions for use

The prescribed single dose of the drug is swallowed whole.

It is important to take Veroshpiron after meals. Recommended time for taking the daily dosage or its first part in the morning (before lunch)

If there is a need to divide the dose into 2 doses, then the second part should be taken no later than 20-00 in the evening (after lunch).

Dosage regimen for elevated aldosterone (testosterone):

When planning surgical intervention, the daily dose is 100-400 mg of Spironolactone. If surgical treatment is not planned, then the dosage is selected individually and is the minimum at which the required effect is achieved.

Course of treatment for edema of various etiologies:

The recommended starting dosage is 100 mg. If necessary, a dose of 25 mg can be prescribed or increased to 200 mg. The duration of treatment is determined by the doctor.

Directions for use for liver cirrhosis:

The initial dosage is 100 mg, in more severe cases - 200 mg. The maximum dose of Spironolactone per day is 400 mg. As the condition improves, the dose is reduced. The duration of treatment is selected by the doctor individually.

Treatment of hypertension:

The recommended dosage of Veroshpiron is 50-100 mg per day. As a rule, the drug is used in combination with antihypertensive drugs.

Therapy for hypokalemia:

To normalize the level of Potassium in the blood, Veroshpiron should be taken at a dose of 25-100 mg.

Use in childhood:

The initial dose should be 1-3 mg per kilogram of the child’s weight. Maintenance dosage - 1-2 mg per kilogram of body weight. For children under 5 years of age (especially infants and children under one year old), a single dose in tablet form is dissolved in a small amount of water and taken as a suspension.

Indications for use, dosage and instructions

By itself, Veroshpiron 100 mg is not the main drug that eliminates the causes of the disease and the disease itself. It is usually prescribed in combination with other drugs to eliminate the symptoms of essential hypertension. Its use also occurs in the following pathologies:

• nephrotic syndrome,
• Increased pathological swelling,
• Reduced levels of potassium and magnesium in the body,
• Kohn syndrome,
• Cirrhosis.

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The drug is also used for diagnostic purposes to establish the diagnosis of Primary hyperaldosteronism.

Veroshpiron (INN spironolactone) in tablets and capsules should be taken in the same dosages. In case of swelling, you must use the following instructions:

1. Edema caused by nephrotic syndrome: 100-200 milligrams per day for adults.
2. Caused by CHF: the same dosage for 5 days. When combined with other diuretics, the dose can be gradually reduced to 25 milligrams.
3. Cirrhosis: 100 to 400 milligrams.
4. Children's pathologies: from 1 milligram per kilogram of body weight. The dosage changes over time.

For other diseases:

1. Hypertension: once in a volume of 50 to 100 milligrams.
2. Potassium and magnesium deficiency: 25 to 100 milligrams per day, depending on the severity of the problem.
3. Hyperaldosteronism: from 100 to 400 milligrams per day, depending on the type of disease and its severity. Over time, it is allowed to reduce the dosage (gradually) to 25 milligrams per day.

For diagnostic studies, the daily dosage can be increased to 400 milligrams, and the medicine will need to be taken for four days.

The drug should be taken with a small amount of water after meals. The standard duration of treatment is twenty days. It can be repeated only after six months. The exact dosage, based on the individual characteristics of the patient, is determined by the attending physician.

Overdose

Symptoms of overdose: nausea, vomiting, dizziness, decreased blood pressure, diarrhea, skin rash, hyperkalemia (paresthesia, muscle weakness, arrhythmias), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increased urea concentration.

Treatment includes gastric lavage and symptomatic treatment of dehydration and arterial hypotension.

In case of hyperkalemia, it is important to normalize water-electrolyte metabolism with the help of potassium-removing diuretics, rapid parenteral administration of dextrose solution (5-20% solutions) with insulin at the rate of 0.25-0.5 units per 1 g of dextrose. In severe cases, hemodialysis is performed

Indications for use

Instructions for use provide a list of indications for the use of the drug. Mainly "Veroshpiron" treats swelling. The cause of fluid stagnation in the body may be a problem with the cardiovascular or endocrine systems. The capsules also help with high blood pressure. When a person is admitted to the hospital with cerebral edema, he is prescribed Veroshpiron. The reason for taking it is paralysis due to low levels of calcium in the blood and severe burns. It is prohibited to use the drug on your own, as you can miscalculate the dosage and cause low blood pressure.

Side effects

Frequent adverse reactions are the following:

• hyperkalemia;
• heart rhythm disturbances;
• nausea;
• bouts of vomiting;
• drowsiness;
• erectile dysfunction;
• decreased libido in adults;
• polycystic ovary syndrome;
• disturbances of menstruation (menstruation), which leads to gynecological problems in women;
• gynecomastia.

Rare adverse reactions:

• allergy;
• dehydration;
• decreased sodium levels in the blood;
• headache;
• disturbances of consciousness;
• gastritis;
• stomach ache;
• hirsutism;
• hair loss;
• muscle weakness;
• rashes on the body. Sometimes people taking Veroshpiron suffer from acne;
• severe decrease in pressure;
• kidney failure.

Compliance with the correct dosage indicated in the annotation is a measure to prevent side effects.

Veroshpiron during pregnancy

Initially, this drug positions itself as a diuretic drug that is used during edema caused by various diseases. However, Veroshpiron also has another, no less important property - it lowers the level of male hormones. Quite often, it is their excess amount that prevents a woman from becoming pregnant.

The instructions for use clearly state that pregnancy is one of the contraindications for the use of this medication. However, why do some doctors still prescribe it? Will this leave a negative imprint on the child in the future? Not enough research has been conducted in this area, but practice states that in the history of treatment with this medicine there have been no facts that it led to any pathologies of the fetus. No abnormalities were also found in children who were exposed to it for some time. This guides those who prescribe Veroshpiron when planning pregnancy. The other side emphasizes that in modern medicine there are a lot of medications, and choosing a more reliable analogue is better than risking your health and that of your baby.

If Veroshpiron was prescribed during pregnancy, it would be useful to consult with another specialist, and only after several conclusions can you begin a course of treatment. It is recommended to replace Veroshpiron with any of its analogues approved for the treatment of pregnant women.

Indications

Most often, this medication is prescribed for edema, which is a symptom of various diseases:

• Essential hypertension (high blood pressure);
• Secondary hyperaldosteronism (increased aldosterone levels);
• Cirrhosis of the liver;
• Nephrotic syndrome;
• Ascites;
• Prevention of hypokalemia (lack of potassium in the body);
• Used to diagnose hyperaldosteronism;
• Edema resulting from chronic heart failure.

Contraindications

Veroshpiron cannot be used in all situations. Exceptions include:

• Pregnancy, especially the first trimester;
• Lactation period;
• Hyponatremia (low sodium concentration in blood plasma);
• Hyperkalemia (increased potassium levels in the body);
• Anuria (a problem in which urine does not flow into the bladder);
• Acute renal failure;
• Individual intolerance to any reagents of the drug;
• Lactose deficiency;
• Age less than three years;
• Addison's disease;

Important! This medication can only be used at the planning stage of pregnancy and as prescribed by a doctor.

In addition, there are a considerable number of cases when Veroshpiron needs to be used with extreme caution.

Important! A complete list of all contraindications can be found in the attached instructions.

Side effects

Veroshpiron is a rather strong medicine; it can cause a number of complications, which include:

From the gastrointestinal tract:

• Diarrhea;
• Nausea;
• Vomit;
• Gastritis;
• Internal bleeding;
• Constipation.

Kidneys:

• Kidney failure.

Nervous system:

• Headache and dizziness;
• Drowsiness;
• Lethargy;
• Confusion.

Circulatory system:

• Thrombocytopenia;
• Agranulocytosis (decreased white blood cell count);
• Megaloblastosis.

Immunity:

• Allergies (itching, redness of the skin, rash).

Muscles:

• Spasms;
• Cramps.

Endocrine organs:

• In women, the menstrual cycle is disrupted, pain in the mammary glands, hirsutism (hair takes on a masculine “character”), and, less commonly, breast cancer;
• In men - gynecomastia (enlargement of the mammary glands).

Interaction with other drugs

The use of Veroshpiron can have many adverse reactions, if you notice them, you must immediately stop treatment. These include:

• Digestive system - nausea, vomiting, ulcers, erosions and bleeding, diarrhea, inflammation of various types, constipation, pain in the abdomen, liver dysfunction.
• Nervous system – headaches, dizziness, lethargy, drowsiness, motor system disorders.
• Circulatory system - a decrease in the number of platelets in the blood, a sharp decrease in the number of leukocytes, megaloblastosis.
• Hormonal system - enlargement of the mammary glands and pain in them, impaired potency in men, disturbance or absence of the menstrual cycle, increased hair growth.
• Urinary system – acute kidney dysfunction.
• Immune system - various rashes on the skin, urticaria, swelling of the skin and subcutaneous fat on the face, anaphylactic shock.
• Muscles - spasms, cramps.

Before starting therapy with Veroshpiron, you must notify your doctor about taking other medications to avoid complications of treatment. Veroshpiron has the following interactions with drugs:

• Anticoagulants – reduces their effectiveness.
• Cardiac glycosides – reduces toxicity.
• Norepinephrine - reduces the sensitivity of blood vessels to it.
• Mitotane - reduces its effectiveness.
• Diuretics and antihypertensive drugs – increases their effectiveness.
• Phenazol – enhances its absorption by the body.
• Preparations containing lithium – increases their toxicity.
• Carbenoxolone - accelerates its exit from the body, simultaneous use leads to sodium retention in the blood.
• Buserelin, Gonadorelin – increases efficiency.
• Salicylates - combined use reduces the diuretic effect.
• Potassium-sparing and potassium-containing drugs, aldosterone receptor antagonists, angiotensin II receptor blockers - combined use contributes to the development of hyperkalemia.
• Cholestyramine, ammonia - simultaneous use increases the risk of increasing the acid balance of the body.
• Antipyretics - simultaneous use may develop hyperkalemia.

Medicine Veroshpiron

According to the pharmacological classification, the drug belongs to the potassium-sparing diuretics. Veroshpiron can be prescribed only according to indications - the instructions for use indicate possible negative side effects and overdose if the prescribed recommendations are not followed. The medication has a pronounced diuretic effect and eliminates swelling.

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The active substance spironolactone, according to the instructions, is a component that acts opposite to the adrenal hormone aldosterone. Acts in the kidney department - nephron, eliminates fluid and sodium retention, suppresses the potassium-removing effect.

Spironolactone interferes with the production of kidney tubular enzymes. By binding to receptors, it increases the excretion of sodium and chlorine ions with water and urine, reduces the loss of potassium ions, and reduces the acidity of urine.

After administration, it is completely absorbed from the gastrointestinal tract, bioavailability is 100%, consumption of food increases it to the maximum. Spironolactone reaches its highest concentration 2-6 hours after morning administration.

The main metabolite of spironolactone is canrenone, and alpha-thiomethylspironolactone is also formed. They bind to plasma proteins up to 90%, reaching maximum concentrations after 2-4 hours. Substances are excreted by the kidneys and intestines.

According to the instructions for use, the drug Veroshpiron is prescribed to patients for the following indications:

• essential hypertension (included in combination treatment);
• edema syndrome coupled with chronic heart failure;
• secondary hyperaldosteronism and conditions in which it can be detected - liver cirrhosis, ascites, edema, nephrotic syndrome;
• hypokalemia or hypomagnesemia;
• primary hyperaldosteronism or Conn's syndrome.

The instructions say that the use of Veroshpiron may affect the effectiveness of other medications:

• reduces the effect of anticoagulants, coumarin, heparin, and the toxicity of cardiac glycosides;
• increases the toxicity of digoxin and lithium due to decreased clearance;
• enhances the metabolism of carbenoxolone, which ensures sodium retention;
• increases the effect of furosemide and antihypertensive drugs;
• potassium preparations, potassium supplements, aldosterone effect blockers, potassium-sparing diuretics increase the risk of developing hyperkalemia;
• salicylates reduce the diuretic effect;
• taking ammonium chloride, cholestyramine together with Veroshpiron develops metabolic acidosis;
• Fludrocortisone increases tubular secretion of potassium.

Veroshpiron is usually prescribed by endocrinologists. This is what these pills are prescribed for:

• edema caused by heart failure;
• disturbances in the functioning of endocrine organs (multiple cysts on the ovaries, hirsutism, Conn's disease);
• arterial hypertension;
• ascites (with liver cirrhosis);
• cerebral edema;
• paroxysmal myoplegia caused by calcium deficiency;
• myasthenia gravis;
• nephrotic syndrome;
• massive burns;
• swelling during pregnancy.

The article describes the use of the drug "Veroshpiron", for which it is not recommended to take it. It also contains information about contraindications and side effects.

annotation

Many patients are concerned about the question, what is Veroshpiron used for? It turns out that the list of uses for this diuretic potassium-sparing agent is quite wide. The main active ingredient is Spironolactone, and the medication is produced in the form of capsules and film-coated tablets.

The main purposes of the drug are:

• Polycystic ovary syndrome, premenstrual syndrome, hirsutism
• Diagnosis of hyperaldosteronism
• Myasthenia (auxiliary drug)
• Aldosterone-producing adrenal adenoma
• Arterial hypertension
• Primary hyperaldosteronism
• Hypokalemia
• Edema syndrome, nephrotic syndrome, liver cirrhosis, edema during pregnancy

It is prohibited to prescribe medication for a diagnosis of:

• Addison's disease
• hyperkalemia,
• chronic renal failure,
• Hypersensitivity,
• hypercalcemia,
• anuria,
• hyponatremia,
• metabolic acidosis,
• pregnancy (first trimester),
• diabetic nephropathy,
• enlargement of the mammary glands,
• liver failure,
• diabetes,
• menstrual irregularities

Prescribed with caution in case of AV block (possibility of intensification due to the development of hyperkalemia), decompensated cirrhosis of the liver, surgical interventions, taking drugs that cause gynecomastia in old age.

When using the drug, the following negative manifestations may occur:

• dizziness,
• diarrhea or constipation,
• intestinal colic,
• ulceration and bleeding in the gastrointestinal tract,
• thrombocytopenia
• gastritis,
• abdominal pain,
• agranulocytosis,
• nausea,
• megaloblastosis,
• vomit,
• drowsiness,
• hyperuricemia,
• lethargy,
• hypercreatininemia,
• increase in urea concentration,
• decreased potency,
• headache,
• lethargy,
• muscle spasms,
• ataxia

Gynecomastia, erectile dysfunction in men

Among women:

• amenorrhea,
• dysmenorrhea,
• allergic reactions (maculopapular and erythematous rashes, urticaria, drug fever),
• metrorrhagia during menopause,
• breast carcinoma,
• hirsutism,
• breast tenderness,
• deepening of the voice

Symptoms of excessive use of the drug are nausea, vomiting, dizziness, diarrhea, skin rash, hyperkalemia (paresthesia, myasthenia, arrhythmias), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increased urea concentration.

special instructions

If simultaneous administration of NSAIDs is necessary, monitoring of renal function and blood electrolytes is mandatory. During treatment, avoid foods rich in potassium. the drug weakens the effect of indirect anticoagulants.

It reduces the sensitivity of blood vessels to norepinephrine and increases the half-life of digoxin. Enhances the toxic effects of lithium ions. Accelerates the metabolism and excretion of carbenoxolone. Diuretics (furosemide, benzothiadiazine derivatives, ethacrynic acid) enhance and accelerate, NSAIDs reduce the diuretic and natriuretic effects.

Reduces the effect of anticoagulants (coumarin derivatives, heparin, indandione), and the toxicity of cardiac glycosides. Strengthening the effect of diuretics and antihypertensive drugs. ACE inhibitors, indomethacin, cyclosporine, other potassium-sparing diuretics, potassium ion preparations and potassium supplements - risk

If a patient is prescribed Veroshpiron, but regularly takes other medications, it is necessary to take into account the possible development of drug interactions, which in some cases leads to undesirable consequences. Among the main groups of drugs, joint interaction with Veroshpiron should be taken into account:

1. Combination with anticoagulants reduces their effectiveness. Simultaneous administration with a group of cardiac glycosides leads to a decrease in the toxic effect of the latter.
2. There is a decrease in the toxic reaction to the norepinephrine group. This is especially true when combined with Verapamil.
3. Mitotane in combination with Veroshpiron has less effect.
4. Co-administration with antihypertensives (especially Indapamide), hypothiazide drugs, in particular Diacarb or Diuver, leads to an enhanced effect.
5. Lithium-containing drugs increase the toxic effect on the body when combined with Veroshpiron.
6. Combination with drugs that help preserve potassium in the body, as well as containing this microelement, leads to the possible development of a hyperkalemic state.
7. Salicylates lead to a decrease in the severity of the diuretic effect.
8. Cholestyramine and ammonium chloride lead to possible acidosis.
9. Nonsteroidal anti-inflammatory drugs lead to possible hyperkalemic complications.

If Veroshpiron does not have an effect or causes side effects, it should be discontinued.

Use of the drug Veroshpiron

In case of primary hyperaldosteronism, for short-term treatment, during preparation for surgery, Veroshpiron is prescribed in a daily dose of 100–400 mg. In inoperable patients, the drug can be used for long-term maintenance treatment at the minimum effective dose, which is set individually (by reducing the initial dose of the drug every 14 days to the minimum effective dose). The duration of treatment in adults and children is individual, in some cases it can be several years, but it always requires use in the minimum effective daily dose, subject to regular monitoring of the electrolyte composition of the blood serum and indicators of renal function. With long-term use, to reduce the risk of side effects, it is advisable to prescribe Veroshpiron in combination with other diuretics. For adults with edema of various origins (heart failure, liver cirrhosis or nephrotic syndrome), the drug is prescribed in an initial daily dose of 100 mg, divided into 2 doses; in the future, depending on the clinical effect, the daily dose of Veroshpiron can be reduced to 25 mg or increased to 200 mg. If the diuretic effect does not develop, you can additionally prescribe another diuretic acting at the level of the proximal renal tubules; It is recommended not to change the dose of Veroshpiron. For children with edema of various origins, Veroshpiron is prescribed in a daily dose of 3 mg/kg body weight in 1–2 doses. For adults with essential hypertension (arterial hypertension), Veroshpiron is prescribed in an initial daily dose of 50–100 mg, divided into 2 doses. Veroshpiron can be used in combination with other diuretic or antihypertensive drugs. The maximum antihypertensive effect of Veroshpiron develops no earlier than after 2 weeks of treatment. After this, a maintenance dose of the drug is selected. For hypokalemia in adults caused by the use of diuretics (in cases where the use of potassium supplements or other methods are ineffective), Veroshpiron is prescribed in a daily dose of 25–100 mg.

special instructions

During treatment with spironolactone, alcohol intake is prohibited. Rapid weight loss should be avoided. Hyperkalemia in patients with severe heart failure Spironolactone may increase the risk of hyperkalemia in patients with diabetic nephropathy. Caution should be exercised when prescribing to patients prone to acidosis or hyperkalemia due to an underlying disease (for example, diabetes mellitus). Caution should also be exercised in patients with moderate renal impairment (serum creatinine between 1.2 mg/100 ml and 1.8 mg/100 ml or creatinine clearance between 60 ml/min and 30 ml/min), hypotension or hypovolemia. The dosage form contains lactose. The drug should not be prescribed to patients with rare congenital forms of lactose intolerance: Lapp lactase deficiency, glucose-galactose malabsorption. Treatment should be stopped or suspended if blood potassium levels exceed 4 mg/dL. Spironolactone therapy may interfere with the determination of serum and digoxin, plasma cortisol and epinephrine. Concomitant use of potassium supplements, a diet rich in potassium, use of other potassium-sparing diuretics, use of potassium-containing salt substitutes, use of ACE inhibitors, angiotensin II antagonists, aldosterone receptor antagonists, heparin or low molecular weight heparins, trimethoprim or other drugs that cause hyperkalemia may lead to severe hyperkalemia. , especially in patients with renal failure. Hyperkalemia can be life-threatening

Serum potassium levels should be carefully monitored in patients with severe heart failure. If blood potassium levels exceed 3.5 mmol/L, potassium-sparing diuretics should be avoided. It is recommended to monitor potassium and creatinine levels in the blood one week after starting treatment, and then every six months. Spironolactone therapy may cause a transient increase in serum urea nitrogen, especially in patients with pre-existing renal impairment and hyperkalemia. Spironolactone may cause the development of reversible hyperchloremic metabolic acidosis. Thus, in patients with impaired renal and hepatic function, as well as in elderly patients, biochemical indicators of renal function, as well as electrolyte balance, should be regularly examined.

Veroshpiron and its difference from other diuretics

Diuretics have one unpleasant quality: when they are taken along with excess fluid, potassium is also lost. Veroshpiron has no such drawback. This is a high-quality and effective potassium-sparing diuretic, the basic component of which is spironolactin.

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The mechanism of action of the drug is quite complex. It is enough for patients to know that its active substance acts on the adrenal cortex, blocking the formation of the hormone aldosterone (namely, it promotes the removal of potassium during water retention). As a result, fluid leaves the body along with sodium and chlorine, but potassium reserves are not depleted.

The use of Veroshpiron tablets helps eliminate swelling, reduce blood pressure, and improve blood circulation. It is produced in capsules (the proportion of active ingredient in them is 50 or 100 mg) and tablets (25 mg). The diuretic effect when taking the drug is observed after 2-5 days. Spironolactin is completely absorbed from the gastrointestinal tract (it is also able to pass through the placenta and enter breast milk) and is excreted from the body in urine (60%) and feces (40%).

Description of the dosage form

Tablets: white or almost white, flat, round, with a bevel, a characteristic odor and the marking “VEROSPIRON” on one side.

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Capsule 50 mg: hard gelatin, size No. 3; cap - opaque, yellow; the body is opaque, white.

Capsule 100 mg: hard gelatin, size No. 0; the lid is opaque, orange in color; the body is opaque, yellow.

The contents of the capsules are a fine-grained granular powder mixture of white color.

Advise or dissuade what conclusions patients draw

Reviews testify in favor of diuretic tablets Veroshpiron. People confirm its effectiveness. This diuretic fully copes with its purpose: swelling goes away within 2-3 days after taking it, blood pressure returns to normal

Many people pay attention to this fact: in parallel with this, weight decreases. By removing excess fluid, some lose 5 kg in just a week

But such a medicine should under no circumstances be used as a means to gain weight, as it can cause kidney failure.

Among the reviews there are also negative ones. Quite often the drug provokes side effects. In addition, people do not like the fact that they have to wait for the cumulative effect and limit themselves in nutrition. After all, foods containing potassium are prohibited: apricots, oranges, prunes, bananas, tomatoes.

"Veroshpiron" for intracranial pressure in pregnant women

The drug is contraindicated for expectant mothers, as well as those who are breastfeeding. "Veroshpiron" can penetrate the placenta and cause harm to the fetus. If a woman is forced to take the drug during lactation, she needs to stop breastfeeding and resume it no earlier than one day after the last dose of this medicine.

During pregnancy, in extremely rare cases, it is used to relieve edema in the 2nd or 3rd trimester, when the benefit to the mother will be much higher than the possible risk to the fetus

Veroshpiron for weight loss

On the Internet and in some media you can find recommendations for taking Veroshpiron for weight loss. Despite the fact that this diuretic drug can get rid of several kilograms by removing fluid from the body, using it for weight loss is strictly prohibited.

This diuretic helps remove sodium and calcium ions from the body and causes dehydration. Loss of electrolytes can lead to seizures and cardiac dysfunction, while dehydration can lead to disruption of all body functions.

Also, taking Veroshpiron for the purpose of losing weight may be accompanied by a number of side effects of this drug:

• tendency to bleed;
• liver dysfunction;
• diarrhea, vomiting and nausea;
• menstrual irregularities in women or gynecomastia in men;
• stomach diseases, etc.

We should not forget that uncontrolled use of this diuretic by people with certain kidney diseases can lead to the development of kidney failure and cause the movement of stones through the urinary tract.

Remember! Taking Veroshpiron and other diuretics for the purpose of losing weight is absolutely unjustified and dangerous! Read more about losing weight

Treatment of edema with Veroshpiron

The main treatment is diuretics. For the treatment of CHF, Veroshpiron is prescribed in a complex to eliminate edema from 50 mg to a maximum daily dose of 100-200 mg. The doctor begins treatment with low doses under the control of blood electrolyte composition and creatinine, then adjusts the dose.

In combination with a salt-free diet, which is recommended to adhere to for swelling and hypertension, too active treatment with diuretics leads to complications of therapy. To prevent which it is recommended:

• conduct dynamic monitoring of the adequacy of diuretic therapy;
• monitor the level of electrolytes in the blood;
• combine different groups of drugs;
• follow a rational diet.

Swelling in children over 3 years of age can be relieved with Veroshpiron at a dose of 1-3.3 mg/kg body weight per day. A doctor will help you more accurately calculate the course and assess the degree of risk for the child.

In childhood, during pregnancy and breastfeeding

For children, the medication is prescribed upon reaching 5 years of age.

The drug should not be used during pregnancy.

Spironolactone is converted into metabolites that cross the placenta, which can lead to the threat of congenital pathologies of the fetus.

The active ingredient is absorbed into breast milk. If treatment is necessary during lactation, the patient should switch to artificial feeding.

Contraindications

Experts recommend taking the drug Veroshpiron for the following pathologies:

• primary arterial hypertension;
• swelling during chronic heart failure (as monotherapy or together with a standard treatment program);
• in conditions with symptoms of secondary hyperaldosteronism, as well as in liver cirrhosis with edema;
• with nephrotic syndrome;
• as an adjuvant to prevent the development of hypokalemia/hypomagnesemia while taking diuretics, and also if there is no other method of regulating potassium levels;
• for Crohn's syndrome (for short-term use before surgery);
• to make a diagnosis of essential hypertension.

Drug interactions of Veroshpiron

The instructions for Veroshpiron warn that the drug weakens the effect of anticoagulants and enhances the effect of adrenaline, cardiac glycosides and lithium. Corticosteroids and diuretics enhance the effect of Veroshpiron, and nonsteroidal anti-inflammatory drugs weaken its effect.

When prescribing Veroshpiron, you should inform your doctor about taking other medications, since this drug can interact with many of them.

Veroshpiron:

• reduces the effectiveness of anticoagulants (coumarin derivatives, Heparin, Indandione);
• reduces the toxicity of cardiac glycosides (Strophanthin K, Digitoxin, Celanide, Korglikon, etc.);
• reduces vascular sensitivity to Norepinephrine;
• reduces the effectiveness of Mitotane;
• enhances the effectiveness of antihypertensive and diuretic drugs;
• enhances the metabolism of Phenazol;
• increases the toxicity of lithium-containing drugs;
• accelerates the excretion of Carbenoxolone, and their combined use leads to sodium retention;
• enhances the effect of Buserelin, Triptorelin and Gonadorelin;
• when taken simultaneously with salicylates, the diuretic effect of the drug decreases;
• when taken with potassium-sparing diuretics or potassium-containing drugs, Indomethacin, aldosterone blockers, angiotensin II antagonists and cyclosporines, there is a risk of developing hyperkalemia;
• when taken with cholestyramine and ammonium chloride, the risk of developing acidosis increases;
• when taken with nonsteroidal anti-inflammatory drugs, there is a risk of developing hyperkalemia;
• when taken with Fludrocortisone, increased secretion of potassium in the renal tubules develops;

combined use with Digoxin can lead to a slower elimination of the latter and cause its toxic effect on the body.

Description of the drug and composition

A drug

is potassium-sparing

, and has a pronounced and long-lasting diuretic effect. The active ingredient of this medicinal product is

(one of

bark

). This substance has a long-lasting effect and can prevent the retention of water and sodium in the lower parts of the renal tubules. Veroshpiron does not have a significant effect on blood circulation in the kidneys, helps reduce the acidity of urine and reduces the excretion of potassium from the body.

The diuretic effect of this drug helps lower blood pressure. It begins to appear 2-5 days after starting to take Veroshpiron, and persists for 3 days after its discontinuation.

After oral administration, spironolactone is completely absorbed from the digestive tract into the blood and enters the kidneys, providing a diuretic effect. The drug is excreted from the body mainly through urine and partly through feces.

Mechanism of action of the drug

Hypertension is a pathology in which a person’s blood pressure increases. Normally, blood pressure should be 120 per 80 mmHg. If the pressure exceeds 140 by 90 mmHg, we are talking about arterial hypertension. There is a classification of pathology. Hypertension can be primary or secondary.

The most common is primary (essential) hypertension. The exact causes of the development of the disease are still unknown to medicine. Of course, it is impossible to cure the disease completely. However, with the help of conservative therapy, stable compensation of the disease can be achieved.

Diuretic drugs are widely used to treat hypertension. The product under the trade name Veroshpiron is in greatest demand. Great demand is due to low price and high efficiency indicators.

The tablets contain the following components:

1. The active ingredient is spironolactone.
2. Auxiliary ingredients: silicon dioxide, talc, corn starch, magnesium stearate, lactose monohydrate.

What effect does spironolactone have? The main active substance in the distal nephron prevents the retention of sodium and water by aldosterone. Spironolactone also reduces the potassium-removing effect of aldosterone and the synthesis of permeases. The substance reduces the acidity of urine, reduces the excretion of potassium and urea ions, and increases the excretion of sodium ions.

How to take Veroshpiron for blood pressure: before or after meals?

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Some potassium-sparing diuretics can help lower blood pressure. One of the most popular diuretics is Veroshpiron. How to take Veroshpiron with blood pressure?

The instructions for use say that the optimal daily dosage is 50-100 mg. But the dose, frequency of use and duration of administration can be adjusted by the treating cardiologist.

Tablets are sold at any pharmacy. A diuretic is available by prescription. How much does Veroshpiron cost? The price of the medicine is about 70-100 rubles for 20 tablets (25 mg). The manufacturer of the product is Gedeon Richter, Hungary.

Mechanism of action of the drug

Hypertension is a pathology in which a person’s blood pressure increases. Normally, blood pressure should be 120 per 80 mmHg. If the pressure exceeds 140 by 90 mmHg, we are talking about arterial hypertension. There is a classification of pathology. Hypertension can be primary or secondary.

The most common is primary (essential) hypertension. The exact causes of the development of the disease are still unknown to medicine. Of course, it is impossible to cure the disease completely. However, with the help of conservative therapy, stable compensation of the disease can be achieved.

Diuretic drugs are widely used to treat hypertension. The product under the trade name Veroshpiron is in greatest demand. Great demand is due to low price and high efficiency indicators.

The tablets contain the following components:

1. The active ingredient is spironolactone.
2. Auxiliary ingredients: silicon dioxide, talc, corn starch, magnesium stearate, lactose monohydrate.

What effect does spironolactone have? The main active substance in the distal nephron prevents the retention of sodium and water by aldosterone. Spironolactone also reduces the potassium-removing effect of aldosterone and the synthesis of permeases. The substance reduces the acidity of urine, reduces the excretion of potassium and urea ions, and increases the excretion of sodium ions.

Due to the diuretic effect, a hypotensive effect is achieved. The maximum effect from taking the tablet is observed no earlier than after 7 hours. The active substance is excreted from the body by the kidneys.

Stable compensation of blood pressure is achieved after 2-5 weeks of taking Veroshpiron

Instructions for use of the drug

In what cases are Veroshpiron tablets used? The instructions say that the main indication is essential hypertension. Moreover, the diuretic can be combined with other antihypertensive medications. It is permissible to take the medicine for increased intracranial pressure.

Also indications for use are edema syndrome in chronic heart failure, liver cirrhosis, ascites, nephrotic syndrome. The medicine can also be prescribed as part of complex therapy in the treatment of hypomagnesemia or hypokalemia. Sometimes Veroshpiron tablets are prescribed for Cohn syndrome during the period of preoperative preparation and for idiopathic hyperaldosteronism.

For idiopathic hyperaldosteronism, you should take 100-400 mg of Veroshpiron per day. For hypokalemia and severe hyperaldosteronism, the dose is increased to 300 mg per day. To treat hypomagnesemia and hypokalemia, you need to take 25-100 mg of medication.

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How to take Veroshpiron for edema? To treat this syndrome, you need to drink 100-200 mg of the drug (in 2-3 doses). Also, in case of swelling, a combination of Veroshpiron with loop or thiazide diuretics is allowed. Duration of treatment – ​​5 days.

How to take Veroshpiron with high blood or intracranial pressure? According to the instructions, the optimal daily dosage is 50-100 mg (once). Patients often ask whether to take pills before or after meals? Doctors recommend drinking the product during or after meals.

If you have high blood pressure, Veroshpiron should be taken continuously for at least 5 weeks. If necessary, the course of treatment can be extended.

Contraindications and side effects

Veroshpiron is contraindicated in case of hypersensitivity to the components of the tablets. Also, the drug is not prescribed to adult patients suffering from hyperkalemia, hyponatremia, Addison's disease, acute renal failure, and anuria. Strict contraindications are pregnancy and lactation.

Prescribe tablets with caution for diabetes mellitus, AV blockade, diabetic nephropathy, menstrual irregularities, local or general anesthesia, liver and kidney diseases, and metabolic acidosis. It is not recommended to prescribe Veroshpiron to elderly hypertensive patients.

Side effects:

• From the side of the central nervous system - ataxia, inhibited reaction, muscle spasms, drowsiness, confusion, cramps in the lower extremities, headaches, lethargy.
• From the hematopoietic organs – thrombocytopenia, agranulocytosis, megaloblastosis.
• Metabolic: hyperuricemia, increased urea levels, hyponatremia, hyperkalemia, hypercreatininemia, metabolic acidosis, hyperchloremic alkalosis.
• From the gastrointestinal tract - gastritis, constipation, intestinal colic, liver dysfunction, nausea, vomiting, diarrhea.
• Allergic reactions.
• Alopecia.
• Hypertrichosis.
• Acute renal failure.
• From the endocrine system - erectile dysfunction, gynecomastia, decreased libido (in men). Hirsutism, amenorrhea, dimenorrhea, metrorrhagia, breast carcinoma (in women).

If side effects occur, the drug should be discontinued and symptomatic therapy performed.

Reviews and analogues

Patients respond differently to Veroshpiron. Some hypertensive patients claim that while taking the pills they were able to stabilize their blood pressure and avoid side effects.

Some patients complain that Veroshpiron, although it helped stop pressure surges, caused many negative consequences. Among the most common side effects, patients note decreased libido, drowsiness, diarrhea, and cramps in the calf muscles.

The following can serve as analogues to Veroshpiron:

1. Spironolactone (45-70 rubles).
2. Torasemide (120-200 rubles).
3. Furosemide (25-40 rubles).
4. Trifas (1000-1200 rubles).

Reviews from doctors

Veroshpiron is a fairly good diuretic with a hypotensive effect. In my opinion, thiazide diuretics are best used for resistant essential hypertension. Moreover, in the severe stage of hypertension, I consider the most appropriate combination of Veroshpiron with ACE inhibitors and calcium channel blockers.

If arterial hypertension is not accompanied by constant crises and is easily compensated for, then it is not necessary to use diuretics. In this case, you can get by with sartans, beta-blockers or ACE inhibitors.

I consider a significant disadvantage of Veroshpiron to be its poor tolerability. As practice shows, pills often cause muscle cramps, headaches, dizziness, and slow reaction. These side effects can be mitigated by reducing the dosage. But in this case, the effectiveness of therapy will significantly decrease.

To summarize, I can say that Veroshpiron is an effective diuretic, but the drug is poorly tolerated. I believe that the use of the drug is justified only for resistant forms of hypertension.

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Drugs are classified depending on the severity and speed of action:

1. Potent diuretics: osmotic diuretics and loop diuretics.
2. Diuretics with a moderate natriuretic effect: thiazides and sulfonamides (thiazide-like).
3. Low-acting diuretics: potassium-sparing and carbonic anhydrase inhibitors.

The speed of action of the drugs is directly related to the method of therapy. Thus, if an immediate response is necessary, drugs belonging to the first and second groups are used, while weak diuretics are used for planned, long-term therapy.

Subgroups of diuretics differ in a number of qualities that directly affect the speed and mechanism of action.

Loop subgroup

The loop diuretics are a category of the most powerful diuretics that affect the reabsorption of chlorine and sodium ions, as well as enhancing the excretion of potassium ions.

Diuretics are used for:

• acute and chronic heart failure;
• hypertension;
• cerebral and pulmonary edema;
• renal failure;
• poisoning with dialysable poisons;
• hypercalcemia.

The drugs effectively relax the smooth muscles of blood vessels and help improve renal blood flow.

Thiazide and thiazide-like diuretics

The thiazide subgroup of diuretics is an effective and most commonly used category of diuretics.

Drugs are used to improve the condition of:

• hypertension;
• chronic heart failure.

An increase in diuresis helps to reduce the volume of blood circulation and reduce the load on the heart muscle. Also, the effect of medications helps prevent congestion in the lungs. Diuretics of this type relax the walls of blood vessels and alter the reactivity of the cardiovascular system, reducing the response to vasoconstrictors and increasing the depressor response to ganglion blocking agents.

Thiazide-like subgroup - drugs that have mechanisms of action similar to thiazide diuretics, but differ in chemical structure.

Potassium-sparing subgroup

Potassium-sparing diuretics have a much shorter and less pronounced effect than drugs of the loop subgroup, but their use does not cause hypokalemia.

List of diuretics for blood pressure

Not all diuretics are used to normalize blood pressure. The most well-known means include:

The drugs differ in the mechanism and duration of action, as a result of which you should not select a drug to lower blood pressure on your own. The medication should be prescribed on the recommendation of the attending physician based on the patient’s indications.

Features of the use of diuretics

Before starting to use diuretics, you should consult with a specialist, familiarize yourself with contraindications and side effects.

To control the effect of the drug it is necessary:

1. Measure the volume of fluid consumed and excreted throughout the day.
2. Measure blood pressure levels in the morning and evening.
3. Monitor changes in body weight.
4. If there is swelling, measure the circumference of the legs and abdomen.
5. Determine the extent of side effects.

Depending on the sensitivity of the patient’s body to the action of drugs and the expected effect, the attending physician prescribes the required group of drugs and calculates the individual dosage.

Features of the use of loop diuretics

Loop diuretics for the treatment of arterial hypertension are a subgroup of fast-acting drugs.

Features of medicines:

1. Fluid removal is observed 60 minutes after taking the tablets.
2. The action lasts up to 4 hours.
3. There is an increased risk of ion imbalance.
4. To reduce the risk of signs of hypokalemia, it is recommended to take potassium preparations - Asparkam, Kalinor, Panangin.

Treatment with loop diuretics is also divided into active and maintenance phases; administration begins with the minimum dosage specified by the specialist. Changing or prescribing the dose of medication on your own is strictly prohibited.

Features of the use of thiazide diuretics

The main advantage of thiazide diuretics is the absence of addiction and a decrease in effect with prolonged use.

Features of application:

1. Diuretics should not be used for more than 7 days in a row.
2. Between courses of treatment it is necessary to take a break of 4 days.
3. The effect of the drug is observed 2 hours after administration.
4. The diuretic effect with a single use is observed within 12 hours.
5. To compensate for potassium losses, it is recommended to add dried apricots, bananas, baked potatoes, and prunes to the diet.

Medicines in this group are used in small doses to reduce the severity of side effects.

Features of the use of potassium-sparing drugs

Drugs in this group reduce blood pressure, remove sodium from the body, but completely retain the potassium content.

Features of potassium-sparing diuretic drugs:

1. The effect is observed 2 hours after administration.
2. Reception regimen: 1 time per day.
3. If the urea level in the blood increases, the tablets are taken after 1 day.

The effect of diuretics such as Spironolactone and Veroshpiron is observed only on the 2nd day after use.

Herbal diuretic tablets

Diuretics based on herbal components are a safe method for preventing a number of diseases and safely lowering blood pressure. Unlike synthetic medicines, the use of plants in folk medicine lasts much longer, which has made it possible to accurately identify all the side effects of drugs.

Diuretic herbs are used in the form of tablets, infusions, or teas. The most well-known diuretic plants used to reduce blood pressure include:

• shepherd's purse;
• Rowan;
• cottonweed;
• barberry;
• astragalus;
• arnica;
• dill;
• knotweed;
• birch.

These herbs and woody plant forms do not limit the range of plants with diuretic properties.

Herbal infusions are used to treat:

1. Edema of various nature.
2. Hypertension.
3. Liver cirrhosis.
4. Pulmonary or cerebral edema.
5. Epilepsy.
6. Glaucoma.
7. Hydrocephalus.
8. Ascites.

Improvements in hypertension and heart failure are due to changes in the tone of blood vessels and a reduction in the load on the heart. However, the effect of many medicinal herbs is preventive.

Herbal diuretics for hypertension:

• "Canephron";
• "Urocholum";
• "Cyston";
• "Nephroleptin";
• "Olymethine";
• "Urolesan";
• "Phytolysin";
• "Sunklin."

Before choosing and starting home therapy, it is also necessary to consult with your doctor, since herbal infusions and tablets, like synthetic medications, have a number of individual contraindications and side effects, the severity of which can be quite significant if the dosage is exceeded or an allergic reaction occurs.

Consequences of drinking alcohol

List of consequences:

• disruption of the process of urine formation;
• severe blow to internal organs;
• destruction of liver cells;
• high risk of developing severe side effects of the drug;
• dizziness, loss of consciousness;
• drowsy state;
• acute heart failure;
• the appearance of a rash on the extremities;
• redness of the skin;
• increased potassium content in the bloodstream (this leads to nausea, vomiting, severe pain in the abdomen);
• the appearance of signs of dehydration (extreme thirst, small amount of urine, decreased blood pressure, weak pulse).

This is a deadly combination that destroys healthy liver cells. As a result, the organ cannot process toxins and various harmful substances. The consequences of joint use are often eliminated in a hospital setting.

What happens during an overdose?

Since Veroshpiron therapy involves the use of significant doses of the drug over a long period of time, an overdose cannot be ruled out.

What signs can be used to judge drug intoxication?

1. First of all, this is indicated by nausea and vomiting.
2. Hyperkalemia may develop with cardiac arrhythmia, muscle weakness and tingling, crawling sensations.
3. Hyponatremia is possible, which is accompanied by dry mouth, thirst and drowsiness.
4. Hypercalcemia cannot be ruled out, the symptoms of which include mild depression, spatial disorientation, and hallucinations.
5. An overdose can cause dehydration. A mild form of dehydration is characterized by a feeling of fatigue and weakness. In severe cases, confusion, a drop in blood pressure, and blue discoloration of the mucous membranes and skin may be observed.

If signs of drug poisoning appear, it is necessary to urgently rinse the stomach. For rinsing, warm boiled water is used, to which you can add salt. If there is an excess of potassium, potassium-removing diuretics are used to normalize the water-electrolyte balance. Glucose injections with insulin are also used. In case of severe poisoning, hemodialysis is prescribed.

Mechanism of influence

Veroshpiron is a potassium-sparing diuretic, the active substance of which is spironolactone. This synthetic drug blocks the endogenous mineralocorticoid hormone aldosterone, produced by the adrenal cortex.

In order to understand how the drug works and how the diuretic effect occurs, you need to remember the main stages of urine formation. The kidneys consist of the smallest structural units - nephrons, each of which is represented by a glomerulus of vessels surrounded by a capsule, tubules and collecting ducts. The nephron is enveloped in a network of small capillaries that are actively involved in urine formation.

Briefly, the main processes occurring in the nephron can be described in the following stages.

1. The flow of blood through the afferent arteriole into the glomerular system.
2. Plasma filtration due to pressure gradient differences.
3. Accumulation of primary urine in the Bowman–Shumlyansky capsule.
4. Entry of urine into the renal tubular system.
5. Reabsorption (absorption back into the blood) of substances and water needed by the body.
6. Secretion (release from the blood into the tubules) of metabolic products.
7. Excretion of secondary urine into the collecting ducts.

The process of urine formation is controlled by the neurohumoral regulation system. Under its influence, diuresis (the volume of secondary urine) increases or decreases, and the processes of reabsorption and secretion change.

One of the links that regulates kidney function is the hormone aldosterone. By binding to specific receptors in the renal tubules, it enhances the reabsorption of chlorine, sodium and water ions, and at the same time increases the secretion of potassium into the urine.

Spironolactone in the drug has a mild diuretic effect compared to other diuretics. Therefore, to achieve a lasting result, a complex intake of drugs is prescribed, which the specialist determines based on the clinical situation.

Instructions

• Russian
• Kazakh

Tradename

International nonproprietary name

Dosage form

Compound

One tablet contains

active substance - spironolactone 25 mg

excipients: colloidal silicon dioxide, magnesium stearate, talc, corn starch, lactose monohydrate.

Description

Tablets, white or almost white, round, flat, beveled, marked “Verospiron” on one side and with a characteristic mercaptan odor.

Pharmacotherapeutic group

Diuretics. Potassium-sparing diuretics. Aldosterone antagonists. Spironolactone.

ATX code C03D A01

Pharmacological properties

Pharmacokinetics

Absorption of spironolactone from the gastrointestinal tract is rapid and complete. It is largely bound to plasma proteins (approximately 90%). Spironolactone undergoes rapid metabolism. Its active metabolites are 7α-thiomethylspironolactone and canrenone. Although the half-life of spironolactone itself is short (1.3 hours), the half-lives of its active metabolites are longer (2.8 to 11.2 hours). Metabolites are excreted mainly in the urine; a small part is excreted in the feces. Spironolactone and its metabolites cross the placenta and are excreted in breast milk.

After taking 100 mg of spironolactone daily for 15 days, the time to peak plasma concentration (tmax), peak plasma concentration (Cmax) and elimination half-life (t1/2) of spironolactone were: 2.6 hours, 80 ng/ml and , approximately 1.4 hours, respectively. For 7α-thiomethylspironolactone and canrenone, these figures were 3.2 and 4.3 hours, respectively; 391 ng/ml and 181 ng/ml; 13.8 and 16.5 hours.

The effect on the kidneys of a single dose of spironolactone peaks after 7 hours and persists for at least 24 hours.

Pharmacodynamics

Spironolactone is a competitive antagonist of aldosterone. It acts in the distal tubules of the nephron, inhibiting the retention of sodium and water ions, as well as the excretion of potassium ions—the effects of aldosterone. Not only does it increase Na+ and Cl- excretion and decrease urinary K+ excretion, it also decreases H+ excretion. As a consequence of its diuretic effect, it has a hypotensive effect.

Indications for use

- congestive heart failure in cases where the patient does not respond to treatment with other diuretics or there is a need to potentiate their effects

- Essential arterial hypertension, mainly in cases of hypokalemia, usually in combination with other antihypertensive drugs

- cirrhosis of the liver, accompanied by edema and/or ascites

- treatment of primary hyperaldosteronism

- edema caused by nephrotic syndrome

- treatment of hypokalemia (in cases where it is impossible to receive other therapy)

- prevention of hypokalemia in patients receiving cardiac glycosides in cases where other approaches are considered inappropriate or inappropriate

Directions for use and doses

Veroshpiron® is prescribed in one or two doses after meals. It is recommended to take the daily dose or the first part of the daily dose in the morning.

In cases of diagnosed primary hyperaldosteronism, the drug can be prescribed in preparation for surgery at a dose of 100-400 mg. In patients for whom surgery is not planned, the drug can be used as long-term maintenance therapy in the lowest effective dosage, determined individually. In the described situation, the initial dose can be reduced every 14 days until the minimum effective dose is reached. In cases of long-term use, it is recommended to use it in combination with diuretics of other groups to reduce side effects.

Edema (congestive heart failure, nephrotic syndrome)

Adults: the initial daily dose is 100 mg (25-200 mg) and is prescribed in one or two doses.

If higher doses are prescribed, Veroshpiron® can be taken in combination with other groups of diuretics that act in more proximal parts of the renal tubules. In this case, the dosage of Veroshpiron® should be adjusted.

Liver cirrhosis accompanied by ascites or edema

If the Na+/K+ ratio in urine is greater than 1, the initial daily and maximum daily doses are 100 mg. If this ratio is less than 1, the initial daily dose is 200 mg, the maximum is 400 mg/day. The maintenance dose should be determined individually.

Essential arterial hypertension

The initial daily dose, prescribed in one or two doses, is 50-100 mg and is taken in combination with other antihypertensive drugs. Therapy should be continued for two weeks, since by the end of this period the maximum antihypertensive effect is achieved. Then the dose should be adjusted individually depending on the effect achieved.

In patients who do not have enough nutritional supplements with K+ or other methods of potassium replacement therapy, the drug is taken in a daily dose of 25-100 mg.

The initial daily dose is 1-3 mg/kg body weight in one or two doses. The dose should be reduced to 1-2 mg/kg in case of maintenance therapy in combination with other diuretics.

It is recommended to begin treatment with lower doses, followed by gradual increases until maximum effect is achieved. Hepatic and renal impairment should be taken into account as they affect drug metabolism and excretion.

Analogs

It is necessary to replace the diuretic with medications with identical effects. If Veroshpiron has indications for use that completely coincide with the synonym, it is important to additionally verify the properties of the generic. It should prevent the leaching of magnesium and potassium salts, maintaining normal electrolyte balance. Veroshpiron - analogues with identical indications for use:

• Spironolactone (direct);
• Epletor;
• Renial;
• Eridanus;
• Decriz;
• Epplepres;
• Inspra;
• Espiro.

Substitutes (synonyms) for the active substance are the following drugs:

• Spironolactone from different manufacturers - Sandoz, Darnitsa, Vero (Russian analogue of Veroshpiron), Unilan (USA), etc.;
• Veroshpilakton (analogue of Veroshpiron in Russia);
• Spironol (domestic analogue);
• Aldactone;
• Urakton;
• Spirix.

Veroshpiron can be replaced with these agents without loss of effectiveness. Veroshpiron differs from the indicated products by the manufacturer. Therefore, there is practically no difference (differences) between these medications.

Veroshpiron photo

Storage conditions

Effect of the drug Veroshpiron on the body

The drug Veroshpiron is considered a potassium-sparing diuretic. The main element, when interacting with aldosterone, prevents the absorption of fluid into the renal tubules. At the same time, it does not have a negative effect on the functionality of the kidneys.

The main component and additional components are quickly absorbed in the gastrointestinal tract and enter the blood vessels. They are excreted from the body mainly through the kidneys and partly through the intestines. The drug has a pronounced diuretic effect and also helps lower blood pressure.

When using medications with potassium-sparing properties, liver dysfunction and muscle cramps may occur. Rapid absorption of the drug allows 90% of the active substance to be processed. Taking the diuretic Veroshpiron provokes such ailments as:

• dizziness;
• drowsiness;
• lethargy;
• vomit;
• diarrhea;
• itching, redness, urticaria;
• muscle spasms;
• disruptions in the endocrine system.

With long-term use of a diuretic drug, women may experience amenorrhea, dysmenorrhea, chest pain and heavy uterine bleeding.

In men, decreased erection and carcinoma of the mammary appendages are observed.

These symptoms are temporary. After stopping taking the drug Veroshpiron, all functions are completely restored.

While in the human body, a diuretic drug complicates the detection of the level of adrenaline, digoxin and cortisol in the blood.

At the initial stage of taking the drug, it is recommended to avoid activities that require concentration and a quick psychomotor reaction.

Indications

The drug Verospiron is prescribed for the following ailments:

• polycystic ovary syndrome;
• excess of androgens (male sex hormones);
• chronic heart failure;
• high blood pressure;
• hypokalemia;
• hypomagnesemia;
  Cirrhosis of the liver
• ascites;
• cirrhosis of the liver;
• Conn's syndrome;
• nephrotic diabetes;
• idiopathic hyperaldosteronism;
• hypertension;
• swelling accompanied by fluid accumulation in the abdominal area;
• dysfunction of the movement of the upper and lower extremities (due to excess potassium ions).

Contraindications

Veroshpiron should not be taken during pregnancy.

• pregnancy;
• lactation;
• diabetes mellitus;
• kidney disorders;
• high levels of potassium in the blood;
• liver failure;
• Addison's disease;
• carcinoma of mammary appendages;
• lactose deficiency;
• hypersensitivity to one of the constituent elements of the drug.

In addition, it is not recommended to be given to children under three years of age and to patients over 50 years of age.

This diuretic is also prescribed to detect aldosterone and to diagnose kidney function. It was noted that taking a potassium-sparing diuretic is not tied to the time of eating.

When prescribing Veroshpiron, you should inform your doctor about taking other medications, since this drug can interact with many of them.

Veroshpiron:

• reduces the effectiveness of anticoagulants (coumarin derivatives, Heparin, Indandione);
• reduces the toxicity of cardiac glycosides (Strophanthin K, Digitoxin, Celanide, Korglikon, etc.);
• reduces vascular sensitivity to Norepinephrine;
• reduces the effectiveness of Mitotane;
• enhances the effectiveness of antihypertensive and diuretic drugs;
• enhances the metabolism of Phenazol;
• increases the toxicity of lithium-containing drugs;
• accelerates the excretion of Carbenoxolone, and their combined use leads to sodium retention;
• enhances the effect of Buserelin, Triptorelin and Gonadorelin;
• when taken simultaneously with salicylates, the diuretic effect of the drug decreases;
• when taken with potassium-sparing diuretics or potassium-containing drugs, Indomethacin, aldosterone blockers, angiotensin II antagonists and cyclosporines, there is a risk of developing hyperkalemia;
• when taken with cholestyramine and ammonium chloride, the risk of developing acidosis increases;
• when taken with nonsteroidal anti-inflammatory drugs, there is a risk of developing hyperkalemia;
• when taken with Fludrocortisone, increased secretion of potassium in the renal tubules develops;

combined use with Digoxin can lead to a slower elimination of the latter and cause its toxic effect on the body.

• ACE inhibitors;
• anti-inflammatory (non-steroidal);
• angiotensin receptor blockers;
• Tacrolimus;
• Cyclosporine;
• Potassium preparations;
• potassium-sparing diuretics.

• preparations containing Lithium;
• Digoxin.

Combination with these drugs requires caution and dose adjustment.

Reviews and analogues

Patients respond differently to Veroshpiron. Some hypertensive patients claim that while taking the pills they were able to stabilize their blood pressure and avoid side effects.

Some patients complain that Veroshpiron, although it helped stop pressure surges, caused many negative consequences. Among the most common side effects, patients note decreased libido, drowsiness, diarrhea, and cramps in the calf muscles.

The following can serve as analogues to Veroshpiron:

1. Spironolactone (45-70 rubles).
2. Torasemide (120-200 rubles).
3. Furosemide (25-40 rubles).
4. Trifas (1000-1200 rubles).

Overdose: symptoms and treatment

An overdose of the drug occurs in the event of an incorrectly calculated amount of the drug taken. The condition is characterized by some symptoms. First of all, Veroshpiron sharply reduces blood pressure. As a result, the patient feels an unstable rhythm in the heart, weakness and dizziness. If you suspect an overdose, you should consult a doctor. Doctors will perform gastric lavage and take the necessary tests to monitor the functioning of the body. The patient is prescribed fluids in large quantities and coffee to increase pressure in the blood vessels. If tests show a sharp decrease in potassium levels in the blood, the patient is prescribed insulin and dextrose.

What could be the undesirable consequences?

The instructions for the drug indicate the following side effects that may occur during drug therapy.

1. The digestive system may react to “Veroshpiron” with nausea, abdominal pain, indigestion (diarrhea or constipation).
2. Undesirable effects from the central nervous system may include dizziness, slowed reflexes, confusion, headache, and drowsiness.
3. Laboratory tests during treatment with the drug can detect a decrease in leukocytes, platelets, an increase in uric acid in the blood, and an imbalance of water-salt balance.
4. In men under the influence of “Veroshpiron”, gynecomastia may appear. It is reversible. In addition, a decrease in potency is possible.
5. In women, negative consequences such as disruptions in the menstrual cycle, pain caused by uterine spasms, and pain in the mammary glands cannot be ruled out.
6. Skin manifestations (itching, rash, hair loss) are not excluded.
7. Acute renal failure is possible.
8. Cramps of the calf muscles may occur.

What are the risks of an overdose of Veroshpiron?

From patient reviews, it is known that cases of overdose are rare. If this happens, then all side effects worsen. The following symptoms may also appear:

• thirst and dry mucous membranes;
• increase in the amount of uric acid;
• vomiting and nausea;
• muscle weakness and drowsiness;
• skin rash;
• diarrhea;
• hypernatremia and hyperkalemia;
• dehydration of the body.

If an overdose occurs, you should quickly rinse the stomach with plenty of water (drink a lot and induce a gag reflex). Then use caffeine to increase blood pressure. For hyperkalemia, doctors prescribe dextrose and insulin. There is no special antidote for Veroshpiron. In emergency cases, hemodialysis is performed.

If the attending physician's instructions regarding the required doses are not followed, an overdose may occur, which manifests itself in the form of:

• confusion;
• rashes on the skin;
• dehydration of the body;
• weak frequent stools;
• nausea;
• gagging;
• drowsiness.

Taking antihypertensive drugs in most cases is due to deterioration in health, poor diet and old age, which causes hypertension. In our time, hypertension is called a “slow killer”: it wears out blood vessels and the heart gradually, without causing harm with sudden attacks, with the exception of hypertensive crises. Diuretic tablets "Veroshpiron" are a popular solution for reducing the volume of circulating fluid. But is it safe to take them?

Possible analogues of Veroshpiron

Similar drugs of Veroshpiron that have a similar effect are:

• Spironolactone;
• Lasix;
• Mannitol;
• Furosemide.

Before replacing the product, you must consult a doctor.

Veroshpiron for children

Veroshpiron can be used in pediatric practice as a diuretic for various diseases. The dosage and duration of its use is determined only by the doctor, and the child’s parents must strictly follow all medical recommendations.

Despite the fact that contraindications for this drug indicate a restriction for use by children under 3 years of age, in practice the drug is in some cases prescribed to younger children (including infants). However, treatment with Veroshpiron for children in this age group is carried out in a hospital setting or under strict medical supervision.

Dosage of Veroshpiron for edema in children: 1. The initial daily dose is 1-3 mg/kg for 1-4 doses.2. After 5 days, the initial dose can be adjusted (if necessary, it can be increased 3 times).

It is usually recommended to give this diuretic to your child twice a day at the same time: morning and afternoon. Between doses it is necessary to maintain an interval of about 10-12 hours.

Children under 6 years of age are recommended to take tablets of this drug. For children who cannot swallow the tablet on their own, grind it into powder and mix it with milk or baby food.

DETAILS: No Shpa 6. No Shpa children's dosage

In some cases, especially in infants, vomiting occurs after taking Veroshpiron. If it appears earlier than half an hour after administration, the child must be given another dose of the drug. If more than half an hour has passed from the time of administration to the attack of vomiting, then there is no need to give another dose.

An overdose of Veroshpiron is especially dangerous in young children. It is accompanied by an increase in many side effects. The child becomes increasingly drowsy, weak, and may experience heart rhythm disturbances or convulsions.

Signs of dehydration are also detected: lack of saliva, the skin becomes dry, and there may be vomiting or diarrhea. In such cases, it is necessary to urgently stop taking the drug, rinse the child’s stomach and call a doctor or an ambulance.

How does Veroshpiron interact with other drugs?

1. “Veroshpiron” reduces the therapeutic effect of anticoagulants - drugs that reduce blood clotting and prevent the formation of blood clots.
2. The drug reduces the toxic effect of cardiac glycosides, but increases the toxicity of lithium, since it impairs its excretion from the body.
3. It is possible that the effect of some muscle relaxants, in particular tubocurarine, may be enhanced.
4. “Veroshpiron” slows down the excretion of digoxin, which can lead to poisoning with this medicine.
5. The combination of “Veroshpiron” with other diuretics enhances the diuretic effect and sodium excretion.
6. “Veroshpiron”, in combination with drugs that lower blood pressure, enhances their effect.
7. Orthostatic hypotension may develop if the drug is used together with alcohol, barbiturates, or drugs.
8. It is not recommended to be treated with carbexolone, since veroshpiron significantly reduces its effectiveness, accelerating its breakdown and elimination.
9. It is not advisable to use with NSAIDs, which reduce the diuretic and natriuretic effects of veroshpiron.
10. The risk of hyperkalemia increases if treatment with the drug is carried out together with medications that contain potassium.
11. An undesirable change in the acid-base balance is possible when combined with ACE inhibitors and angiotensin II antagonists.
12. It is not recommended to prescribe the drug if antitumor therapy with mitotane is being performed.
13. The drug enhances the effect of some antitumor drugs (triptorelin, buserelin).

Reviews

Based on reviews from people who have used the potassium-sparing diuretic Veroshpiron, we can conclude that the first effect occurs within about an hour.

“After taking Veroshpiron, after 40-50 minutes an intense urge to urinate begins. In the following days, activity decreases somewhat." Marina, 30 years old

Improvement in skin condition is also noticeable.

“Along with the removal of excess fluid, the body is cleansed, and at the same time, my acne and pimples disappeared, my skin became cleaner, smoother and my complexion changed for the better.” Svetlana, 28 years old

In addition, the potassium-sparing diuretic significantly reduces the level of male hormones, although it is not hormonal. Despite the fact that Veroshpiron is contraindicated for children under three years of age, in medical practice there are cases when it is prescribed even to infants.

Therapy with the drug Veroshpiron for children of this age category is carried out under the strict supervision of a doctor or in a hospital. Taking a diuretic in children under one year of age provokes vomiting, convulsions, weakness, intestinal disorders and arrhythmias. Tatyana, 38 years old

For swelling of any type, self-medication is not recommended. How long should you continue taking this type of medication and the dosage of the drug can only be prescribed by your attending physician, since each organism is individual.

Almost all reviews about Veroshpiron indicate its high effectiveness. Patients note the rapid disappearance of edema and normalization

on the 3-5th day of admission. There are also reviews that the drug has a positive effect on the body under various

among women.

Reviews of the side effects of Veroshpiron are not common. Some of the patients noted the appearance of headaches, weakness, diarrhea, and nausea while taking the drug. There are isolated reviews about the appearance of muscle cramps. All review authors note that side effects quickly disappeared after discontinuation of the drug.

Parents whose children took Veroshpiron in the form of crushed tablets note that the drug tastes bitter, and some children have difficulty taking it. In some cases, this caused the child to vomit. The therapeutic effectiveness of Veroshpiron was assessed positively by parents.

In all reviews, the price of this drug is rated as “acceptable.”

Ivan Kirilenko, urologist: the drug perfectly helps cope with swelling. It does not act quickly, but does not have significant negative effects on the body, unlike other groups of diuretics.

Olga Ivanchenko, cardiologist: Veroshpiron is the drug of choice for patients with hypertension and heart disease. The product effectively treats potassium imbalances and also eliminates edema in such groups of patients.

Matvey P.: I am 70 years old, my heart hurts periodically, there is swelling in my legs and face in the morning. In addition to the list of medications, the cardiologist prescribed Veroshpilactone or Veroshpiron. There is no difference between the drugs Veroshpilakton and Veroshpiron, since these drugs have the same composition.