Spironolactone, an aldosterone antagonist being competitively binds to the aldosterone receptor in the distal renal tubules.
Aldosterone acts as a potassium-sparing diuretic by increasing the amount discharged from the body of sodium and water while simultaneously excretion of potassium and magnesium delay.
The diuretic effect is usually develops 2-5 days of treatment and lasts for 2-3 days after discontinuation of the drug.
Obolensky OP, Russia
1 tablet contains:
The active ingredient is:
100 mg of spironolactone.
- Otechny syndrome in chronic heart failure, liver cirrhosis (especially in the simultaneous presence of hypokalemia and hyperaldosteronism), nephrotic syndrome;
- essential hypertension in adults;
- Diagnosis and treatment of primary hyperaldosteronism (Conn’s syndrome);
- prevention of hypokalemia in the treatment saluretikami and in patients receiving cardiac glycosides, myasthenia gravis (adjuvant).
Hypersensitivity, Addison’s disease, acute or rapidly progressive renal failure, chronic renal failure, with a significant reduction of excretory functions (Cl creatinine less than 10 ml / min), anuria, hyperkalemia, hyponatremia, hypercalcemia.
Precautions: Reduced renal excretory function, liver dysfunction (increased sensitivity to changes in electrolyte balance), diabetes mellitus (especially diabetic nephropathy), susceptibility to metabolic acidosis (with acidosis amplified hyperkalemic effect of spironolactone, spironolactone can contribute acidosis), menstrual disturbances and / or breast enlargement, AV block (may increase due to the development of hyperkalemia).
From the nervous system and sensory organs: dizziness, drowsiness, lethargy, weakness, headache, ataxia, confusion.
From the digestive tract: nausea, vomiting, diarrhea, cramps, intestinal colic, gastritis, ulcers and bleeding in the gastrointestinal tract, liver dysfunction.
With the genitourinary system: gynecomastia (usually reversible, in rare cases can persist after discontinuation of drugs), breast pain, erectile dysfunction in men, reduced potency in men, menstrual disorders or amenorrhea, metrorrhagia in menopausal hirsutism, voice changes in women.
For the skin: maculopapular or erythematous skin rash, alopecia, hypertrichosis, pruritus, urticaria.
Other: leg cramps, benign tumors of the breast, chest pain, leucopenia (including agranulocytosis), thrombocytopenia, electrolyte imbalance, hyperkalemia, increase in blood urea nitrogen, creatinine, osteomalacia, drug fever.
How to accept, acceptance rate and dosage
The tablets are taken orally after a meal.
Adults can take the daily dose in one or more steps.
Edema in chronic heart failure: initial dose is 25 mg / day, maximum – 100 mg / day. The maintenance dose is determined individually.
Edema amid cirrhosis: 100-400 mg / day (depending upon the ratio of potassium and sodium). The maintenance dose is determined individually.
Peripheral edema amid nephrotic syndrome: daily dosage of 100-200 mg / day.
Essential hypertension in adults: 50-100 mg / day. When necessary, the daily dose gradually over two weeks can be increased to 200 mg / day. Duration of treatment – at least 2 weeks.
Children: is usually administered at the rate of 3 mg / kg of body weight per day. The dose should be selected based on their response and tolerability. Multiplicity of reception is generally 1-2 times a day.
Diagnosis and treatment of primary hyperaldosteronism: can be used for initial diagnosis, as an indirect indicator of primary hyperaldosteronism in patients who are on a normal diet. The long test: adults – 400 mg / day for 3-4 weeks. Removal of hypertension and hypokalaemia indirectly favors the diagnosis of primary hyperaldosteronism Short test: adult daily dose – 400 mg for 4 days..
If the reception period of spironolactone, potassium ion concentration in serum increases but decreases when canceling spironolactone, should be considered as a possible diagnosis of primary hyperaldosteronism. After diagnosis hyperaldosteronism diagnosed using more informative diagnostic test, spironolactone can be taken in preparation for the operation at a dose of 100 to 400 mg / day.
In patients who are not subject to the operation, Veroshpilakton can be used as long-term maintenance therapy at the lowest effective doses, which are set for the patient individually.
Prevention of hypokalemia in the treatment saluretikami: 25-100 mg / day.
Missed Dose: take the missed dose as soon as possible. Do not take it if before the next dose is not time left. Do not take a double dose.
Veroshpilakton reduces vascular sensitivity to norepinephrine. This must be taken into account in general and local anesthesia in patients taking Veroshpilakton.
The simultaneous use of potassium-sparing diuretics with indomethacin or ACE inhibitors leads to the development of hyperkalemia. In combination with other diuretics and antihypertensive drugs Veroshpilakton reinforces their action. Therefore, when added to the treatment regimen Veroshpilaktona dosage of such drugs should be reduced.
It is shown that increases spironolactone T1 / 2 digoxin. This can lead to an increase of digoxin concentration in the blood up to a toxic, so their joint reception is necessary to reduce the dose or increase the interval between doses of digoxin.
Acetylsalicylic acid weakens the diuretic effect of spironolactone secretion by blocking the major metabolite – canrenone in the renal tubules. It is shown that indomethacin inhibit mefanaminovaya acid excretion canrenone.
Spironolactone enhances the metabolism of antipyrine.
Symptoms: nausea, vomiting, drowsiness, confusion, rash and diarrhea. Possible electrolyte imbalance and dehydration.
Treatment: Veroshpilaktona reception should be stopped immediately, cause vomiting and stomach wash.
No specific antidote. There should be symptomatic treatment of dehydration, electrolyte imbalance and hypotension.
Removal of hyperkalemia achieved rapid administration of glucose (20-50% solution) and the rate of insulin 0.25-0.5 IU insulin per 1 g glucose.
Kaliyvyvodyaschie used diuretics and ion exchange resins.