Veroshpilakton tab 25mg 20 pcs Obolensky

$1.48

Veroshpilakton tab 25mg 20 pcs Obolensky

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Description

Composition
Active substance:
1 tablet contains: spironolactone – 0.025 g
Excipients:
Magnesium stearate, lactose (milk sugar), potato starch, colloidal silicon dioxide (Aerosil), talc.
Description:
Tablets white or white with kremovatam color, round, ploskotsilindricheskoy shape scored on one side and a chamfer or almost odorless with a slight specific odor.
Product form:
Tablets of 25 mg. 10, 15, 20 or 30 tablets in blisters of PVC film and aluminum foil printed patent. 1, 2, 3 blisters with instructions for use placed in a pile of cardboard.
Contraindications
Hypersensitivity to any component of the drug, Addison’s disease, hyperkalemia, hyponatraemia, severe renal impairment (creatinine clearance less than 10 mL / min), anuria, pregnancy, lactation. Infancy (up to 3 years), in connection with a solid dosage form.
Precautions: hypercalcemia, metabolic acidosis, atrioventricular block (hyperkalemia enhances it), diabetes (with confirmed or suspected chronic renal failure), diabetic nephropathy, surgery, medication intake, causing gynecomastia, local and general anesthesia, advanced age, menstrual disorders, breast enlargement, hepatic failure.
Dosage
25 mg
Indications
Essential hypertension (as part of combination therapy); edema syndrome in chronic heart failure (can be used as monotherapy or in combination with standard therapy); conditions that may be detected secondary hyperaldosteronism, including cirrhosis of the liver accompanied by ascites and / or edema, nephrotic syndrome, and other conditions accompanied by edema; hypokalaemia / hypomagnesaemia (as an aid to prevent it during treatment with diuretics and impossibility to use other ways of potassium level correction); primary hyperaldosteronism (Conn syndrome) – short for preoperative treatment; for diagnosis of primary hyperaldosteronism.
Interaction with other drugs
Reduces the effect of anticoagulants, anticoagulants (heparin, coumarin derivatives, indandinona) and toxicity of cardiac glycosides (t. K. Normalization of potassium levels in the blood inhibits toxicity).
Enhances metabolism fenazola (antipyrine).
Reduces vascular sensitivity to noepinefrinu (requires care in compliance anesthesia) that increases the half-life of digoxin – possible intoxication – digoxin.
It enhances the toxic action of lithium due to reduced clearance.
It speeds up the metabolism and excretion of carbenoxolone.
Carbenoxolone promotes sodium retention spironolactone.
Glucocorticosteroid preparations, diuretics (benzothiadiazine derivatives, furosemide, ethacrynic acid) increase and accelerate the diuretic and natriuretic effects.
It enhances the action of diuretic and antihypertensive medicaments.
Nonsteroidal anti-inflammatory drugs reduce the diuretic and natriuretic effects, increases the risk of hyperkalemia.
Glucocorticosteroid drugs increase the diuretic and natriuretic effect in hypoalbuminemia and / or hyponatremia.
The risk of hyperkalemia when taken with potassium preparations, potassium supplements and potassium-sparing diuretics, angiotensin-converting enzyme (acidosis), angiotensin II antagonists, aldosterone blockers, indomethacin, cyclosporin.
Salicylates, indomethacin reduce diuretic effect.
Ammonium chloride, cholestyramine hyperkalemic contribute to the development of metabolic acidosis.
Fludrocortisone cause paradoxical amplification potassium tubular section.
It reduces the effect of mitotane.
It enhances the effect of triptorelin, buserelin, gonadorelin.
Overdose
Symptoms include nausea, vomiting, dizziness, diarrhea, skin rash, hyperkalemia (paresthesia, muscle weakness, arrhythmia), hyponatremia (dry mouth, thirst, drowsiness) hypercalcemia, dehydration, increasing urea concentrations.
Treatment: gastric lavage, symptomatic treatment of dehydration and hypotension. If hyperkalemia necessary to normalize the water and electrolyte metabolism via kaliyvyvodyaschih diuretics rapid parenteral administration of 5-20% dextrose with insulin at the rate of 0.25-0.5 U per 1 g of dextrose; you can enter, if necessary repeatedly. In severe cases, hemodialysis.
pharmachologic effect
Pharmacological group:
Potassium-sparing diuretic agent.
Pharmacodynamics:
Spironolactone is a potassium-sparing diuretic, a specific antagonist of aldosterone depot (mineralokortikosteroidny adrenocortical hormone). The distal nephron spironolactone prevents aldosterone delay sodium kaliyvyvodyaschy water and suppresses the effect of aldosterone, decreased synthesis permeases in aldosterone-sensitive portion of the collecting ducts and distal tubules. By binding to the aldosterone receptor, increases the excretion of sodium, chloride and water excretion, reduces the excretion of potassium ion and urea reduces the acidity of urine.
Maximum effect is observed after 7 hours after oral administration and lasts for at least 24 hours hypotensive effect of the drug caused by the presence diuretic effect which endures. Diuretic effect is manifested by 2-5 day of treatment.
Pharmacokinetics:
When administered rapidly and completely absorbed from the gastrointestinal tract and converted to active metabolites: metabolite containing sulfur (80%) and partially canrenone (20%). The maximum concentration (Cmax) in plasma canrenone achieved within 2-4 hours, its association with plasma proteins 90%.
Communication with plasma proteins about 98% (canrenone – 90%).
After daily administration of 100 mg spironolactone for 15 days Cmax is 80 mg / ml, the time to reach Cmax after the next morning reception – 2-6 hours.
Spironolactone bad into the organs and tissues, thus itself and its metabolites cross the placental barrier and kankreon – in breast milk. The volume of distribution – 0.05 L / kg. The half-life (T1 / 2) of spironolactone 13-24 hours, active metabolites – up to 15 hours.
Excreted by the kidneys: 50% – as metabolites, 10% – intact and partially – feces. Excretion of canrenone (mainly kidneys) biphasic, T1 / 2 in the first phase – 2-3 h, in the second – 12-96 hours.
In liver cirrhosis and congestive heart failure duration half-life period is increased without signs cumulative probability is higher in chronic renal failure and hyperkalemia.
Conditions of supply of pharmacies
On prescription.
side effects
On the part of the gastrointestinal tract: nausea, vomiting, diarrhea, ulceration and bleeding from the gastrointestinal tract, gastritis, intestinal colic, abdominal pain, constipation.
Liver: abnormal liver function.
On the part of the central nervous system: ataxia, confusion, dizziness, headache, drowsiness, lethargy, confusion, muscle spasm.
On the part of the hematopoietic system: leucopenia (including agranulocytosis), thrombocytopenia.
From endocrine system: deepening of voice, men – gynecomastia (the probability of development depends on the dose, duration of treatment and usually is reversible); reduction in potency and an erection; for women – the menstrual cycle; dysmenorrhea, amenorrhea, metrorrhagia, menopause, hirsutism, pain in the breast, carcinoma of the breast (due to the presence of drug intake is not installed).
Metabolic disorders: hypercreatininemia, increasing concentrations of urea, disruption of water and salt exchange (hyperkalemia, hyponatremia) and acid-base balance (hyperchloremic metabolic acidosis or alkalosis), hyperuricemia.
In applying Veroshpilaktona may develop gynecomastia. The likelihood of gynecomastia depends on the dose and duration of therapy. Thus gynecomastia usually it is reversible and disappears after discontinuation of the drug, and only in rare cases, breast remains somewhat increased.
Allergic reactions: rash, maculopapular and rarely erythematous rash, drug fever, itching.
With the Skin: alopecia, hypertrichosis.
From the urinary system: acute renal failure.
On the part of the musculoskeletal system: leg cramps.
special instructions
Perhaps a temporary increase in the level of urea nitrogen in serum, especially with reduced renal function, and hyperkalemia. Hyperchloraemic possible reversible metabolic acidosis.
In diseases of the kidney and liver, as well as in the elderly requires regular monitoring of serum electrolytes and kidney function.
The drug is difficult to determine digoxin, cortisol and adrenaline in the blood.
Despite the lack of direct effect on carbohydrate metabolism, diabetes mellitus, especially with diabetic nephropathy, it requires special care because of the possibility of hyperkalemia.
In treating non-steroidal antiinflammatory drugs should monitor renal function and electrolyte levels in the blood.
Avoid foods rich in potassium.
During treatment with alcohol is contraindicated.
Effect on ability to drive and mechanisms, work on which is associated with an increased risk of injury:
In the initial period of treatment is prohibited to drive and engage in activities that require high concentration and psychomotor speed reactions. Duration limits set individually.
Storage conditions
In a dry, dark place at a temperature not higher than 25 C. Keep out of reach of children.
Dosing and Administration
Inside.
In essential hypertension
The daily dose for adults is usually 50-100 mg once daily and may be increased to 200 mg, the dose should be increased gradually, one every 2 weeks. To achieve an adequate response to therapy, the drug should be taken at least 2 weeks. If necessary, a correction of the dose.
Idiopathic hyperaldosteronism 100-400 mg / day.
When expressed hyperaldosteronism hypokalemia and 300 mg / day (maximum 400 mg) for 2-3 hours, while improving the dose was gradually reduced to 25 mg / day.
Hypokalemia / hypomagnesemia
When hypokalemia and / or hypomagnesemia caused diuretic therapy, administered drug dose of 25-100 mg / day, once or in several stages. The maximum daily dose of 400 mg when potassium oral formulations, or other methods of filling the deficit ineffective.
Diagnosis treatment of primary hyperaldosteronism
As a diagnostic agent for the diagnostic test, short: for 4 days at 400 mg / day, spreading to several doses per day. With increasing potassium concentration in blood during drug administration and after withdrawal reducing its presence can assume primary hyperaldosteronism.
With long-term diagnostic test: the same dose for 3-4 weeks. Upon reaching hypokalemia correction and hypertension can assume the presence of primary hyperaldosteronism.
A short course of preoperative treatment of primary hyperaldosteronism
After diagnosis hyperaldosteronism installed using more accurate diagnostic methods should take Veroshpilakton 100-400 mg / day, divided into 1-4 Hour per day for the entire period of preparation for surgery. If the operation is not shown, the Veroshpilakton used for long-term maintenance therapy, using the lowest effective dose which is adjusted individually for each patient.
Swelling in the background of nephrotic syndrome
The daily dose for adults is usually 100-200 mg / day. It revealed no influence on Veroshpilaktona basic pathological process, and therefore the use of this drug is recommended only in cases where other therapies are ineffective.
When the edematous syndrome in chronic heart failure daily for 5 days at 100-200 mg / day in 2-3 hours, in combination with the “loop” or thiazide diuretic. Depending on the effect, the daily dose is reduced to 25 mg. The maintenance dose is adjusted individually. The maximum dose of 200 mg / day.
Swelling in the background of liver cirrhosis
If the ratio of urine sodium and potassium ions (Na + / K +) exceeds 1.0, the daily intake for adults normally being 100 mg. If the ratio is less than 1.0, the daily dose for adults is usually 200-400 mg. The maintenance dose is adjusted individually.
Edema in children
The initial dose is 1-3,3 mg / kg body weight, or 30-90 mg / m2 / day. The reception 1-4. After 5 days, and the dose adjusted if necessary, increase 3-fold compared to the original.
Information
Appearance may differ from that depicted in the picture. There are contraindications. You need to read the manual or consult with a specialist

Additional information

Weight0.100 kg
Manufacturer

Obolensky

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