Description of the dosage form
Tablets are white or white with a creamy tint, round, flat-cylindrical, with a score on one side and a bevel, almost odorless or with a weak specific odor.
pharmachologic effect
Spironolactone is a potassium-sparing diuretic, a specific antagonist of aldosterone (mineralocorticosteroid hormone of the adrenal cortex) with prolonged action. In the distal parts of the nephron, spironolactone prevents the retention of sodium and water by aldosterone and suppresses the potassium-removing effect of aldosterone, reduces the synthesis of permeases in the aldosterone-dependent area of the collecting ducts and distal tubules. By binding to aldosterone receptors, it increases the excretion of sodium, chlorine and water ions in the urine, reduces the excretion of potassium and urea ions, and reduces the acidity of urine.
The maximum effect is observed 7 hours after oral administration and lasts for at least 24 hours. The hypotensive effect of the drug is due to the presence of a diuretic effect, which is not constant: the diuretic effect appears on days 2-5 of treatment.
Pharmacokinetics
Suction and distribution
When taken orally, it is quickly and completely absorbed from the gastrointestinal tract. The maximum concentration of Cmax canrenone in the blood plasma is achieved 2-4 hours after administration. Binds to plasma proteins by approximately 98% (canrenone - 90%). Volume of distribution (Vd) - 0.05 l/kg.
After daily administration of spironolactone at a dose of 100 mg for 15 days, Cmax is 80 ng/ml, the time to reach Cmax after the next morning dose is 2-6 hours.
Spironolactone penetrates poorly into organs and tissues, while itself and its metabolites penetrate the placental barrier, and canrenone passes into breast milk.
Metabolism
Spironolactone is converted into active metabolites: a metabolite containing sulfur (80%) and partly canrenone (20%).
Removal
Excreted by the kidneys: 50% - in the form of metabolites, 10% - unchanged and partially through the intestines. The half-life (T1/2) of spironolactone is 13-24 hours, of active metabolites - up to 15 hours. The elimination of canrenone (mainly by the kidneys) is two-phase, T1/2 in the first phase is 2-3 hours, in the second - 12-96 hours.
Pharmacokinetics in selected patient groups
In liver cirrhosis and heart failure, the duration of T1/2 increases without signs of cumulation, the likelihood of which is higher in chronic renal failure and hyperkalemia.
Verospiron
Orally, after meals, 1 or 2 times a day. Taking the daily dose or the first part of the daily dose of the drug is recommended in the morning.
Adults
Essential hypertension
Additional therapy in the treatment of arterial hypertension in case of insufficient effectiveness of previously used antihypertensive drugs
The initial dose of spironolactone when used simultaneously with other antihypertensive drugs is 25 mg/day. If after 4 weeks the blood pressure does not reach the target values, the dose of the drug can be increased by 2 times.
In hypertensive patients receiving medications that may cause hyperkalemia (eg, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers), serum potassium and creatinine levels should be assessed before initiating spironolactone. Veroshpiron should not be used in patients whose serum potassium content exceeds 5.0 mmol/l and whose serum creatinine concentration exceeds 220 µmol/l.
Frequent monitoring of potassium and creatinine levels in the blood is required for 3 months after starting spironolactone.
Congestive heart failure
Edema due to congestive heart failure or nephrotic syndrome
The initial dose is 100 mg and can vary from 25 to 200 mg/day; the drug can be taken in 1-2 doses. When taking higher doses, Veroshpiron can be used in conjunction with a diuretic that acts in the proximal renal tubule. In this case, the dose of spironolactone should be adjusted.
Adjunctive therapy in the treatment of severe heart failure (NYHA class II1-IV and ejection fraction ≤35%)
It has been established that if the potassium content in the blood serum does not exceed 5.0 mmol/l, and the concentration of creatinine in the blood serum does not exceed 220 μmol/l, against the background of basic standard therapy, the dose of spironolactone at the beginning of use should be 25 mg/day.
In patients with good tolerance of the drug at a dose of 25 mg/day, according to clinical indications, the dose can be increased to 50 mg/day. For patients with poor tolerance to therapy with Veroshpiron at a dose of 25 mg/day, the dose of the drug can be reduced to 25 mg once every 2 days.
Ascites and edema due to liver cirrhosis
If the ratio of sodium and potassium ions in the urine exceeds 1.0, then the daily dose of the drug should be 100 mg. If the specified ratio is less than 1.0, then the dose of the drug should be in the range from 200 to 400 mg/day.
The maintenance dose should be determined individually for each patient.
Hypokalemia
The drug is prescribed at a dose of 25-100 mg/day if the use of potassium supplements or other potassium-sparing methods is insufficient.
Primary hyperaldosteronism
For diagnostic purposes
1) Long-term test: spironolactone is taken 400 mg/day for 3-4 weeks. When correction of hypokalemia and arterial hypertension is achieved, the presence of primary hyperaldosteronism can be assumed.
2) Short test: spironolactone is taken 400 mg/day for 4 days. If the potassium content in the blood serum increases while taking spironolactone and decreases after its discontinuation, the presence of primary hyperaldosteronism can be assumed.
Treatment
In preparation for surgical treatment, spironolactone is used in doses of 100 to 400 mg/day. If surgery is not indicated, spironolactone can be used for long-term maintenance therapy at the lowest effective dose. In this case, the initial dose of the drug may be reduced every 14 days until the lowest effective dose is reached.
To reduce the severity of side effects with long-term use, Veroshpiron is recommended to be used in combination with other diuretics.
Special patient groups
Children and teenagers under 18 years of age
The initial dose of the drug is 1-3 mg/kg body weight per day in 1-4 doses. When conducting maintenance therapy or when used simultaneously with other diuretics, the dose of Veroshpiron should be reduced to 1-2 mg/kg body weight.
When used in children under 3 years of age, a suspension can be used. To prepare a suspension, tablets should be crushed and mixed with liquid or pasty food. The suspension should be used immediately, immediately after preparation.
Elderly patients (over 65 years old)
It is recommended to start treatment with the drug with the lowest dose and gradually increase it until the maximum desired effect is achieved. Caution should be exercised in patients with severe renal or hepatic impairment, which may affect the metabolism and excretion of spironolactone. In addition, when using the drug in elderly patients, the risk of developing hyperkalemia should be taken into account (see section "Special Instructions").
Indications for use of Veroshpiron
- Essential hypertension (as part of combination therapy);
- edema syndrome in chronic heart failure (can be used in monotherapy and in combination with standard therapy);
- conditions in which secondary hyperaldosteronism may be detected, including cirrhosis of the liver accompanied by ascites and/or edema, nephrotic syndrome, as well as other conditions accompanied by edema;
- 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);
- primary hyperaldosteronism (Conn's syndrome) - for a short preoperative course of treatment;
- to establish the diagnosis of primary hyperaldosteronism.
Contraindications to the use of Veroshpiron
- Hypersensitivity to any of the components of the drug;
- Addison's disease;
- hyperkalemia;
- hyponatremia;
- severe renal failure (creatinine clearance less than 10 ml/min);
- anuria;
- pregnancy;
- lactation period (breastfeeding);
- children under 3 years of age (for solid dosage form);
- lactase deficiency, lactose intolerance, glucose-galactose malabsorption syndrome (since the drug contains lactose monohydrate).
With caution: hypercalcemia, metabolic acidosis, AV block (hyperkalemia enhances it); diabetes mellitus (with confirmed or suspected chronic renal failure); diabetic nephropathy; surgical interventions during anesthesia; taking medications that cause gynecomastia; local and general anesthesia; elderly age; menstrual irregularities, enlarged mammary glands; liver failure, liver cirrhosis.
Contraindications for use
Taking the drug is prohibited in the presence of the following violations:
- anuria;
- severe renal failure;
- sodium deficiency;
- excess potassium;
- Addison's pathology.
During pregnancy and during breastfeeding (any period), Veroshpiron is also not taken. The drug should be used with caution in elderly people and patients with the following diseases:
- diabetes mellitus of both types;
- acidosis;
- excess calcium;
- installation of AV block;
- disturbances of the monthly cycle;
- chronic kidney and liver diseases;
- local or general anesthesia;
- diabetic nephropathy.
Side effects
From the gastrointestinal tract: nausea, vomiting, diarrhea, ulceration and bleeding from the gastrointestinal tract, gastritis, intestinal colic, abdominal pain, constipation.
From the liver: impaired liver function.
From the nervous system: ataxia, lethargy, dizziness, headache, drowsiness, lethargy, confusion, muscle spasm.
From the blood and lymphatic system: agranulocytosis, thrombocytopenia, megaloblastosis.
From laboratory parameters: hyperuricemia, hypercreatininemia, increased urea concentration, disturbance of water and electrolyte balance (hyperkalemia, hyponatremia) and acid-base status (metabolic hyperchloremic acidosis or alkalosis).
From the endocrine system: deepening of the voice, in men - gynecomastia (the likelihood of development depends on the dose, duration of treatment and is usually reversible, and disappears after discontinuation of the drug, and only in rare cases the mammary gland remains slightly enlarged), decreased potency and erection; in women - menstrual irregularities, dysmenorrhea, amenorrhea, metrorrhagia during menopause, hirsutism, pain in the mammary glands, breast carcinoma (no connection with the drug has been established).
Allergic reactions: urticaria, maculopapular and erythematous rash, drug fever, pruritus, eosinophilia, Stevens-Johnson syndrome, toxic epidermal necrolysis.
From the skin and subcutaneous tissues: alopecia, hypertrichosis.
From the kidneys and urinary tract: acute renal failure.
Musculoskeletal and connective tissue disorders: calf muscle cramps.
From the respiratory system: shortness of breath.
If any of the above adverse reactions worsen or other adverse events not listed in the instructions occur, the patient should inform the doctor.
Veroshpilakton (Veroshpiron) (caps. 100 mg No. 30)
A country
Russia
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Active substance
Spironolactone
Compound
1 capsule contains: spironolactone 100 mg. Excipients: povidone - 10 mg, lactose monohydrate - 112 mg, potato starch - 82.4 mg, colloidal silicon dioxide (aerosil) - 4 mg, sodium lauryl sulfate - 5.2 mg, talc - 3.2 mg, magnesium stearate - 3.2 mg. Capsules No. 1 with a blue body and cap; the contents of the capsules are white or white powder with a yellowish tint.
pharmachologic effect
Spironolactone is a potassium-sparing diuretic, a specific antagonist of aldosterone (mineralocorticosteroid hormone of the adrenal cortex) with prolonged action. In the distal parts of the nephron, spironolactone prevents the retention of sodium and water by aldosterone and suppresses the potassium-removing effect of aldosterone, reduces the synthesis of permeases in the aldosterone-dependent area of the collecting ducts and distal tubules. By binding to aldosterone receptors, it increases the excretion of sodium, chlorine and water ions in the urine, reduces the excretion of potassium and urea ions, and reduces the acidity of urine. The maximum effect is observed 7 hours after oral administration and lasts for at least 24 hours. The hypotensive effect of the drug is due to the presence of a diuretic effect , which is not permanent: the diuretic effect appears on days 2-5 of treatment.
Indications for use
— essential hypertension (as part of combination therapy); — edematous syndrome in chronic heart failure (can be used in monotherapy and in combination with standard therapy); — conditions in which secondary hyperaldosteronism may be detected, including cirrhosis of the liver, accompanied by ascites and/or edema , nephrotic syndrome, as well as other conditions accompanied by edema; - 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); - primary hyperaldosteronism (Conn's syndrome) - for a short preoperative course of treatment; - to establish a diagnosis of primary hyperaldosteronism.
Mode of application
Orally. Essential hypertension The daily dose for adults is usually 50-100 mg once and can be increased to 200 mg, and the dose should be increased gradually, once every 2 weeks. To achieve an adequate response to therapy, the drug must be taken for at least 2 weeks. If necessary, adjust the dose. Idiopathic hyperaldosteronism Prescribed at a dose of 100-400 mg/day. Severe hyperaldosteronism and hypokalemia Prescribed 300 mg/day (maximum 400 mg/day) in 2-3 doses; if the condition improves, the dose is gradually reduced to 25 mg/day. Hypokalemia and/or hypomagnesemia For hypokalemia and/or hypomagnesemia caused by diuretic therapy, the drug is prescribed at a dose of 25-100 mg/day, once or in several doses. The maximum daily dose is 400 mg, if potassium preparations for oral administration or other methods of replenishing its deficiency are ineffective. Diagnosis and treatment of primary hyperaldosteronism As a diagnostic tool for a short diagnostic test: for 4 days, 400 mg / day, divided into several doses per 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: at the same dose for 3-4 weeks. When correction of hypokalemia and arterial hypertension is achieved, the presence of primary hyperaldosteronism can be assumed. A short course of preoperative therapy for primary hyperaldosteronism After the diagnosis of hyperaldosteronism is established using more accurate diagnostic methods, Verospilactone should be taken 100-400 mg / day, divided into 1-4 doses during the entire period of preparation for surgery. If surgery is not indicated, then the drug Verospilactone is used for long-term maintenance therapy, using the lowest effective dose, which is selected individually for each patient. Edema due to nephrotic syndrome The daily dose for adults is usually 100-200 mg/day. No effect of spironolactone on the underlying pathological process has been identified, and therefore the use of this drug is recommended only in cases where other types of therapy are ineffective. Edema syndrome due to chronic heart failure Daily, for 5 days, 100-200 mg / day in 2 days 3 doses, in combination with a loop or thiazide diuretic. Depending on the effect, the daily dose is reduced to 25 mg. The maintenance dose is selected individually. The maximum dose is 200 mg/day. Edema due to cirrhosis of the liver. If the ratio of sodium and potassium ions (Na+/K+) in the urine exceeds 1.0, then the daily dose for adults is usually 100 mg. If the ratio is less than 1.0, then the daily dose for adults is usually 200-400 mg. The maintenance dose is selected individually. Edema in children The initial dose in children over 3 years of age 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 and, if necessary, increased by 3 times compared to the original.
Interaction
Reduces the effect of anticoagulants, indirect anticoagulants (heparin, coumarin derivatives, indandione) and the toxicity of cardiac glycosides (since normalization of potassium levels in the blood prevents the development of toxicity). Enhances the metabolism of phenazone (antipyrine). Reduces the sensitivity of blood vessels to norepinephrine (care is required when carrying out anesthesia), increases T1/2 of digoxin - digoxin intoxication is possible. Increases the toxic effect of lithium due to decreased clearance. Possibly enhances the effect of non-depolarizing muscle relaxants (for example, tubocurarine). Accelerates the metabolism and excretion of carbenoxolone. Carbenoxolone promotes sodium retention by spironolactone. GCS and diuretics ( thiazides and thiazide-like, furosemide, ethacrynic acid) enhance and accelerate the diuretic and natriuretic effects. Enhances the effect of diuretic and antihypertensive drugs. NSAIDs reduce the diuretic and natriuretic effects, increasing the risk of hyperkalemia. Alcohol (ethanol), barbiturates, narcotic substances increase orthostatic hypotension. GCS enhance the diuretic and natriuretic effect in hypoalbuminemia and/or hyponatremia. The risk of developing hyperkalemia increases when taken with potassium preparations, potassium supplements and potassium-sparing diuretics, ACE inhibitors (acidosis), angiotensin II receptor antagonists, aldosterone blockers, indomethacin, cyclosporine. Salicylates, indomet qing reduce the diuretic effect of spironolactone. Ammonium chloride, cholestyramine contribute to the development of hyperkalemic metabolic acidosis. Fludrocortisone causes a paradoxical increase in tubular secretion of potassium. Spironolactone reduces the effect of mitotane. Enhances the effects of triptorelin, buserelin, gonadorelin.
Side effect
From the gastrointestinal tract: nausea, vomiting, diarrhea, ulcerations and bleeding from the gastrointestinal tract, gastritis, intestinal colic, abdominal pain, constipation. From the liver: impaired liver function. From the nervous system: ataxia, lethargy, dizziness, headache pain, drowsiness, lethargy, confusion, muscle spasm. From the blood and lymphatic system: agranulocytosis, thrombocytopenia, megaloblastosis. From laboratory indicators: hyperuricemia, hypercreatininemia, increased urea concentration, water-electrolyte imbalance (hyperkalemia, hyponatremia) and acid - the underlying condition (metabolic hyperchloremic acidosis or alkalosis). From the endocrine system: deepening of the voice, in men - gynecomastia (the likelihood of development depends on the dose, duration of treatment and is usually reversible, and disappears after discontinuation of the drug, and only in rare cases chest gland remains slightly enlarged), decreased potency and erection; in women - menstrual irregularities, dysmenorrhea, amenorrhea, metrorrhagia during menopause, hirsutism, pain in the mammary glands, breast carcinoma (no connection with the drug has been established). Allergic reactions: urticaria, maculopapular and erythematous rash, drug fever, pruritus, eosinophilia, Stevens-Johnson syndrome, toxic epidermal necrolysis. From the skin and subcutaneous tissues: alopecia, hypertrichosis. From the kidneys and urinary tract: acute renal failure. From the musculoskeletal and connective tissue: cramps of the calf muscles From the respiratory system: shortness of breath. If any of the above adverse reactions worsen or other adverse events not listed in the instructions occur, the patient should inform the doctor.
Contraindications
- hypersensitivity to any of the components of the drug; - Addison's disease; - hyperkalemia; - hyponatremia; - severe renal failure (creatinine clearance less than 10 ml/min); - anuria; - pregnancy; - lactation (breastfeeding); - children age up to 3 years (for solid dosage form); - lactase deficiency, lactose intolerance, glucose-galactose malabsorption syndrome (since the drug contains lactose monohydrate). With caution: - hypercalcemia, metabolic acidosis, AV block (hyperkalemia contributes to its strengthening);—diabetes mellitus (with confirmed or suspected chronic renal failure);—diabetic nephropathy;—surgical interventions during anesthesia; taking medications that cause gynecomastia; local and general anesthesia; old age; menstrual irregularities, enlarged mammary glands; liver failure, liver cirrhosis.
Overdose
Symptoms: nausea, vomiting, dizziness, diarrhea, skin rash, hyperkalemia (paresthesia, muscle weakness, arrhythmias), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increased urea concentration. Treatment: gastric lavage, symptomatic treatment of dehydration and arterial hypotension. In case of hyperkalemia, it is necessary to normalize the water-electrolyte balance with the help of potassium-removing diuretics, rapid parenteral administration of a 5-20% dextrose (glucose) solution with insulin at the rate of 0.25-0.5 units per 1 g of dextrose (glucose). You can re-enter if necessary. In severe cases, hemodialysis is performed.
special instructions
A temporary increase in serum urea nitrogen is possible, especially with reduced renal function and hyperkalemia. Reversible hyperchloremic metabolic acidosis is possible. In case of impaired renal and hepatic function, as well as in old age, regular monitoring of serum electrolytes and renal function is necessary. The drug makes it difficult to determine digoxin , cortisol and adrenaline in the blood. Despite the lack of a direct effect on carbohydrate metabolism, the presence of diabetes mellitus, especially with diabetic nephropathy, requires special caution due to the possibility of developing hyperkalemia. When treating NSAIDs simultaneously, renal function and electrolyte levels in the blood should be monitored. Avoid eating foods rich in potassium. During treatment, alcohol consumption is contraindicated. Impact on the ability to drive vehicles and operate machinery. During the initial period of treatment, it is prohibited to drive a vehicle and engage in activities that require increased concentration and speed of psychomotor reactions. The duration of restrictions is set individually.
Dispensing conditions in pharmacies
On prescription
Drug interactions
Reduces the effect of anticoagulants, indirect anticoagulants (heparin, coumarin derivatives, indanedione) and the toxicity of cardiac glycosides (since normalization of potassium content in the blood prevents the development of toxicity).
Enhances the metabolism of phenazone (antipyrine).
Reduces the sensitivity of blood vessels to norepinephrine (care is required when performing anesthesia), increases T1/2 of digoxin - digoxin intoxication is possible.
Increases the toxic effect of lithium due to decreased clearance.
Possibly enhances the effect of non-depolarizing muscle relaxants (for example, tubocurarine).
Accelerates the metabolism and excretion of carbenoxolone.
Carbenoxolone promotes sodium retention by spironolactone.
GCS and diuretics (thiazides and thiazide-like, furosemide, ethacrynic acid) enhance and accelerate the diuretic and natriuretic effects.
Enhances the effect of diuretic and antihypertensive drugs.
NSAIDs reduce the diuretic and natriuretic effects, increasing the risk of hyperkalemia.
Alcohol (ethanol), barbiturates, and narcotic substances increase orthostatic hypotension.
GCS enhance the diuretic and natriuretic effect in hypoalbuminemia and/or hyponatremia.
The risk of developing hyperkalemia increases when taken with potassium preparations, potassium supplements and potassium-sparing diuretics, ACE inhibitors (acidosis), angiotensin II receptor antagonists, aldosterone blockers, indomethacin, cyclosporine.
Salicylates and indomethacin reduce the diuretic effect of spironolactone.
Ammonium chloride and cholestyramine contribute to the development of hyperkalemic metabolic acidosis.
Fludrocortisone causes a paradoxical increase in tubular secretion of potassium.
Spironolactone reduces the effect of mitotane.
Enhances the effects of triptorelin, buserelin, gonadorelin.
Dosage of Veroshpiron
Inside.
Essential hypertension
The daily dose for adults is usually 50-100 mg once and can be increased to 200 mg, and the dose should be increased gradually, once every 2 weeks. To achieve an adequate response to therapy, the drug must be taken for at least 2 weeks. If necessary, adjust the dose.
Idiopathic hyperaldosteronism
Prescribed at a dose of 100-400 mg/day.
Severe hyperaldosteronism and hypokalemia
Prescribe 300 mg/day (maximum 400 mg/day) in 2-3 doses; as the condition improves, the dose is gradually reduced to 25 mg/day.
Hypokalemia and/or hypomagnesemia
For hypokalemia and/or hypomagnesemia caused by diuretic therapy, the drug is prescribed at a dose of 25-100 mg/day, once or in several doses. The maximum daily dose is 400 mg if oral potassium supplements or other methods of replenishing the deficiency are ineffective.
Diagnosis and treatment of primary hyperaldosteronism
As a diagnostic agent for a short diagnostic test: for 4 days, 400 mg/day, divided into several doses per 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: at the same dose for 3-4 weeks. When correction of hypokalemia and arterial hypertension is achieved, the presence of primary hyperaldosteronism can be assumed.
Short course of preoperative therapy for primary hyperaldosteronism
After the diagnosis of hyperaldosteronism has been established using more accurate diagnostic methods, Verospilactone should be taken at a dose of 100-400 mg/day, divided into 1-4 doses during the entire period of preparation for surgery. If surgery is not indicated, then the drug Verospilactone is used for long-term maintenance therapy, using the lowest effective dose, which is selected individually for each patient.
Edema due to nephrotic syndrome
The daily dose for adults is usually 100-200 mg/day. No effect of spironolactone on the underlying pathological process has been identified, and therefore the use of this drug is recommended only in cases where other types of therapy are ineffective.
Edema syndrome due to chronic heart failure
Daily, for 5 days, 100-200 mg/day in 2-3 divided doses, in combination with a loop or thiazide diuretic. Depending on the effect, the daily dose is reduced to 25 mg. The maintenance dose is selected individually. Maximum dose 200 mg/day.
Edema due to liver cirrhosis
If the ratio of sodium and potassium ions (Na+/K+) in the urine exceeds 1.0, then the daily dose for adults is usually 100 mg. If the ratio is less than 1.0, then the daily dose for adults is usually 200-400 mg. The maintenance dose is selected individually.
Edema in children
The initial dose in children over 3 years of age 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 and, if necessary, increased by 3 times compared to the original.
Instructions for use of "Veroshpiron"
Capsules and tablets are used according to general rules. The dosage is prescribed depending on the patient’s disease:
- For essential hypertension, take 50 or 100 mg once. Gradually this amount can be increased to 200 mg.
- For idiopathic hyperaldosteronism, the amount is set in the range from 100 to 400 mg per day.
- If hyperaldosteronism is severe, potassium deficiency is observed, take 300 g per day (the amount is divided by 2-3 times).
- If there is a deficiency of magnesium and potassium associated with diuretics, take no more than 100 mg per day. The reception takes place once or 2-3 times.
- To diagnose a pathology called “Primary hyperaldosteronism,” the following norm has been established: 400 mg per day for 4 days in a row. This amount is divided into 2-3 doses.
- In the presence of edema (including with CHF), the daily dose is up to 200 mg.
- Swelling in cirrhosis: 100 mg or from 200 to 400 mg (depending on the ratio of the concentration of sodium and potassium cations).
- Swelling in children: the amount is calculated based on the ratio of 1-3 mg per kg of weight. The dose is adjusted after taking it for 5 consecutive days.
Tablets or capsules should be taken after meals. The course of therapy lasts up to 20 days. Then they take a break for at least 6 months, and if necessary, resume treatment again.
Important!
If the course lasts for 2 months or more, acute renal failure may develop. In case of overdose, vomiting, skin rash, and diarrhea are observed. Therefore, it is necessary to strictly follow the dosage as recommended by the doctor and instructions.
Overdose
Symptoms: nausea, vomiting, dizziness, diarrhea, skin rash, hyperkalemia (paresthesia, muscle weakness, arrhythmias), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increased urea concentration.
Treatment: gastric lavage, symptomatic treatment of dehydration and arterial hypotension. In case of hyperkalemia, it is necessary to normalize the water-electrolyte balance with the help of potassium-removing diuretics, rapid parenteral administration of a 5-20% dextrose (glucose) solution with insulin at the rate of 0.25-0.5 units per 1 g of dextrose (glucose); can be re-entered if necessary. In severe cases, hemodialysis is performed.
