Indications Veroshpiron tablets
congestive heart failure in cases where the patient has not responded to treatment with other diuretics or there is a need to potentiate their effects.
Essential hypertension, mainly way for hypokalemia, usually in combination with other antihypertensive drugs.
In cases of cirrhosis of the liver, accompanied by edema and/or ascites.
For the treatment of primary hyperaldosteronism.
For edema due to nephrotic syndrome.
/>For the treatment of hypokalemia when other therapy is not possible.
For the prevention of hypokalemia in patients receiving cardiac glycosides in cases where other methods are considered inappropriate or inappropriate.
Use of Veroshpiron tablets
dosage schedule.
Adults
Primary hyperaldosteronism
For diagnostic purposes. Long-term test: spironolactone is used at 400 mg/day for 3–4 weeks. When correction of hypokalemia and hypertension is achieved, the presence of primary hyperaldosteronism can be assumed.
Short test: spironolactone is taken 400 mg/day for 4 days. If the potassium content in the blood increases while taking the drug Veroshpiron and decreases after discontinuation, the presence of primary hyperaldosteronism can be assumed.
Treatment. In preparation for surgical treatment, spironolactone is used at a dose of 100–400 mg/day. In patients for whom surgery is not planned, the drug can be used as long-term maintenance therapy at the lowest effective dose, which is determined individually. In the described situation, the initial dose can be reduced every 14 days until the minimum effective dose is reached. To reduce the severity of side effects with long-term use, the drug Veroshpiron is recommended to be used in combination with other diuretics.
Swelling due to congestive heart failure or nephrotic syndrome. The initial daily dose is 100 mg and can be varied in the range of 25–200 mg/day, prescribed in 1 or 2 doses. If higher doses are prescribed, Veroshpiron can be used in combination with other groups of diuretics that act in more proximal parts of the renal tubules. In this case, the dose of Veroshpiron should be adjusted.
Additional therapy in the treatment of severe heart failure (class III-IV according to the NYHA classification and with an ejection fraction of ≤35%). Based on the results of randomized studies of the use of aldactone (RALES: see pharmacodynamics), it was established that if the potassium content in the blood serum does not exceed 5.0 mEq/l, and the concentration of creatinine in the blood serum does not exceed 2.5 mg/dl, at the beginning of use against the background of basic standard therapy, the dose of spironolactone should be 25 mg/day. For patients who tolerate the drug well at a dose of 25 mg/day, according to clinical indications, it can be increased to 50 mg/day. For patients who cannot tolerate the drug at a dose of 25 mg/day, the dose of the drug can be reduced to 25 mg once every 2 days (see SPECIAL INSTRUCTIONS).
Additional therapy in the treatment of 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. If after 4 weeks blood pressure does not reach target values, the dose can be doubled. In patients with hypertension receiving drugs that can cause hyperkalemia (for example, 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 2.5 mg/dl. Potassium and creatinine levels in the blood should be carefully monitored for 3 months after starting spironolactone.
Ascites and edema due to cirrhosis of the liver. If the Na+/K+ ratio in urine is more than 1, the daily dose is 100 mg. If this ratio is less than 1, the dose of the drug should be in the range of 200–400 mg/day. The maintenance dose should be determined individually.
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