Действующее вещество: Спиронолактон (Spironolactone). Концентрация действующего вещества (мг): 25
Фармакологические свойства
В инструкции к Верошпирону препарат описывается как калийсберегающий диуретик. Основное действующее вещество конкурирует с альдостероном (гормоном коры надпочечников) и тормозит его действие. Na+ , Cl- и вода не всасываются обратно в почечных канальцах, а K+ и мочевина наоборот, проникают сквозь эндотелий сосудистого клубочка в кровь. Усиление мочеиспускания вызывает снижение артериального давления и исчезновение отеков. Мочегонный эффект проявляется только через 3-5 дней после первого дня приема препарата. Верошпирон существенно не влияет на функцию почечных канальцев и не приводит к кислотно-щелочному дисбалансу организма.
Показания к применению
Отечный синдром при хронической сердечной недостаточности, циррозе печени, нефротическом синдроме, эссенциальная артериальная гипертензия (у взрослых), первичный гиперальдостеронизм (для уточнения диагноза и кратковременного предоперационного лечения), профилактика гипокалиемии при лечении салуретиками, асцит.
Противопоказания
Болезнь Аддисона. Острая почечная недостаточность, хроническая почечная недостаточность со значительным снижением выделительной функции (ККменьше10 млмин), анурия, гиперкалиемия, гипонатриемия, беременность, лактация (грудное вскармливание), повышенная чувствительность к спиронолактону и другим компонентам препарата.
Применение при беременности и в период грудного вскармливания
Перед началом приема любого препарата, посоветуйтесь с Вашим врачом или фармацевтом. Верошпирон противопоказан во время беременности и в период кормления грудью.
Способ применения и дозы
При отечном синдроме при хронической сердечной недостаточности препарат назначают взрослым в начальной суточной дозе 25 мг. Максимальная доза - 100 мгсут. Поддерживающая доза определяется индивидуально. При отечном синдроме при циррозе печени препарат назначают в дозе 100-400 мгсут (в зависимости от соотношения калия и натрия). Поддерживающая доза определяется индивидуально. При отечном синдроме при нефротическом синдроме препарат назначают в дозе 100-200 мгсут. При эссенциальной артериальной гипертензии начальная суточная доза составляет 50-100 мг (разделенные на несколько приемов). При необходимости суточную дозу постепенно в течение 2 недель увеличивают до 200 мг. Продолжительность лечения не менее 2 недель. Для профилактики гипокалиемии, вызванной приемом салуретиков, Верошпирон применяют в суточной дозе 25-100 мг. Верошпирон может использоваться для начальной диагностики как косвенный показатель первичного альдостеронизма у больных, находящихся на нормальном рационе. Для этого проводят тесты. Длинный тест: взрослым Верошпирон назначают в суточной дозе 400 мг в течение 3-4 недель. Устранение гипокалиемии и артериальной гипертензии косвенно свидетельствует о первичном гиперальдостеронизме. Короткий тест: Верошпирон назначают в суточной дозе 400 мг в течение 4 дней. Если в период приема препарата концентрация калия в сыворотке крови повышается и снижается при отмене Верошпирона, то результат может косвенно свидетельствовать первичном гиперальдостеронизме. После того, как диагноз гиперальдостеронизма поставлен с помощью более информативных диагностических тестов, Верошпирон можно назначать при подготовке к операции в дозе 100-400 мгсут. У больных, не подлежащих операции, Верошпирон можно применять в качестве длительной поддерживающей терапии в самых низких эффективных дозах, которые устанавливаются индивидуально. Детям назначают препарат в суточной дозе из расчета 3 мгкг. Дозу подбирают индивидуально. Кратность приема - 1-2 раз в сутки.
Побочное действие
Со стороны эндокринной системы: гинекомастия (обычно проходит после отмены препарата, но в редких случаях может сохраняться), боль в молочных железах, снижение либидо, нарушения менструального цикла. Со стороны пищеварительной системы: диспептические явления (в т. ч. тошнота), нарушения функции печени. Со стороны ЦНС: головокружение, слабость, рассеянность. Со стороны водно-электролитного баланса: гиперкалиемия, нарушения электролитного баланса. Со стороны системы кроветворения: лейкопения, агранулоцитоз, тромбоцитопенияДерматологические реакции: алопеция, гипертрихоз, крапивница, зуд, сыпь. Прочие: судороги икроножных мышц.
Передозировка
По отзывам о Верошпироне больных, передозировка препаратом возникает крайне редко. В случае ее возникновения обостряются все побочные действия лекарственного средства. Нужно срочно промыть желудок, употребить большое количество жидкости и кофеин для повышения артериального давления. При гиперкалиемии врач назначает декстрозу и инсулин.
Особые указания
Управление автотранспортом и другими механизмами. В начале лечения следует отказаться от управления транспортными средствами и работы с опасными механизмами на период времени, продолжительность которого определяется индивидуально. В дальнейшем врач примет решение по данному ограничению.
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