Androgenetic alopecia in women

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.

Composition and action

Veroshpiron is a strong diuretic, the active substance of which is spironolactone, an aldosterone antagonist. Additional components of the drug are:

• Talc;
• Starch;
• Colloidal silicon dioxide;
• Quinoline dyes;
• Magnesium salt.

Each component has a positive effect on the body of a person losing weight, activates all processes, and helps fight excess weight. The positive properties of the product are:

• Getting rid of edema;
• Diuretic action.
• Removing toxins from the body.
• Filling the body with useful components;
• Rapid breakdown of fat deposits.

The drug is available in the form of capsules and tablets, which are affordable. Tablets are available in packs of 20 pieces, and capsules – 30 pieces. If we compare the price category, it is somewhat cheaper to buy the drug in tablets. They do not have a specific smell or taste, are easy to use and give the desired effect. A faster effect is observed after taking capsules, the composition of which does not interact with the environment, but begins to dissolve only after entering the body.

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.

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.

Contraindications and side effects

Despite its natural composition and complete safety for the body when taken correctly, Veroshpiron still has certain contraindications, in which losing weight with the help of such a diuretic is strictly prohibited. Contraindications are:

• Age up to 16 years;
• Pregnancy;
• Lactation;
• Anuria;
• Hyponatremia;
• Allergic reactions to the composition of the drug.

Before giving preference to this medication, you should visit a specialist, undergo an examination, and identify the presence of indications and contraindications for use. If you have the above conditions, for safety reasons it is not recommended to take Veroshpiron.

Failure to comply with all rules and recommendations leads to serious consequences; side effects are:

• Spasms and cramps;
• Nausea, vomiting;
• Hyperuricemia;
• Allergic reactions;
• Dizziness, drowsiness;
• Alopecia;
• Decreased potency in men.

To avoid such unpleasant manifestations after the drug, it is important to take into account contraindications, as well as comply with the required dosages. It must be remembered that increasing the dosage has never brought the desired results to anyone; on the contrary, it provoked a deterioration in well-being. Before taking Veroshpiron, you should read the available instructions and study all the rules of use that will not pose a danger.

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.

Synonyms, analogues

You can replace Verospiron with other diuretics. Products in which the active ingredient, as in Veroshpiron, is Spironolactone, are called synonyms. The most famous:

1. Vero-Spironolactone (Veropharm, Russia).
2. Veroshpilakton (Obolenskoye Pharmaceutical Enterprise, Russia).
3. Spironol (OZONE LLC, Russia).
4. Spironolactone-Darnitsa (PJSC Darnitsa, Ukraine).
5. Spilactone (World Medicine Ilac, Türkiye).
6. Spironolactone Sandoz Salutas (Pharma GmbH, Germany).
7. Spironaxane (SANOFI WINTHROP INDUSTRIE, France).
8. Spirix (NYCOMED DANMARK, Denmark).
9. Urakton (Societa Prodotti Antibiotici, Italy).

Analogue drugs have an effect similar to Veroshpiron - they relieve swelling and remove excess water, but are made on the basis of other active ingredients, and therefore have other side effects and contraindications. For weight loss, it is recommended to use potassium-sparing diuretics, the active substance of which is eplerenone:

1. Inspra - manufacturers Pfizer Pharmaceuticals (USA), Pharmacy Limited (UK).
2. Renial is manufactured by Kievmedpreparat (Ukraine).
3. Eplepres - manufacturer Kiev Vitamin Plant (Ukraine).

As analogues, diuretics can also be used to relieve swelling and reduce weight:

1. Furosemide is the active ingredient furosemide. The tablets are produced by Belmedpreparaty (Belarus), as well as Borshchagovsky Chemical Pharmaceutical Plant (Ukraine).
2. Diuver is the active substance torasemide. The tablets are produced by the pharmaceutical companies PLIVA HRVATSKA (Croatia) and TEVA (Russia).
3. Trifas is the active substance torasemide. Manufacturer: BERLIN-CHEMI (Germany).

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.

How to take Veroshpiron for weight loss

The instructions for Veroshpiron indicate dosages for taking it as a decongestant; the indications for its use do not include weight loss. Therefore, when determining the optimal daily dose when using this drug for weight loss, it is advisable to use the recommendations of your family doctor. He will assess your general health, the presence of edema, the amount of excess weight, and, if necessary, prescribe an examination to exclude the possibility of ignoring existing contraindications.

But if you still decide to take this remedy without a doctor’s prescription, start with the minimum dose - 50 mg per day. These are 2 tablets of 0.025 g or 1 capsule of 0.05 g. In most cases, this regimen of administration is enough to remove excess fluid from the body without shock to the body and negative consequences for health. If there is no effect from such a dose, it can be increased to 200 mg per day, but no more.

Verospiron can be taken before, after or during meals. The drug is not fast-acting; it has a full diuretic effect on the 3-5th day of administration. To avoid the development of side effects, the course of treatment should not exceed two weeks.

Important! While taking Veroshpiron, you must completely abstain from alcoholic beverages: the active ingredient of the drug spironolactone and ethyl alcohol are incompatible, their combination can cause serious liver problems.

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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.