Indapamide and Veroshpiron have been used for many decades as diuretic and antihypertensive drugs. They are considered the safest with high efficiency. We have analyzed the advantages and disadvantages of these drugs to find out which one is better.

Description of Veroshpiron

Veroshpiron is a diuretic based on spironolactone. Available in tablet form of 25, 50 and 100 mg. Manufacturer: Gedeon Richter.

Prevents water retention, inhibits the excretion of potassium. A positive result is observed from the 2-5th day of admission. Due to the unstable diuretic effect, diuresis increases.

Veroshpiron is used to remove various fluids from the body that accumulate against the background of CVD.

Research

In a randomized trial with patients diagnosed with severe HF, it was found that the use of spironolactone reduced the risk of death by 30% compared with the placebo group. Patients also had fewer complaints and were less likely to be hospitalized. The maximum effect is observed after 7 hours and lasts a day.

Also, drugs with spironolactone have a positive effect on a heart attack, when there is a history of diabetes and / or symptoms of heart failure develop.

A recent study conducted in 2014 found no reduction in CVD mortality.

The American Heart Association recommends the use of spironolactone-based agents for class 2-4 HF. The efficacy and safety of Veroshpiron has been proven by preclinical and clinical studies.

Sources:

1. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE , Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL. 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2013.

2. The effectiveness of spironolactone therapy in patients with chronic heart failure. Rubanenko O.A. Cardiology: news, opinions, training. 2018.

3. Bertram Pitt, Faiez Zannad, Willem J. Remme, Robert Cody, Alain Castaigne. The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure. New England Journal of Medicine. 1999.

What are the contraindications

Veroshpiron should not be taken in case of intolerance to the components in the composition. It is not prescribed until 2 years of age, during gestation and during breastfeeding.

Other restrictions on the appointment of a diuretic:

1. Addison’s disease;

2. reduced amount of sodium, excess potassium;

3. anuria;

4. kidney failure;

5. lactose intolerance.

The drug is used with caution when there is diabetes, acidosis, hypercalcemia, nephropathy. An additional assessment of the safety of the use of Veroshpiron is needed during surgical interventions and the use of drugs that provoke gynecomastia.

Adverse symptoms

Possible side effects while taking Veroshpiron can be temporary and not dangerous, as well as serious, in which you need to immediately stop the medicine.

What adverse reactions can occur during treatment with Veroshpiron:

1. nausea, constipation, gastritis, colic, abdominal pain;

2. ataxia, lethargy, muscle spasm;

3. megaloblastosis, thrombocytopenia.

The likelihood of gynecomastia depends on the dosage and duration of the course of treatment. The violation is temporary, disappears after the withdrawal of the remedy.

Also, the drug can cause allergies in the form of urticaria. Rarely appear erythematous rash, itching, drug fever, epidermal necrolysis.

How to use

The medicine is taken orally. For adults — 50-100 mg / day. The dosage can be increased up to 200 mg, but gradually. To obtain a positive result, you need to use the medicine for at least 14 days.

After 3 years in the treatment of edema — 1-3 mg / kg per day for 1-4 doses. After a week, the dose, if necessary, changes, increases 3 times from the original.

Overdose is accompanied by nausea, diarrhea, rash, arrhythmia, muscle weakness, paresthesia. These are manifestations characteristic of hyperkalemia and hyponatremia. It also increases the level of urea.

At the use of a high dose it is necessary to carry out a gastric lavage. The doctor prescribes symptomatic drugs to eliminate dehydration and hypertension. In severe cases, hemodialysis is performed.

Who suits

Veroshpiron is prescribed for the following indications:

1. essential hypertension;

2. Conn’s syndrome;

3. edema in CH;

4. hyperaldosteronism;

5. hypomagnesemia / hypokalemia;

6. edematous syndrome after 3 years.

Veroshpiron can be prescribed both as part of complex therapy, and as a monodrug, depending on the pathological process.

Description of Indapamide

Indapamide is a tablet preparation based on the active ingredient of the same name. Refers to thiazide diuretic drugs. Reduces pressure without significantly affecting the frequency of urination. Producers — Ozone, Hemofarm, Valenta, GNTsLS.

It is a diuretic drug prescribed for the treatment of high blood pressure. The advantages of the drug lies in the fact that it does not affect the metabolism of lipids and carbohydrates in diabetes. The effectiveness of the drug does not decrease even in patients who regularly undergo hemodialysis.

The positive effect of taking Indapamide:

1. decrease in blood pressure;

2. increased outflow of fluid;

3. vasodilation;

4. decrease in vascular resistance;

5. decreased thickening of the left ventricular wall.

Research

Indapamide is a highly effective drug for the treatment of hypertension in its mild and moderate forms. It is best to prescribe the drug for diastolic hypertension. Due to the fact that indapamide does not affect the metabolism of carbohydrates and lipids, it can be recommended to patients with diabetes mellitus. In combination with enalapril, it is possible to achieve the target level of blood pressure.

Indapamide is used for the long-term treatment of hypertension in elderly patients. Long-term use of the drug improves the quality of life and cognitive-mnestic functions, which is especially important for elderly patients.

Sources:

1. Long-term therapy with indapamide in elderly and senile patients with arterial hypertension: possibilities of cardionephroprotection and impact on quality of life. Statsenko M.E. Rational pharmacotherapy in cardiology. 2009.

2. Clinical efficacy of Indapamide in patients with hypertension. Podzolkov V.I. breast cancer. 2001.

What are the contraindications

Indapamide is not used for allergies to components. The drug is contraindicated in case of malfunction of the liver and kidneys. Restrictions on taking the drug will also be cerebrovascular accidents, gout, combination with drugs that increase the QT interval.

Adverse symptoms

Indapamide can cause the following side effects:

1. muscle pain;

2. weakness;

3. violation of the heart rhythm;

4. decrease in potassium levels;

5. orthostatic reactions;

6. increase in uric acid;

7. dryness of the mucosa;

8. allergy;

9. exacerbation of lupus erythematosus;

10. cough;

11. metabolic acidosis;

12. purpura, rash;

13. sinusitis, pharyngitis.

How to use

Indapamide is taken 1 tablet per day. It is better to take the medicine in the morning. Increasing the dosage does not lead to an increase in therapeutic efficacy, but may cause side effects and an increased diuretic effect.

With an overdose, drowsiness, signs of a violation of the water and electrolyte balance, anuria, oliguria appear. Rehydration is underway.

Who suits

Indapamide is indicated for the treatment of hypertension.

Cost and analogues

Which drug to choose

Veroshpiron and Indapamide have one indication — the treatment of hypertension. Their mechanism of action is different. They have different restrictions for use and side effects.

Indapamide has an effect due to the diuretic action, Veroshpiron corrects the work of aldosterone, on which the amount of sodium and fluid depends. The latter can be combined with other diuretic drugs, because. has a mild diuretic effect. Veroshpiron and Indapamide can be administered simultaneously.

Veroshpiron has a wider range of indications. It can be used to treat female diseases, which are accompanied by increased production of the male hormone.

Indapamide is better tolerated by patients, but with hypertension it is more effective to use Veroshpiron.

A doctor should prescribe diuretics and antihypertensive drugs. Medicines have many contraindications and can cause severe adverse reactions, so self-medication is dangerous.