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Verospiron Pregnancy |
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Verospiron crosses the placenta (Regitz-Zagrosek [ESC 2018]).
Based on the mechanism of action and data from animal reproduction studies, in utero exposure to Verospiron may cause feminization of a male fetus (limited human data; Liszewski 2019).
Chronic maternal hypertension is associated with adverse events in the fetus/infant. The risk of birth defects, low birth weight, premature delivery, stillbirth, and neonatal death may be increased with chronic hypertension in pregnancy. Actual risks may be related to duration and severity of maternal hypertension. The use of mineralocorticoid receptor antagonists for the treatment of hypertension in pregnancy is generally not recommended (ACOG 203 2019).
The treatment of edema associated with chronic heart failure during pregnancy is similar to that of nonpregnant patients. However, the use of mineralocorticoid receptor antagonists is not recommended. Patients diagnosed after delivery can be treated according to heart failure guidelines (ESC [Bauersachs 2016]; ESC [Regitz-Zagrosek 2018]).
Information related to the use of mineralocorticoid receptor antagonists for the treatment of primary hyperaldosteronism in pregnancy is limited. Women who require use of Verospiron for the treatment of primary hyperaldosteronism should stop treatment during the first trimester once the pregnancy is confirmed. Use of a mineralocorticoid receptor antagonist can be considered again in the second and third trimesters if necessary; high doses have been associated with intrauterine growth restriction (monitor) (Riester 2015).
A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. Excreted into human milk: Yes (as active metabolite)
According to some authorities, use of this drug appears acceptable during breastfeeding.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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