North East and North Cumbria
ICS Formulary
 
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2 Cardiovascular system
02-02-03 Aldosterone antagonists

Spironolactone
Formulary
  • Green Resistant Hypertension - Step 4 NICE NG 136 - consider seeking expert advice
  • Green plus Post-acute myocardial infarction patients and patients with heart failure treatment should be initiated on instructions from a cardiologist or GP with a specialist interest in cardiology. Spironolactone is first choice (ahead of eplerenone) for severe heart failure.
  • Spironolactone 10mg and 50mg in 5ml suspension is also approved unlicensedunlicensed.
  • 50mg/5ml - Recommended strength in children as per NPPG/RCPCH Position Statement: Using Standardised Strengths of Unlicensed Liquid Medicines in Children. 
Link  MHRA Drug Safety Update (Dec 2016): Spironolactone and renin-angiotensin system drugs in heart failure: risk of potentially fatal hyperkalaemia—clarification, December 2016
Link  MHRA Drug Safety Update (Feb 2016): Spironolactone and renin-angiotensin system drugs in heart failure: risk of potentially fatal hyperkalaemia.
Link  RCPCH Position Statement: Using Standardised Concentrations of Liquid Medicines in Children

Green View adult BNF  View SPC online  View childrens BNF
Eplerenone
Formulary
  • For use in post-acute myocardial infarction patients with left ventricular dysfunction and heart failure. Only to be used in patients who are unable to tolerate the estrogenic side effects of spironolactone. Treatment should only be on advice from a cardiologist.
Link  NICE NG106: Chronic heart failure in adults: diagnosis and management

Green plus View adult BNF  View SPC online  View childrens BNF