netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.02.03  Expand sub section  Potassium-sparing diuretics and aldosterone antagonists
Amiloride tabs

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02.02.03  Expand sub section  Aldosterone antagonists
Eplerenone tabs

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Formulary For signs and symptoms of heart failure after recent myocardial infarction as per NICE CG172.

Reserved for patients unable to tolerate spironolactone when used for the treatment of chronic heart failure with left ventricular dysfunction

Link  NICE CG108: Chronic heart failure
Link  NICE CG172 Myocardial Infarction: cardiac rehabilitation and secondary prevention    
Spironolactone tabs

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Formulary Approved off-label indication:
Treatment of hypertension as per NICE CG127

Link  NICE CG108: Chronic heart failure
Link  NICE CG127: Hypertension in adults: diagnosis and management    
Potassium canrenoate injection

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Restricted Drug Unlicensed Aldosterone antagonist. Alternative to oral spironolactone
Spironolactone oral suspension

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Restricted Drug Unlicensed Oedema and ascites in liver cirrhosis, malignant ascites, nephrotic syndrome, congestive heart failure, primary hyperaldosteronism.

Dose: As for licensed oral doses for tablet formulation
note Notes First Choice Item First Choice item
Section Title Section Title (top level) Non Formulary Item Non Formulary section
Section Title Section Title (sub level)
Cytotoxic Drug
Cytotoxic Drug
Restricted Drug
Restricted Drug
Controlled Drug
Unlicensed Drug
High Cost Medicine
High Cost Medicine
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Cancer Drugs Fund
Cancer Drugs Fund


Traffic Light Status Information

Status Description
  Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
  Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
  Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
  Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
  Green   Specialist and non-specialist initiation  
  Grey   Not recommended for prescribing