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

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

Chapter Links...
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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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 CG172 Myocardial Infarction: cardiac rehabilitation and secondary prevention
Spironolactone tabs
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Approved off-label indication:

Treatment of hypertension as per NICE CG127

Link  NICE CG127: Hypertension in adults: diagnosis and management
Potassium canrenoate injection
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Unlicensed Drug Unlicensed

Aldosterone antagonist.

Alternative to oral spironolactone

Spironolactone oral suspension
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Unlicensed 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
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Track Changes
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Link to adult BNF
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Link to SPCs
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHS England

Traffic Light Status Information

Status Description


Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. 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  


Specialist and non-specialist initiation  


Not recommended for prescribing