Spironolactone

Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families

Spironolactone

This information sheet should be read in conjunction with any information provided by the manufacturer. This information sheet explains what spironolactone is, how it is given and some of the possible side effects. Each person reacts differently to medicines, so your child will not necessarily suffer every side effect mentioned. If you have any questions or concerns, please ask your doctor, nurse or pharmacist or telephone one of the contact numbers on this information sheet.

What is spironolactone? The liquid preparation comes in 5mg/ml, 10mg/5ml, 25mg/5ml, 50mg/5ml and 100mg/5ml Spironolactone belongs to a group of medicines strengths. You should use the oral syringe called diuretics. It is commonly used alongside provided to draw up the correct amount of another medicine called furosemide to reduce liquid and squirt it in the inside of your child’s fluid overload, so reducing the amount of work cheek. Please note that some of these strengths the heart has to do to pump blood around the may not be available locally so you should body. It works by making the kidneys produce always tell the pharmacist the strength of your more urine (wee), so your child may have to child’s usual medicine. go to the toilet more often. It also prevents potassium being lost in the urine. It is commonly Your doctor, nurse or pharmacist will have prescribed for children with heart or kidney explained to you how to obtain the correct problems causing excess fluid in the body. dose before you leave hospital. Spironolactone is ‘unlicensed’ for use in children. Who should not You can be assured that your doctor has only take spironolactone? prescribed an ‘unlicensed’ medicine because he or she thinks that the medicine will benefit your People with the following conditions should child and no licensed alternative is available. discuss taking this medicine with their doctor. Hypersensitivity to spironolactone or its How is it given? ingredients Spironolactone is given by mouth up to three High calcium (hyperkalaemia) or high salt times a day with or after food. It is available as (hypernatraemia) blood levels tablets and a liquid preparation. Addison’s disease Tablets come in doses of 25mg, 50mg and Pregnant, could be pregnant, planning to 100mg. If your child is on a proportion of a become pregnant or breastfeeding tablet, you should disperse the tablets in a specific amount of water. You should then draw up the correct volume of liquid using the oral syringe provided and squirt it in the inside of your child’s cheek.

Sheet 1 of 2 Ref: 2017F0310 © GOSH NHS Foundation Trust January 2018 What are the side effects? Spironolactone If any of these side effects are severe or carry on and other medicines for a long time, please tell your doctor. Some medicines can interact with spironolactone, Stomach ache, diarrhoea, skin rash altering how well it works. Always check with Breast tenderness and enlargement in both your doctor or pharmacist before giving your boys and girls, although this will go away once child any other medicines, including herbal spironolactone is stopped or complementary medicines. The following medicines should only be given alongside Irregular periods in girls spironolactone on the advice of your doctor but Feelings of weakness or drowsiness the dosages may need to be altered. ACE inhibitors Alpha blockers Important Information Pain relief medicines such as non-steroidal Spironolactone in a liquid preparation may anti-inflammatory drugs (NSAIDs) including not be available from your local pharmacist indometacin but it can be ordered for you. This may take Angiotensin II receptor antagonists a little longer so remember to order a repeat Anti-arrhythmics prescription in plenty of time. Certain antibacterials, including erythromycin When you receive your new supply of and rifampicin spironolactone, check the strength of the tablets or liquids and the dosage before Anti-depressants including St John’s wort giving it to your child. Anti-epileptics including carbamazepine and Keep medicines in a safe place where children phenytoin cannot reach them Anti-fungals including itraconazole or Keep the tablets or liquid at room ketoconazole temperature, away from bright light or direct Anti-psychotic medicines including lithium sunlight and away from heat. Do not store in Certain anti-viral medicines includgin a fridge. nelfinavir, ritonavir and saquinavir If you forget to give your child a dose and Atomomoxetine it is within a few hours of when the dose Barbiturates including phenobarbitol was due, give it as soon as you remember. Beta blockers Otherwise, do not give this dose but take the next dose when it is due. Do not give a Cardiac glycosides double dose. Ciclosporin and tacrolimus If your child vomits after taking the medicine, Potassium salts inform the doctor or nurse as your child may need to take another one. Do not give them another tablet without first informing your doctor. If your doctor decides that your child should stop taking spironolactone or it passes the expiry date, return any remaining tablets or liquid to your pharmacist. Do not flush them If you have any questions, down the toilet or throw them away. please ask your nurse.

Useful numbers GOSH switchboard: 020 7405 9200 Pharmacy medicines information: 020 7829 8608 (Monday to Friday from 9am to 5pm)

Compiled by the Pharmacy department in collaboration with the Child and Family Information Group Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH www.gosh.nhs.uk