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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 2 - Cardiovascular system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

02.02.03 Potassium-sparing diuretics and aldosterone antagonists
02.02.03 Aldosterone antagonists

Spironolactone tablets
(Tablets)

Formulary

Available as 25mg, 50mg and 100mg

NB: 12.5mg tablets carry a higher cost and are available only for 12.5mg doses. Doubling up of 12.5mg strength is prohibited.

 

Entry reviewed: February 2023

Eplerenone

Formulary

25mg & 50mg Film-Coated Tablets

For 2nd-line use after spironolactone.

 

Entry review: December 2025

Finerenone (Kerendia®)
(10mg, 20mg film coated tablets)

Formulary

Tablets 10mg, 20mg

For use in line with:

Finerenone for treating chronic kidney disease in type 2 diabetes Technology appraisal guidance [TA877] Published: 23 March 2023 https://www.nice.org.uk/guidance/ta877

Serum potassium and eGFR must be measured before initiation and for continuation of therapy.

Entry reviewed: March 2025

Spironolactone 50mg in 5mL
( Sugar-Free Suspension)

Restricted Drug Restricted

Only use if tablets unsuitable. N.B. tablets can be crushed and mixed with water for enteral feeding tube administration.

Standard strength liquid is 50mg/5ml as per RCPCH/NPPG guidance - RCPCH/NPPG Standardised strengths of unlicensed liquids

 

Entry reviewed: December 2022

Classifications
May be initiated in any care setting
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.