Spironolactone for heart failure

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Spironolactone for heart failure

This leaflet is about the use of spironolactone for heart failure.

Information-Standard-logoThis leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again. 

Your child should not take potassium supplements or eat foods that contain a lot of potassium.

Name of drug

Spironolactone (Spy-ron-noh-lak-tone)
Brand name: Aldactone®

Why is it important for my child to take this medicine?

Spironolactone helps your child’s heart to work better. It helps them to make more urine (wee) and therefore lose unnecessary extra fluid from the body. This reduces the work that the heart has to do. Medicines that help the body to lose water are called diuretics (sometimes referred to as ‘water tablets’).

Spironolactone is a special type of diuretic called a potassium-sparing diuretic because, unlike some other diuretics, it does not cause the body to lose potassium. Because of this, it is often used at the same time as other diuretics.

What is spironolactone available as?

  • Tablets: 25 mg, 50 mg, 100 mg
  • Liquid medicine (suspension): 5, 10, 25, 50 or 100 mg in 5 mL

When should I give spironolactone?

Spironolactone is usually given twice each day, although it may sometimes be given three times a day.

If giving it twice each day, give one dose in the morning and one in the evening. Ideally, these should be 10-12 hours apart, for example, between 7 and 8am, and between 7 and 8pm.

Give the medicine at about the same times each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of spironolactone (the dose) that is right for your child. The dose will be shown on the medicine label.

It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet. 

You can crush the tablet and mix it with a small amount of soft food such as yogurt, jam or potato. Make sure your child swallows it straight away, without chewing.

Liquid medicine: Shake the medicine well. Measure out the right amount using an oral syringe or medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

When should the medicine start working?

It may take a few days to see the diuretic efect of spironolactone. The effects on the heart may be seen over weeks to months.

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of spironolactone, give them the same dose again.
  • If your child is sick more than 30 minutes after having a dose of spironolactone, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Wait until the next normal dose.

Never give a double dose of spironolactone.

What if I give too much?

It can be dangerous to give too much spironolactone.

If you think you may have given your child too much spironolactone, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales) or take your child to hospital. Take the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side-effects you must do something about

If your child’s heart beat seems irregular (they may say that it feels fluttery), they have tingling feelings, paralysis (difficulty moving) or difficulty breathing, take them to the hospital straight away, as they may have too much potassium in their blood.

If your child gets a yellowish tinge to the skin or whites of the eyes, contact your doctor straight away, as there may be a problem with your child's liver.

Other side-effects you need to know about
  • Girls may find that their periods become irregular. Contact your doctor if this happens.
  • Boys may notice mild breast development. Discuss with your doctor if this happens.
  • Your child may feel dizzy. If this happens, they should sit or lie down for a short while after taking a dose of spironolactone.
  • Your child may feel generally unwell, feel sick or be sick (vomit) or get stomach cramps or have diarrhoea. They may also get cramps in the legs. These effects should wear off as your child’s body gets used to the medicine. If they are still a problem after a week, contact your doctor for advice.

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.

Can other medicines be given at the same time as spironolactone?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
  • Spironolactone should not be taken with some medicines that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before starting spironolactone.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about spironolactone?

  • Your doctor may do blood tests to check the levels of potassium and other substances in your child’s blood.

Your child should not take potassium supplements. Ask your doctor or a dietician for advice and a diet sheet if necessary.

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

Liquid medicine comes in several different strengths. Make a note of which one you usually have, and check that you have been given the right one each time.

  • Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information

Your child’s doctor or pharmacist will be able to give you more information about spironolactone and about other medicines used to treat heart failure.

You can also get useful information from: 
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