This section gives an overview of the commonly used drugs (excluding opioids) to manage symptoms in patients with terminal illnesses. The information includes basic dosage information as well as indications for use and potential side effects. Please note that non-opioid drugs commonly used in palliative care in Singapore are shown here but the list is NOT exhaustive and neither are the side effects nor indications. Doses are for adults only. Please check with pharmacy colleagues for dose adjustments (if any) in renal or liver impairment. Unless otherwise indicated, use water for injection for dilution in continuous subcutaneous infusions.
*For information on opioids, please search and refer to the drugs with their given context.
Spironolactone
Route, Dosage and Frequency
ROUTE
|
DOSAGE AND FREQUENCY
|
| PO |
12.5-50mg each morning to b.d. (max dose 400mg/day for ascites and 50mg/day for heart failure) |
Other Information
Indications
Ascites associated with portal hypertension (usually in liver cirrhosis, hepatocellular cancer, massive hepatic metastases), Hypertension,Congestive heart failure, Nephrotic syndrome, Primary hyperaldosteronism.
Side-Effects
Central nervous system and gastrointestinal disturbances, Gynecomastia, Hyperkalaemia.
Remarks
Potassium sparing diuretic (aldosterone antagonist). Monitor potassium. Stop if potassium >5mmol/l. Avoid with ACE inhibitors, potassium supplements as can cause hyperkalaemia. May add Furosemide 40-80mg/day in ascites.
Reference
- Watson M. Oxford Handbook of Palliative Care. Oxford, NY: Oxford University Press; 2009.