Dose:  0.5 to 3.0 mg/kg/dose PO

Frequency: Q 24 hours

Comments:  Spironolactone is a potassium sparing diuretic effective in situations of excessive mineralocorticoid concentrations such as congestive heart failure or liver disease. Spironolactone is contraindicated in the presence of anuria or hyperkalemia. The monitoring of serum potassium levels is critical when treating an infant with spironolactone. Once started, the effect of the drug may not be seen for 2 to 3 days since it depends upon the synthesis of a peptide which interacts with aldosterone. See diuretic for comparisons of the effects and complications of the different diuretics. . More comments of spironolactone.

Preparation: To prepare a 1 mg/ml concentration of spironolactone (Aldactone) use ten (10) 25 mg tablets of spironolactone. Add a small amount of water and soak for 5 minutes. Add 50 ml of 1.5% carboxymethylcellulose, 100 ml syrup NF, and mix. QSAD 250 ml with purified water. Stable at room temperature or refrigerate for three months (Nahafa. Ann Pharmacother 1993; 27:1198). Label the bottle with drug, strength, date, time, initials, SHAKE WELL and STABILITY of 90 days.

To prepare a 5 mg/ml concentration of spironolactone (Aldactone) use five (5) 25 mg tablets of spironolactone. Remove tablet coating using a damp paper towel. Then, triturate the tablet in a mortar and pestle until a fine powder is obtained. Add 25 ml of cherry syrup in small amounts, using it to evenly suspend and wash all of the drug out of the mortar into a 1 oz amber bottle. Label the bottle with drug, strength, date, time, initials, SHAKE WELL, REFRIGERATE, and STABILITY of 28 days. May be prepared as a 2.5 mg/ml or 10 mg/ml with same dating.