Spotlight on Spironolactone Oral Suspension for the Treatment of Heart Failure: Focus on Patient Selection and Perspectives.

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  • Additional Information
    • Source:
      Publisher: Dove Medical Press Country of Publication: New Zealand NLM ID: 101273479 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-2048 (Electronic) Linking ISSN: 11766344 NLM ISO Abbreviation: Vasc Health Risk Manag Subsets: MEDLINE
    • Publication Information:
      Original Publication: Auckland : Dove Medical Press, c2005-
    • Subject Terms:
      Patient Selection*; Diuretics/*administration & dosage ; Heart Failure/*drug therapy ; Mineralocorticoid Receptor Antagonists/*administration & dosage ; Spironolactone/*administration & dosage; Administration, Oral ; Clinical Decision-Making ; Diuretics/adverse effects ; Diuretics/chemistry ; Diuretics/pharmacokinetics ; Dosage Forms ; Drug Compounding ; Flavoring Agents/administration & dosage ; Flavoring Agents/chemistry ; Heart Failure/diagnostic imaging ; Heart Failure/physiopathology ; Humans ; Mineralocorticoid Receptor Antagonists/adverse effects ; Mineralocorticoid Receptor Antagonists/chemistry ; Mineralocorticoid Receptor Antagonists/pharmacokinetics ; Risk Factors ; Spironolactone/adverse effects ; Spironolactone/chemistry ; Spironolactone/pharmacokinetics ; Treatment Outcome
    • Abstract:
      Spironolactone, an antagonist of aldosterone, initially used as a potassium-sparing diuretic, was subsequently shown to be a very effective adjunctive agent in the treatment of patients with heart failure with reduced ejection fraction, by halting the disease progression, with significant beneficial effects on both morbidity and mortality. Other uses comprise resistant hypertension, edema in patients with cirrhosis, and other on- and off-label uses. Recent data indicate that spironolactone also may offer some symptomatic relief in patients with heart failure and preserved ejection fraction. However, a variable percentage of patients, particularly among the aged group, may have difficulty in swallowing or may be unable to swallow tablets and thus are deprived of the benefits of such therapy. In 2017, the FDA approved a liquid suspension formulation of spironolactone, CaroSpir ® , which will enable more heart failure and other patients in need of aldosterone inhibition to avail themselves of the protective and beneficial effects of spironolactone. The new drug formulation comes as a banana-flavored oral suspension that contains 25 mg/5 mL of spironolactone, supplied in 4-ounce (118 mL) and 16-ounce (473 mL) bottles. The details of this drug formulation development and the benefits of spironolactone use in patients with heart failure with a focus on patient selection are herein reviewed.
      Competing Interests: The authors report no conflicts of interest in this work.
      (© 2019 Manolis et al.)
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    • Contributed Indexing:
      Keywords: ability to swallow; heart failure; heart failure with reduced ejection fraction; hyperkalemia; mineralocorticoid receptor antagonists; spironolactone; spironolactone oral suspension
    • Accession Number:
      0 (Diuretics)
      0 (Dosage Forms)
      0 (Flavoring Agents)
      0 (Mineralocorticoid Receptor Antagonists)
      27O7W4T232 (Spironolactone)
    • Publication Date:
      Date Created: 20200111 Date Completed: 20200121 Latest Revision: 20200121
    • Publication Date:
      20221213
    • Accession Number:
      PMC6941679
    • Accession Number:
      10.2147/VHRM.S210150
    • Accession Number:
      31920323