2.2. Diuretics
2.2.1. Thiazides and related diuretics
The choice of therapeutic class for the management of hypertension is dependent on individual patient parameters. See the NHSGGC Guidelines for the Management of Hypertension, available on the Clinical Guidelines store on StaffNet - see link in Navigation Panel.
Restrictions:
Restricted to specialist initiation.
Prescribing Notes:
Now available as licensed product Xaqua which is the preferred preparation in NHSGGC.
2.2.2. Loop diuretics
2.2.3. Potassium-sparing diuretics and aldosterone antagonists
Prescribing Notes:
Used in heart failure and in Conn’s syndrome or decompensated liver diseases (ascites). Combination with ACE inhibitors, angiotensin-II receptor antagonists (AIIRAs) or potassium supplements may result in hyperkalaemia (monitor).
Near Patient Testing (NPT) arrangements for GPs may be in place for this medicine. See the relevant section in the Prescribing Resources page for current information.
Restrictions:
Please see prescribing notes below.
Prescribing Notes:
Eplerenone is currently formulary for two indications:
- The use in patients with left ventricular systolic dysfunction accompanied by evidence of heart failure, both manifesting within 3-14 days of myocardial infarction is restricted to specialist initiation and a consultant signature is required.
- The use in addition to standard optimal therapy, to reduce the risk of cardiovascular mortality and morbidity in adult patients with NYHA class II (chronic) heart failure and left ventricular systolic dysfunction (LVEF ≤40%) should be in concordance with the NHSGGC Heart Failure treatment guideline.
Near Patient Testing (NPT) arrangements for GPs may be in place for this medicine. See the relevant section in the Prescribing Resources page for current information.
2.2.4. Potassium-sparing diuretics with other diuretics
2.2.5. Osmotic diuretics
Restrictions:
Restricted to specialist use only.
Prescribing Notes:
For inhaled mannitol for cystic fibrosis see section 3.7 Mucolytics