Spironolactone; effective but regular serum potassium checks recommended forever

Share This Post

Share on facebook
Share on linkedin
Share on twitter
Share on email

Spironolactone is effective for NYHA class III and IV heart failure and hypertension (4th or 5th line) but can be a difficult drug to use. Elevated serum potassium levels may occur in around 18% of patients.

In a case-control study spironolactone was associated with a doubling in the rate of gastrointestinal bleed events.1 This effect was stronger with increasing doses and when spironolactone was combined with NSAIDs/corticosteroids.

Medicines & Healthcare products Regulatory Agency (UK) now advise that “use of spironolactone with ACEi or ARB increases the risk of severe hyperkalaemia, particularly in patients with marked renal impairment, should be used with caution”, and requires regular monitoring of renal function.2

Spironolactone should only be started if serum potassium ≤5.0mmol/L and serum creatinine is ≤221 μmol/L. Monitor serum potassium and creatinine 1 week after initiation or increase in dose of spironolactone, monthly for the first 3 months, then quarterly for a year, and then every 6 months.

 

http://www.goodfellowunit.org/gems/spironolactone-effective-regular-serum-potassium-checks-recommended-forever – Health 24

More To Explore

Is Blue Light Harming Your Skin Health?

Studies suggest blue light from cellphones and computer screens can cause eyestrain, but it’s less clear how tech time may be affecting your complexion. In