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Spironolactone renal threshold — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentSpironolactone renal thresholdGPhC CRA

A heart failure patient on ramipril has eGFR 25 mL/min/1.73 m² and potassium 5.3 mmol/L. A new prescription for spironolactone is presented. What is the most appropriate action?

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Correct answer: D — Withhold supply pending prescriber review of renal function and potassium

Spironolactone increases potassium and can be hazardous in renal impairment or existing hyperkalaemia, especially with ACE inhibitors. The prescriber should review before initiation. The pharmacist should not independently stop ramipril or add unprescribed treatment.

Reference: BNF