A patient is due to start eplerenone 25 mg daily after myocardial infarction. Before the first dose, potassium is 5.2 mmol/L and CrCl is 54 mL/min;

Question

A patient is due to start eplerenone 25 mg daily after myocardial infarction. Before the first dose, potassium is 5.2 mmol/L and CrCl is 54 mL/min; ramipril is already prescribed. What should the pharmacist recommend?

Accepted Answer

Defer initiation and query the prescription; the pre-dose threshold is exceeded

Answer

Start 25 mg on alternate days; apply a post-initiation dose-reduction schedule

Answer

Start 25 mg daily; regard 5.2 mmol/L as within the initiation range

Answer

Start 12.5 mg daily; interpret the potassium result only after treatment begins

Answer

Pause ramipril for 48 hours; assume this makes the current result acceptable

Eplerenone safety — GPhC CRA MCQ

A patient is due to start eplerenone 25 mg daily after myocardial infarction. Before the first dose, potassium is 5.2 mmol/L and CrCl is 54 mL/min; ramipril is already prescribed. What should the pharmacist recommend?