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Spironolactone monitoring — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsSpironolactone monitoringGPhC CRA

A 69-year-old man with heart failure is prescribed spironolactone 25mg once daily in addition to ramipril. His latest eGFR is 48mL/min/1.73m2 and potassium is 4.8mmol/L. What monitoring is required?

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Correct answer: D — Check renal function and potassium after starting and after dose changes

Spironolactone can cause hyperkalaemia, especially with ACE inhibitors and renal impairment. Renal function and potassium should be monitored after initiation and dose titration, then periodically when stable. INR, thyroid function, peak flow, and urate are not the key routine monitoring tests for this medicine.

Reference: BNF; NICE CKS