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Spironolactone and hyperkalaemia — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentSpironolactone and hyperkalaemiaGPhC CRA

A patient with heart failure starts spironolactone 25 mg daily in addition to ramipril and furosemide. The GP asks what follow-up blood tests are important after initiation. What monitoring is required?

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Correct answer: B — Renal function and serum potassium monitoring

Spironolactone can cause hyperkalaemia and worsening renal function, particularly when combined with an ACE inhibitor. Renal function and electrolytes, especially potassium, should be checked after initiation and dose changes. The monitoring plan should also consider blood pressure and clinical status. The other tests are not routine safety monitoring for spironolactone.

Reference: BNF; NICE CKS