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ACE inhibitor and spironolactone — GPhC CRA MCQ

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HardDrug InteractionsACE inhibitor and spironolactoneGPhC CRA

A patient taking ramipril for hypertension is newly prescribed spironolactone for resistant blood pressure. He also uses potassium-containing salt substitute. What is the most important interaction to flag?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — The combination can increase serum potassium

ACE inhibitors and potassium-sparing diuretics can increase potassium, and potassium-containing salt substitutes further increase this risk. Hyperkalaemia may be serious and requires renal function and electrolyte monitoring. The pharmacist should counsel the patient and check that monitoring is arranged. The interaction is pharmacodynamic rather than impaired absorption.

Reference: BNF; NICE CKS