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Spironolactone hyperkalaemia — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsSpironolactone hyperkalaemiaGPhC CRA

A patient with heart failure is prescribed spironolactone 25 mg daily in addition to ramipril. Recent blood tests show potassium 5.7 mmol/L. What is the most appropriate action?

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

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Correct answer: E — Withhold supply and contact the prescriber urgently

Spironolactone can cause hyperkalaemia, especially when combined with ACE inhibitors. A potassium of 5.7 mmol/L is clinically concerning and needs prescriber review before supply. Potassium supplements and high-potassium dietary advice would worsen the risk. NSAIDs can further impair renal function and increase hyperkalaemia risk.

Reference: BNF; NICE CKS