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Spironolactone cirrhosis monitoring — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentSpironolactone cirrhosis monitoringGPhC CRA

A 63-year-old man with ascites due to cirrhosis starts spironolactone. He also takes ramipril for hypertension. The GP asks what should be monitored after initiation. What monitoring is required?

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

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Correct answer: D — Urea, electrolytes, creatinine and potassium

Spironolactone can cause hyperkalaemia and renal function deterioration, especially with ACE inhibitors. In cirrhosis, fluid status and renal function are clinically important during diuretic titration. Electrolytes and creatinine should be monitored according to clinical status and local protocol.

Reference: BNF; NICE CKS