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Spironolactone monitoring — GPhC CRA MCQ

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HardCardiovascular TherapeuticsSpironolactone monitoringGPhC CRA

A 70-year-old woman with heart failure with reduced ejection fraction takes ramipril 10 mg daily and bisoprolol 5 mg daily. The GP plans to start spironolactone; potassium is 4.9 mmol/L and eGFR is 52 mL/min/1.73 m2. What monitoring is required?

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Correct answer: C — Check U&Es and renal function soon after initiation and dose changes

Spironolactone can cause hyperkalaemia and worsening renal function, particularly when combined with ACE inhibitors. Baseline U&Es are needed and repeat monitoring is required shortly after initiation and dose changes, then periodically. INR and digoxin monitoring are not the central requirements unless those medicines are also used.

Reference: BNF; NICE CKS