skip to main content

Spironolactone hyperkalaemia monitoring — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiovascular TherapeuticsSpironolactone hyperkalaemia monitoringGPhC CRA

A 64-year-old man with hypertension is newly prescribed spironolactone 25mg daily for resistant hypertension. He also takes ramipril 10mg daily and indapamide 2.5mg daily. Baseline potassium is 5.1mmol/L and eGFR is 52mL/min/1.73m2. What monitoring is required?

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

Reveal the answer and explanation

Correct answer: D — Check U&Es soon after initiation and after dose changes, with prescriber review of baseline potassium

Spironolactone can cause hyperkalaemia, particularly with ACE inhibitors and reduced renal function. A baseline potassium of 5.1mmol/L is a concern that should be reviewed before routine supply. Early and repeated U&E monitoring is required if treatment proceeds.

Reference: BNF; NICE CKS