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ACE inhibitor and potassium supplement — GPhC CRA MCQ

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ModerateDrug InteractionsACE inhibitor and potassium supplementGPhC CRA

A 74-year-old woman taking ramipril 10mg daily for heart failure asks to buy potassium tablets because she has leg cramps. Her last blood test showed potassium 5.1mmol/L and eGFR 46mL/min/1.73m2. She also takes spironolactone 25mg daily. 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 — Potassium supplementation may worsen hyperkalaemia with ramipril and spironolactone

Ramipril and spironolactone can both increase potassium, and the patient's potassium is already high-normal. OTC potassium could precipitate clinically significant hyperkalaemia. Cramps should be assessed rather than self-treated with potassium. Renal impairment adds risk.

Reference: BNF Ramipril interactions; BNF Spironolactone