Potassium sparing diuretics should not be prescribed routinely but may be useful where hypokalaemia may be expected or where any degree of hypokalaemia could be hazardous (e.g. concomitant digoxin, arrhythmias).
- Tablets 5mg (£33.09 = 28 tablets)
- Potassium conservation when used as an adjunct to thiazide or loop diuretics
- Used alone, initially 10mg daily or 5mg twice daily, adjusted according to response; maximum 20mg daily
- With other diuretics, congestive heart failure and hypertension, initially 5–10mg daily; cirrhosis with ascites, initially 5mg daily
- Tablets 25mg, 50mg, 100mg (£2.16 = 100mg daily)
- Moderate to severe heart failure (adjunct) initially 25mg once daily, increased according to response to maximum 50mg once daily
- Resistant hypertension (adjunct) 25mg once daily (unlicensed indication)
- In severe heart failure, spironolactone added to other treatments in a low dose can reduce mortality and morbidity. Careful monitoring for hyperkalaemia and hypovolaemia is required especially for people taking other diuretics and/or ACE inhibitors.
- Tablets 25mg, 50mg (£7.21 = 50mg daily)
- Start at 25mg daily and increase within 4 weeks according to serum potassium (see notes below)
- Eplerenone has been shown to reduce mortality in patients developing heart failure post MI when initiated within 3-14 days. It may be initiated at a dose of 25mg provided serum potassium less than 5mmol/L and should be titrated to 50mg within 4 weeks unless serum potassium exceeds 5mmol/L. If the serum potassium exceeds 5.5mmol//L, the dose should be reduced or withheld (consult product literature).
2. Cardiovascular >
2.2 Diuretics >
2.2.3 Potassium-sparing diuretics and aldosterone antagonists
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