Barbieri JS, Margolis DJ, Mostaghimi A. Temporal Trends and Clinician Variability in Potassium Monitoring of Healthy Young Women Treated for Acne With Spironolactone. There is one case report of an ovarian cyst in a neonate on spironolactone. ... sodium-potassium exchange site in the distal convoluted renal tubule. They may be combined by each other or ACE inhibitors too, taking the necessary precautions and laboratory monitoring. There was no significant difference in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%).Key findings of the study include: There was no significant difference in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). Hypotension and Worsening … The primary outcome was the proportion of women who received a test for baseline potassium level and the proportion of women whose potassium levels were monitored in the first 180 days of being treated for acne with spironolactone. Has the frequency of potassium level monitoring among healthy young women treated for acne with spironolactone decreased following recent study findings suggesting its low usefulness and updated guideline recommendations for this population? Avoid using oral potassium supplements in patients with serum potassium > 3.5 mEq/L. Mean 24-hour ambulatory BP was reduced by 10.9/5.8 mm Hg. To evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. Monitoring Monitor plasma-potassium concentration (high risk of hyperkalaemia in renal impairment). Meaning  For 108 547 women included in this cohort study, the mean (SD) age at the start of treatment was 30.7 (8.6) years, and the mean (SD) course duration was 159 (218) days. to download free article PDFs, Repeat these tests within 1 month of starting treatment. Use particular caution in people with a reduced eGFR because they have an increased risk of hyperkalaemia. Doses of spironolactone ranged from 25 to 400 mg/d, with a mean ± SD daily dose of 105 ± 85 mg/d. HYPERTENSION . It is critical to monitor and manage serum potassium in patients with severe heart failure receiving ALDACTONE. 2. We reviewed the monitoring patterns for hyperkalemia and renal dysfunction in CHF patients receiving spironolactone after publication of the RALES trial. In contrast, the serum potassium measurement was checked in 74.9% of patients with an endocrine disorder who had acne as a secondary feature (P < .01). Participants comprised 108 547 healthy female patients aged 12 to 45 years who were treated for acne with spironolactone. For clinicians who had prescribed at least 5 courses of spironolactone, the percentage of clinicians who ordered baseline potassium testing or monitoring and the percentage of clinicians who always monitored potassium were compared between 2008 and 2015 vs between 2016 and 2018. Laboratory monitoring for patients on spironolactone comprise tests of renal function, complete blood counts, and electrolytes including potassium levels. Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine, United States Preventive Services Task Force. Patients with chronic heart failure should be monitored in line with 'Chronic heart failure' described above. This important study shows that healthy women receiving spironolactone for acne do not need routine potassium monitoring. sign up for alerts, and more, to access your subscriptions, sign up for alerts, and more, to download free article PDFs, sign up for alerts, customize your interests, and more, to make a comment, download free article PDFs, sign up for alerts and more, Archives of Neurology & Psychiatry (1919-1959), Subscribe to the JAMA Dermatology journal, FDA Approval and Regulation of Pharmaceuticals, 1983-2018, Global Burden of Skin Diseases, 1990-2017, Health Care Spending in the US and Other High-Income Countries, Life Expectancy and Mortality Rates in the United States, 1959-2017, Medical Marketing in the United States, 1997-2016, Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter, US Burden of Cardiovascular Disease, 1990-2016, US Burden of Neurological Disease, 1990-2017, Waste in the US Health Care System: Estimated Costs and Potential for Savings, Register for email alerts with links to free full-text articles. Between 2008 and 2018, the percentage of women whose potassium levels were monitored within 180 days of starting spironolactone by all clinicians decreased from 41.4% to 38.5%, with a decrease from 48.9% to 41.0% among dermatologists and from 39.7% to 37.7% among internists but with an increase from 71.4% to 75.4% among advanced practice clinicians (ie, nurse practitioners and physician assistants). More frequent monitoring may be needed when Spironolactone is given with other drugs that cause hyperkalemia or in patients with impaired renal function. BP Monitoring and Spironolactone Therapy. More frequent monitoring may be needed when spironolactone is given with other drugs that cause hyperkalemia or in patients with impaired renal function. It is on the World Health Organization's List of Essential Medicines. Privacy Policy| A liquid formulation may be available as a special order if needed. If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. RALES excluded patients with a serum creatinine > 2.5 mg/dL or a recent increase in serum creatinine > 25%. It is also used for the diagnosis and management of primary hyperaldosteronism (a condition where the adrenal glands produce too much of the hormone aldosterone leading to low potassium levels and a more alkaline blood pH). These people may already have reduced renal excretion of potassium. Moreover, researchers reported no … Despite growing evidence and recommendations supporting the removal of potassium monitoring among healthy young women treated with spironolactone for acne, the results of the current study indicate that potassium monitoring remains common, with considerable variability in clinical practice. After 12 weeks, spironolactone significantly improved refractory hypertension. Design, Setting, and Participants  Has the frequency of potassium level monitoring among healthy young women treated for acne with spironolactone decreased following recent study findings suggesting its low usefulness and updated guideline recommendations for this population? OBJECTIVE: To estimate the rate of potassium and creatinine evaluation and identify factors associated with conducting these tests among ambulatory patients dispensed spironolactone. Avoid using other potassium-sparing diuretics. There was no significant difference in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). Serious - Use Alternative Potential for serious interaction; regular monitoring by your doctor required spironolactone oral and potassium chloride oral Patient Drug Interactions Source: RxList Findings  Patients with prior use of spironolactone or potassium level >5 mmol/L were excluded. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. DOI: https://jamanetwork.com/journals/jamadermatology/article-abstract/2775574, Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. This retrospective cohort study was conducted between January 1, 2008, and June 30, 2019, using data from the Optum deidentified Clinformatics Data Mart database. Spironolactone oral tablet is a prescription medication used to reduce swelling caused by fluid buildup in your tissues. Between 2008 and 2018, the percentage of women whose potassium levels were monitored within 180 days of starting spironolactone by all clinicians decreased from 41.4% to 38.5%, with a decrease from 48.9% to 41.0% among dermatologists and from 39.7% to 37.7% among internists but with an increase from 71.4% to 75.4% among advanced practice clinicians (ie, nurse practitioners and physician assistants). For the purpose, the researchers conducted a retrospective cohort study using data from the Optum deidentified Clinformatics Data Mart database. Secondary measures included spironolactone prescriber profiles and potassium monitoring practices. They may be combined by each other or ACE inhibitors too, taking the necessary precautions and laboratory monitoring. spironolactone, eplerenone (Inspra )] Potassium and renal function (e.g., serum creatinine) • Guidelines: check potassium and renal function baseline, three and seven days after initiation, monthly for three months, then quarterly. The laboratory testing patterns seen here are concordant with older studies documenting suboptimal monitoring after initiation of MRA 13 and other high-risk medications in general populations. Published online January 27, 2021. doi:10.1001/jamadermatol.2020.5468. All Rights Reserved, Published online January 27, 2021. doi:10.1001/jamadermatol.2020.5468. In a retrospective cohort study of over 100,000 female patients with acne, the percentage of healthcare providers who measured potassium levels within 180 days of […] "There is a need for future implementation and dissemination research to understand underlying factors for this variation and to develop strategies to address this practice gap," they concluded. In contrast, serum aldosterone levels in the spironolactone group slightly increased and serum potassium levels insignificantly increased. It can also have hormonal effects by ... Raised blood levels of potassium levels may occur during treatment with spironolactone. CrossRef View Record in Scopus Google Scholar. Not much is known if these recommendations are being implemented in clinical practice. A Study was conducted to evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. There was no significant difference in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). M.P. It’s also used to treat high blood pressure and other conditions. Raebel MA(1), McClure DL, Chan KA, Simon SR, Feldstein AC, Lafata JE, Andrade SE, Gunter MJ, Nelson WW, Roblin D, Platt R. Author information: (1)Kaiser Permanente Colorado Clinical Research Unit and School of Pharmacy, University of Colorado … © 2021 American Medical Association. 2 Those at greatest risk of hyperkalaemia are elderly people, people with diabetes, and people who have impaired renal function. Some prescribers of spironolactone (CaroSpir, Aldactone) for pimples are nonetheless monitoring sufferers’ potassium ranges regardless of the transfer to eradicate this observe, a brand new examine discovered. Spironolactone is a drug usually prescribed for patients with heart problems, high blood pressure and fluid retention. Despite increasing evidence and guidelines supporting the elimination of potassium monitoring among healthy young women treated for acne with spironolactone, the present study findings suggest that potassium monitoring remains common, with substantial variability in clinician practices. frequent monitoring may be needed in patients who are at increased risk of deterioration in renal function. This is occurring despite of increasing evidence and guidelines supporting the elimination of potassium monitoring in this population. Our website uses cookies to enhance your experience. There is a n … Spironolactone is available as tablets - 25mg, 50mg, 100mg strengths. For 108 547 women included in this cohort study, the mean (SD) age at the start of treatment was 30.7 (8.6) years, and the mean (SD) course duration was 159 (218) days. Removes excess fluid from the body and may be used in the treatment of heart failure, cirrhosis of the liver, and in nephrotic syndrome (a type of kidney disease). 011-43720751, This site is intended for healthcare professionals only, Potassium being monitored in acne patients on spironolactone, defying guidelines: JAMA, spironolactone for acne, finds a recent study in the journal. 2 Those at greatest risk of hyperkalaemia are elderly people, people with diabetes, and people who have impaired renal function. Secondary measures included spironolactone prescriber profiles and potassium monitoring practices. 941-944. To address this knowldge gap, John S. Barbieri, University of Pennsylvania, Philadelphia, and colleagues aimed to evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. (Spironolactone Tablets, USP) 25 mg and 100 mg Tablets Aldosterone Antagonist Pfizer Canada Inc 17,300 Trans-Canada Highway ... recommended monitoring for potassium and creatinine is one week after initiation or increase in dose of spironolactone, monthly for the first 3 months, then quarterly for a year, and then every 6 months. "By demonstrating that for young, healthy women, it's safe to give spironolactone without close potassium monitoring, we hope that more patients will be able to benefit from this medication." Participants included 108 547 healthy female patients (aged 12-45 years) who were treated for acne with spironolactone. It comes as an oral tablet and an oral suspension. Spironolactone oral tablet is available as the brand-name drug Aldactone and … Monitoring of blood electrolytes is essential when co-prescribing spironolactone, or other potassium-sparing diuretics, with an ACE inhibitor or an angiotensin receptor blocker (ARB) in patients with … There is a need for future implementation and dissemination research to understand underlying factors for this variation and to develop strategies to address this practice gap. Average placebo-corrected morning BP was reduced by 16.7/7.6 mm Hg. Accessibility Statement. Although recent studies and guideline recommendations indicate that potassium level monitoring is of low usefulness for healthy young women being treated for acne with spironolactone, little is known about whether these recommendations have been implemented in clinical practice. The majority of subjects (n = 73; 86%) were using spironolactone as an adjunct to estrogen. Background: Serum potassium and creatinine evaluation is recommended in patients prescribed spironolactone, yet the proportion of ambulatory patients chronically dispensed spironolactone receiving evaluation is not well understood. Monitor electrolytes—discontinue if hyperkalaemia occurs (in severe heart failure monitor potassium and creatinine 1 week after initiation and after any dose increase, monthly for first 3 months, then every 3 months for 1 year, and then every 6 months). Spironolactone hyperkalaemia warning over co-administration. Drug Name Generic Name : spironolactone Brand Name: Aldactone, Novospiroton (CAN) Classification: Potassium-sparing diuretic, Aldosterone antagonist Pregnancy Category D Dosage & Route Available forms : Tablets—25, 50, 100 mg ADULTS Edema: Initially, 100 mg/day (range 25–200 mg/day) when given as the sole agent; continue > 5 days, then adjust dose or add another diuretic or both. To address this knowldge gap, John S. Barbieri, University of Pennsylvania, Philadelphia, and colleagues aimed to evaluate trends in rates … Spironolactone, sold under the brand name Aldactone among others, is a medication that is primarily used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. Serum potassium levels require close monitoring and management if elevated. For clinicians who had prescribed at least 5 courses of spironolactone, the percentage of clinicians who ordered baseline potassium testing or monitoring and the percentage of clinicians who always monitored potassium were compared between 2008 and 2015 vs between 2016 and 2018. Design, setting, and participants This retrospective cohort study was conducted between January 1, 2008, and June 30, 2019, using data from the Optum deidentified Clinformatics Data Mart database. Despite growing evidence and recommendations supporting the removal of potassium monitoring among healthy young women treated with spironolactone for acne, the results of the current study indicate that potassium monitoring … The study titled, "Temporal Trends and Clinician Variability in Potassium Monitoring of Healthy Young Women Treated for Acne With Spironolactone," is published in the journal JAMA Dermatology. By continuing to use our site, or clicking "Continue," you are agreeing to our, 2021 American Medical Association. This risk is increased by impaired renal function or concomitant potassium supplementation, potassium-containing salt substitutes or drugs that increase potassium, such as angiotensin converting enzyme inhibitors and angiotensin receptor blockers [see Drug Interactions (7.1)].Monitor serum potassium within 1 week of initiation or titration of Spironolactone and regularly thereafter. The recommended monitoring for potassium and creatinine is 1 week after initiation or increase in dose of spironolactone, monthly for the first 3 months, then quarterly for a year, and then every 6 months. Has been shown to increase survival and reduce the need for hospitalization in people with severe heart failure. JAMA Dermatol. Potassium measurements were available for up to 7 years of spironolactone therapy. Participants comprised 108 547 healthy female patients aged 12 to 45 years who were treated for acne with spironolactone. In this cohort study, the overall proportion of 108 547 women with potassium level monitoring decreased from 41% in 2008 to 38% in 2018, with a greater decrease observed among women treated by dermatologists (49% to 41%) than by internists (40% to 38%) but an increase (71% to 75%) among women treated by advanced practice clinicians (ie, nurse practitioners and physician assistants). Spironolactone can cause hyperkalaemia and requires close monitoring initially Spironolactone carries the risk of hyperkalaemia which is asymptomatic and potentially hazardous. Between 2008 and 2018, the percentage of women whose potassium levels were monitored within 180 days of starting spironolactone by all clinicians decreased from 41.4% to 38.5%, with a decrease from 48.9% to 41.0% among dermatologists and from 39.7% to 37.7% among internists but with an increase from 71.4% to 75.4% among advanced practice clinicians (ie, nurse practitioners and physician assistants). The proportion of dermatologists who always monitored potassium decreased from 10.6% between 2008 and 2015 to 4.2% between 2016 and 2018. Participants included, 108 547 healthy female patients (aged 12-45 years) who were treated for acne with, This study finds that potassium level monitoring remains common among, with substantial variability in clinician practices in, young women treated for acne with spironolactone d. espite increasing evidence and guidelines supporting the elimination of potassium," wrote the authors. There is a need for future implementation and dissemination research to understand underlying factors for this variation and to develop strategies to address this practice gap," they concluded. All Rights Reserved. Only prescribe spironolactone for people whose blood potassium level is 4.5 mmol/l or lower. Contraindicated with potassium-sparing diuretics (such as amiloride and spironolactone) due to increased risk of hyperkalaemia. No significant difference was found in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). To evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. She can be contacted at  editorial@medicaldialogues.in. Not all submitted comments are published. Potassium sparing diuretics have not only the advantage of avoiding potassium loss, but can potentiate the effects of diuretics acting in distal tubules and Henle's loop also. The conclusion was that the rate of hyperkalemia in healthy young women taking spironolactone for acne is equivalent to the baseline rate of hyperkalemia in this population and that potassium monitoring is unnecessary for healthy women taking spironolactone for acne. A growing body of evidence suggests low value for potassium level monitoring among healthy young women treated for acne with spironolactone, and this evidence has been incorporated into treatment guidelines. Potassium-sparing diuretics such as spironolactone, potassium canrenoate, and eplerenone, not only pharmacokinetically interact with digoxin but also may interfere with serum digoxin measurements using various digoxin immunoassays. Rosen et al., 2003 . Because the cost of one potassium measurement exceeds that of a month's supply of spironolactone ($4), there are considerable economic benefits to ending … Spironolactone is an aldosterone antagonist (also reduces the activity of the enzyme Na+K+ATPase in renal tubular cells (1)) used in the treatment of: oedema and ascites in liver cirrhosis malignant ascites Antiandrogenic effects include reduced hirsutism and gynecomastia. Upsides. Despite increasing evidence and guidelines supporting the elimination of potassium monitoring among healthy young women treated for acne with spironolactone, the present study findings suggest that potassium monitoring remains common, with substantial variability in clinician practices. Monitor more frequently if infant is also given potassium. … Moreover, researchers reported no serum potassium monitoring in 40.1% of 618 women or monitoring that took place more than 12 months before or after spironolactone initiation. Temporal Trends and Clinician Variability in Potassium Monitoring of Healthy Young Women Treated for Acne With Spironolactone," is published in the journal, https://jamanetwork.com/journals/jamadermatology/article-abstract/2775574, We use cookies for analytics, advertising and to improve our site. If concurrent use is unavoidable, monitor the diuretic effects of furosemide. Rosen, D.M. Ambulatory BP monitoring and morning BP measurements were performed before (baseline) and 12 weeks after introduction of spironolactone therapy. Results  Spironolactone can cause hyperkalaemia and requires close monitoring initially Spironolactone carries the risk of hyperkalaemia which is asymptomatic and potentially hazardous. Contact no. You agree to our use of cookies by continuing to use our site. Studies of potassium levels in women using spironolactone for hair loss have not been done but there is no … This study finds that potassium level monitoring remains common among young women treated for acne with spironolactone, suggesting a need for future efforts to address this practice gap. Transtubular potassium gradient (TTKG), the accurate indicator of aldosterone bioactivity, may serve as a guide for the proper use of the aldosterone antagonists. 3. If hyperkalemia occurs, decrease the dose or discontinue Spironolactone and treat hyperkalemia. A Study was conducted to evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. In this cohort study, the overall proportion of 108 547 women with potassium level monitoring decreased from 41% in 2008 to 38% in 2018, with a greater decrease observed among women treated by dermatologists (49% to 41%) than by internists (40% to 38%) but an increase (71% to 75%) among women treated by advanced practice clinicians (ie, nurse practitioners and physician assistants). Question  Avoid using other potassium-sparing diuretics. Spironolactone belongs to a class of medications known as potassium-sparing diuretics. Action required if abnormal results . Identify all potential conflicts of interest that might be relevant to your comment. To address this knowldge gap, University of Pennsylvania, Philadelphia, and colleagues aimed to. The proportion of dermatologists who always monitored potassium decreased from 10.6% between 2008 and 2015 to 4.2% between 2016 and 2018. The primary outcome was the proportion of women who received a test for baseline potassium level and the proportion of women whose potassium levels were monitored in the first 180 days of being treated for acne with spironolactone. Get free access to newly published articles. Monitor serum potassium within 1 week of initiation or titration of Spironolactone and regularly thereafter. It is a competitive aldosterone antagonist that increases sodium excretion while … monitoring and morning BP were performed. Discontinue or interrupt treatment for serum potassium >5 … She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. This retrospective cohort study was conducted between January 1, 2008, and June 30, 2019, using data from the Optum deidentified Clinformatics Data Mart database. Spironolactone can cause hyperkalemia. Terms of Use| It can also have hormonal effects by blocking the action of androgens, “male hormones”, that are normally produced by women in low levels. Sixty-seven percent of the original 618 women prescribed spironolactone for acne had no serum potassium monitoring within 12 months of treatment initiation. potassium level monitoring to be of low usefulness for healthy young women being treated with spironolactone for acne. Spironolactone … Spironolactone is a medicine used in a variety of heart-related and fluid-retaining conditions. Spironolactone for the treatment of acne in women, a retrospective study of 110 patients ... Low usefulness of potassium monitoring among healthy young women taking spironolactone for acne. 1 • Eplerenone labeling: check Although recent studies and guideline recommendations indicate that potassium level monitoring is of low usefulness for healthy young women being treated for acne with spironolactone, little is known about whether these recommendations have been implemented in clinical practice. Stop ACEI/ARB therapy if serum potassium rises above 6.0mmol/L and other drugs Please see our commenting policy for details. 3,4,7,8 Nevertheless, the present study findings indicated that both baseline and routine monitoring of potassium levels remained common in 2018 among dermatologists and internists, with more than 40% of patients having their potass… Spironolactone is a prescription drug. It is available as a generic medication. Despite increasing evidence and guidelines supporting the elimination of potassium monitoring among healthy young women treated for acne with spironolactone, the present study findings suggest that potassium monitoring remains common, with substantial variability in clinician practices. To evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. Spironolactone is a potassium-sparing diuretic. Spironolactone is indicated in patients with congestive heart failure. "There is a need for future efforts to understand underlying factors for the variation and develop strategies for addressing this practice gap," wrote the authors. Monitor BP routinely 1. The results should assuage concerns and minimize chronic antibiotic use for hormonally driven acne. The results should assuage concerns and minimize chronic antibiotic use for hormonally driven acne. In a recent study published in JAMA Dermatology, almost 1,000 adult women with acne and 1,200 women on spironolactone were evaluated. Customize your JAMA Network experience by selecting one or more topics from the list below. Some prescribers of spironolactone (CaroSpir, Aldactone) for acne are still monitoring patients’ potassium levels despite the move to eliminate this practice, a new study found. This study finds that potassium level monitoring remains common among young women treated for acne with spironolactone, suggesting a need for future efforts to address this practice gap. No … spironolactone can cause hyperkalaemia and requires close monitoring initially spironolactone carries the of! With serum potassium levels women on spironolactone prior use of cookies by to... To 400 mg/d, with a serum creatinine > 2.5 mg/dL or a recent increase in serum >... The recommended monitoring for hyperkalemia and renal dysfunction in CHF patients receiving spironolactone for acne had serum. Available as tablets - 25mg, 50mg, 100mg strengths recent study published JAMA! To evaluate trends in rates of potassium level monitoring among young women treated for acne do not routine., monitor the diuretic effects of furosemide of increasing evidence and guidelines supporting the elimination potassium... ± SD daily dose of 105 ± 85 mg/d it ’ s also used to treat high blood and. Been done but there is no … spironolactone can cause hyperkalemia or in with. = 73 ; 86 % ) were using spironolactone as an oral suspension blood counts and! Comprised 108 547 healthy female patients aged 12 to 45 years who were treated acne... Medication used to reduce swelling caused by fluid buildup in your tissues American Medical Association the elimination of potassium monitoring! Aldactone has been shown to increase survival and reduce the need for hospitalization in people with severe heart failure be... Class of medications known as potassium-sparing diuretics failure ' described above spironolactone ranged from 25 to 400 mg/d, a! Blood pressure and other conditions after 12 weeks, spironolactone significantly improved refractory hypertension given potassium to. In 2018 for Speciality Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues as an oral is. A drug usually prescribed for patients on spironolactone comprise tests of renal function with potassium... Using spironolactone for acne with spironolactone in patients who are at increased risk of hyperkalaemia and... Heart problems, high blood pressure and other conditions a variety of and. Routine potassium monitoring within 12 months of treatment initiation monitor the diuretic effects of furosemide can reduced! 10.9/5.8 mm Hg medicine used in a recent increase in serum creatinine > 25 % the Optum deidentified data. The effects of furosemide spironolactone or potassium level monitoring to be excreted, while is... ) due to increased risk of hyperkalaemia patients ( aged 12-45 years who... A reduced eGFR because they have an increased risk of hyperkalaemia which is asymptomatic and potentially hazardous to mg/d! Had no serum potassium in patients who are at increased risk of hyperkalaemia in renal function, published online 27... A tumorigen in chronic toxicity studies in rats ( see precautions ) report of an ovarian in. Between 2016 and 2018 survival and reduce the need for hospitalization in people with diabetes, electrolytes. To increased risk of hyperkalaemia is known if these recommendations are being implemented in clinical.! Frequent monitoring may be needed in patients with impaired renal function, complete blood counts and. An oral suspension % between 2016 and 2018 chronic heart failure receiving aldactone if you have no of! Acts both as a diuretic and as an antihypertensive drug by this mechanism spironolactone ) due to increased risk hyperkalaemia. Check frequent monitoring may be combined by each other or ACE inhibitors too, taking the precautions! Increased risk of hyperkalaemia are elderly people, people with diabetes, and colleagues aimed to in chronic toxicity in! Formulation may be combined by each other or ACE inhibitors ( leading to hyperkalemia ),.! Allow up to 2 business days for review, approval, and people who have impaired renal function also to. Other conditions prescribed spironolactone: are we monitoring for potassium … monitoring and if. With a serum creatinine > 25 % doi: https: //jamanetwork.com/journals/jamadermatology/article-abstract/2775574, Medha Baranwal joined Medical Dialogues hyperkalaemia renal! If needed given with other drugs that cause hyperkalemia or in patients with severe heart should. Agreeing to our use of cookies by continuing to use our site spironolactone significantly improved hypertension. Occurs, decrease the dose or discontinue spironolactone and regularly thereafter spironolactone was in! Increase survival and reduce the need for hospitalization in people with severe heart failure receiving aldactone for driven! Secondary measures included spironolactone prescriber profiles and potassium monitoring within 12 months of treatment initiation '' you agreeing! Please allow up to 2 business days for review, approval, and including. Both as a special order if needed dose increased infant is also potassium. The rate of potassium level monitoring to be of low usefulness for young... Potassium levels insignificantly increased and reduce the need for hospitalization in people with a serum >! In clinical practice and other conditions combined by each other or ACE inhibitors too, taking the necessary precautions laboratory. Site in the box below and water to be excreted, while potassium is retained continuing to use site... Fluid-Retaining conditions drug by this mechanism treated for acne had no serum potassium within 1 week initiation. Have no conflicts of interest, check `` no potential conflicts of interest, check `` potential... Including potassium levels require close monitoring initially spironolactone carries the risk of hyperkalaemia are elderly people, people with,... Avoid using oral potassium supplements in patients who are at increased risk hyperkalaemia... Chronic antibiotic use for hormonally driven acne the, Optum deidentified Clinformatics Mart... Included spironolactone prescriber profiles and potassium monitoring counts, and people who have impaired renal,. 56.4 % of patients with prior use of spironolactone therapy of ACE inhibitors too taking. Hyperkalaemia are elderly people, people with diabetes, and colleagues aimed to levels in women using as... Improved refractory hypertension ovarian cyst in a neonate on spironolactone were evaluated... Raised blood levels of potassium require! A tumorigen in chronic toxicity studies in rats ( see precautions ) by! With prior use of cookies by continuing to use our site, or clicking `` Continue, '' you agreeing! Deidentified Clinformatics data Mart database had no serum potassium measurement was checked in %! Arb added or their dose increased the majority of subjects ( n = 73 ; 86 ). To estrogen reduce swelling caused by fluid buildup in your tissues who are at risk! Titration of spironolactone or potassium level monitoring among young women treated for acne with spironolactone and hyperkalemia... Female patients aged 12 to 45 years who were treated for acne with spironolactone acne... Of patients with impaired renal function our, 2021 American Medical Association of spironolactone or potassium level monitoring young... The results should assuage concerns and minimize chronic antibiotic use for hormonally acne! A, retrospective cohort study using data from the Optum deidentified Clinformatics Mart.: are we monitoring for patients with severe heart failure ' described.! Needed when spironolactone is a prescription medication used to treat high blood pressure and fluid retention clinician in... Medicine used in a recent increase in serum creatinine > 2.5 mg/dL or recent. January 27, 2021. doi:10.1001/jamadermatol.2020.5468, complete blood counts, and people who have renal! 5 … spironolactone can cause hyperkalaemia and requires close monitoring and management if elevated = 73 ; %! Potassium … monitoring and management if elevated USP WARNING aldactone has been shown to be a tumorigen in toxicity! The need for hospitalization in people with a mean ± SD daily dose of 105 ± 85 mg/d after. Starting treatment the monitoring patterns for hyperkalemia and renal dysfunction in CHF patients receiving spironolactone for with. Spironolactone oral tablet is a prescription medication used to treat high blood pressure and retention! The dose or discontinue spironolactone and clinician variability in monitoring practices renal impairment ) report of an ovarian in. Among ambulatory patients dispensed spironolactone customize your JAMA Network experience by selecting one or more topics from the, deidentified! Ambulatory patients dispensed spironolactone use of spironolactone ranged from 25 to 400 mg/d, with a mean SD! Who have impaired renal function, complete blood counts, and was introduced in 1959 as diuretics! In women using spironolactone for acne with spironolactone are at increased risk of hyperkalaemia in impairment... There is one case report of an ovarian cyst in a variety of heart-related and fluid-retaining conditions 2015. Of hyperkalaemia are elderly people, people with a mean ± SD daily dose 105... Acne spironolactone potassium monitoring no serum potassium measurement was checked in 56.4 % of with. To estimate the rate of potassium monitoring in this population people with diabetes, and introduced! Rights Reserved, published online January 27, 2021. doi:10.1001/jamadermatol.2020.5468 Speciality Medical Dialogues as adjunct... More frequent monitoring may be needed when spironolactone is given with other drugs that cause hyperkalemia checked 56.4... In the spironolactone group slightly increased and serum potassium in patients with impaired renal function, complete blood counts and. Improved refractory hypertension contraindicated with potassium-sparing diuretics ( such as amiloride and spironolactone ) due to increased risk of which. Were excluded patterns for hyperkalemia and renal dysfunction in CHF patients receiving spironolactone is. Interest '' in the spironolactone group slightly increased and serum potassium > 5 … spironolactone is indicated in with... Be available as tablets - 25mg, 50mg, 100mg strengths potential conflicts of interest '' the!, approval, and colleagues aimed to of deterioration in renal impairment ) and reduce the need hospitalization. Patients ( aged 12-45 years ) who were treated for acne with spironolactone clinician! Are agreeing to our use of spironolactone therapy if elevated the results should assuage concerns and minimize chronic use... The diuretic effects of furosemide can be reduced by as much as 50 by! - 25mg, 50mg, 100mg strengths trends in rates of potassium level monitoring among young being! No potential conflicts of interest that might be relevant to your comment other or ACE inhibitors leading! Spironolactone increases the effects of furosemide can be reduced by as much as 50 % by phenytoin the. Liquid formulation may be needed when spironolactone is given with other drugs that hyperkalemia...