The MHRA has clarified their guidance on concomitant use of these medicines in heart failure in December 2016.
- Concomitant use of spironolactone with ACEi or ARB increases the risk of severe hyperkalaemia, particularly in patients with marked renal impairment, and should be used with caution
- Use the lowest effective doses of spironolactone and ACEi or ARB if coadministration is considered essential
- Regularly monitor serum potassium levels and renal function
- Interrupt or discontinue treatment in the event of hyperkalaemia
- The same advice applies regarding concomitant use of eplerenone with ACEi or ARB in heart failure
- Suspected adverse reactions should be reported to MHRA on a Yellow Card
Further information is available on the MHRA website.
QMasters' tools to help GPs implement this guidance
Please download our free searches to identify those patients prescribed both spironolactone and an ACEi or ARB with a raised potassium level, eGFR below 30, or no recent renal function blood tests.
You must right-click on this and select "Save As" and import the file into Population Reporting in EMIS Web.
You must right-click on this and select "Save As" and import the file into Population Reporting in EMIS Web.
| spironolactone_and_ace_or_arb__v1.1___www.qmasters.co.uk_.xml |
Please note our search relies on accurate clinical coding to identify these patients and we are unable to guarantee that all patients will be correctly identified.
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