SpironolactoneATC Code: C03DA01
therapeutic monitoring program
Baseline: Electrolytes, SCr, & BUN prior to initiation. Do not initiate if potassium >5mmol/L or eGFR< 30µmol/L.
After dosage change: Electrolytes, BUN, SCr 3 days and 7 days following increase
Then Q monthly electrolytes, BUN, SCr for 3 months
Followed by Q3monthly electrolytes, BUN, SCr thereafter
*** Important *** - Instruct patients to d/c during episodes of diarrhea/dehydration and during interruption of loop diuretic (if receiving).
Most important interactions:
ACE-Inhibitors/ARBs –Increases risk of hyperkalemia – monitor electrolytes.
NSAID/COX-2 inhibitors – Increases risk of hyperkalemia and renal failure - avoid.