Amiloride/spironolactone + ACEi/ARB — hyperkalemia
- Both impair renal K+ excretion
- ACEi/ARB ↓ aldosterone
- K-sparing diuretic retains K+
- Hyperkalemia ± AKI risk
- Risk ↑ with CKD, diabetes, dehydration
- Check K/Cr after starts or dose changes
Interaction at a glance
- Hyperkalemia ± AKI risk
- Check K/Cr after starts or dose changes
Mechanism
- Both impair renal K+ excretion
- ACEi/ARB ↓ aldosterone
- K-sparing diuretic retains K+
Clinical consequence
Monitoring
- Check K/Cr after starts or dose changes
Who is at greatest risk
- Risk ↑ with CKD, diabetes, dehydration
Self-check
- What should be monitored with Amiloride/spironolactone + ACEi/ARB?
K/Cr after starts or dose changes.
- What is the main clinical risk of Amiloride/spironolactone + ACEi/ARB?
Hyperkalemia ± AKI risk.
- What is the key clinical risk of Amiloride/spironolactone + ACEi/ARB?
Hyperkalemia.
Drugs in this interaction (29)
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