Possible Interaction: Potassium and Spironolactone

“Conclusion: This study showed that spironolactone can reduce potassium requirements and prevent hypokalemia by reducing urinary potassium loss in neutropenic patients on AmB treatment.”

“Results: Patients receiving concomitant AmB and spironolactone had significantly higher plasma potassium levels than those receiving AmB alone (P=0.0027).”

“Those patients receiving AmB and spironolactone required significantly less potassium supplementation to maintain their plasma potassium within the normal range (P=0.022).”

“2 SC-23992 (50 mg) and spironolactone (125 mg) each significantly increased sodium excretion and the sodium : potassium (Na/K) ratio, and decreased potassium excretion, when compared with placebo.”

“Between … whose potassium levels … spironolactone by all clinicians decreased from 41.4% to 38.5%, with a decrease from 48.9% to 41.0% among dermatologists and …% among internists but with an increase from 71.4% to 75.4% among advanced practice clinicians (ie, nurse practitioners and physician assistants).”

“Treatment with spironolactone or potassium supplements alone significantly increased serum potassium concentration by … ± 0.35 mmol/l, respectively (both P < 0.05), and combined therapy with spironolactone … potassium increased serum potassium concentration by 0.69 ± 0.64 mmol/l (…) mutation sites identified in 42 Chinese GS patients are novel.”

“Data showed that eplerenone and spironolactone are both associated with the occurrence of gynecomastia, mastodynia, and abnormal vaginal bleeding and in addition, they can increase natriuresis and cause renal retention of potassium ; furthermore, eplerenone may cause hyperkalemia and promote the onset of metabolic acidosis or hyponatremia.”

“ACEI, ARBs, and spironolactone may cause slight increases in potassium even in anuric patients, requiring increased surveillance.”

“ Potassium increased with spironolactone in non-AAs (4.29±0.5–4.55±0.49 mmol/L) but not in AAs (4.32±0.54–4.31±0.49 mmol/L; race by treatment interaction, P=0.03) during the first month and remained higher throughout the trial.”

“On spironolactone 25 mg, potassium was reduced to 40 mEq daily.”

“Both agents produce dose‐dependent increases in potassium concentrations, although the effect with spironolactone appears to be greater when both agents are administered at recommended doses.”

“The results suggest that spironolactone administration decreases the renal excretion of magnesium and potassium in an equivalent manner.”