PEBC: What You Need to Know: Potassium Sparing Diuretics
Examples: Spironolactone, eplerenone, amiloride, triamterene
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Indications:
-Hypertension (second-line), but specifically heart failure for spironolactone and eplerenone
-Spironolactone is also used for hyperaldosteronism, acne, liver cirrhosis
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Dosing:
-Usually once daily in the morning (due to diuresis effect)
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Adverse Effects:
-Hyperkalemia (hence triamterene and amiloride are often combined with hydrochlorothiazide to balance potassium)
-Hyponatremia
-Increased serum creatinine
-Breast tenderness, menstrual irregularities, impotence (only spironolactone, not eplerenone)
-dizziness, diarrhea, nausea
-muscle cramps
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Drug Interactions:
-Anything that increases potassium levels: ACE inhibitors, ARBs, potassium supplements, NSAIDs, sulfamethoxazole-trimethoprim
-Eplerenone is metabolized via CYP3A4 so caution with strong inhibitors