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Tolerability of spironolactone in patients with chronic heart failure – a cautionary message
Author(s) -
Witham Miles D.,
Gillespie Neil D.,
Struthers Allan D
Publication year - 2004
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.2004.02187.x
Subject(s) - spironolactone , tolerability , medicine , hyperkalemia , heart failure , clinical trial , creatinine , diuretic , adverse effect
Aim To assess how well heart failure patients tolerate spironolactone in routine clinical practice. Design Retrospective analysis of 226 patients attending a specialist heart failure clinic. Results One hundred and thirty of 226 (57.5%) patients tried spironolactone at least once. Forty‐four of 130 (33.8%) discontinued spironolactone due to side‐effects after a mean of 11.1 months; 59/141 (41.8%) trials of spironolactone resulted in at least one side‐effect; therapy was stopped in 30/141 (21.3%) trials due to raised potassium or creatinine. Significant risk factors for raised potassium/creatinine were age and baseline potassium level. Conclusions Potentially serious side‐effects are common despite appropriate use of spironolactone.