Serious adverse events experienced by patients with chronic heart failure taking spironolactone.
In patients with chronic heart failure, spironolactone added to conventional treatment may lead to serious and, occasionally, fatal hyperkalaemia. In some cases this seems to happen because spironolactone causes diarrhoea. Four cases involving men with New York Heart Association functional class III heart failure are presented. As these cases revealed, close monitoring of blood chemistry is mandatory after starting spironolactone, and patients should be advised to stop spironolactone immediately if diarrhoea develops.
Department of Cardiology, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, UK. colin.berry@clinmed.gla.ac.uk
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Berry
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McMurray
D000368:Aged; D003967:Diarrhea / Q000209:etiology; D004232:Diuretics / Q000009:adverse effects* / Q000627:therapeutic use; D017809:Fatal Outcome; D006323:Heart Arrest / Q000209:etiology; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced* / Q000150:complications; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D013148:Spironolactone / Q000009:adverse effects* / Q000627:therapeutic use
D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone