Potassium and spironolactone - British Heart Fou...

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Potassium and spironolactone

16 Replies

Just some more information. Which may be of interest. This is all about lovely blood pressure. Well sort of. Any way had a blood test to check the potassium level as spironolactone which is a diuretics. Lets your body hold onto potassium. Over the three tests i have had june, july and September the potassium was 4.0, 4.4, and 5.2 so it has gradually crept up. Iam not worried as all bloods came back with no further action necessary. But at what figure is it too high? . Back in 2017 before my issue's and before medication i had a 5.5 which is high according to the test. Iam on 25mg of spironolactone. In some way this proves spironolactone is working. And your heart does need potassium. Or am i getting too technical.

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16 Replies
Lezzers profile image
Lezzers

Hi Felly, my husband often has high potassium issues. The figures you've given are at the higher level of normal but nothing to be concerned about, though I think I'd ask why they've stopped testing it if its been rising on each test!! Spironolactone can increase your potassium level but then so can other meds. My husband's level went up to 6 and that was due to his candesartan, he wasn't able to take Spironolactone due to the potassium issue. His gp took him off his candesartan for a month & he had to drink lots of water to flush his potassium out. That worked and he was then put back on his candesartan, his gp did say had his level been any higher she would have sent him to hospital! Yes, you do need potassium but levels that are too high or too low can cause arrhythmias.

in reply to Lezzers

Thanks for that. The trouble is i have to organise the bood test... well gently remind the surgery. Iam keeping a spreadsheet of the figures and will check again in a month. I agree that too much potassium can cause heart arrhythmias. Which i have read about. But its one of them situations where i may need the spironolactone to assist blood pressure and stop water retention . Especially around heart and lungs... as it suppose to be good at assisting gas transfer from lungs to blood? Trouble is, it all becomes a balancing act. And all this chemistry is a bit above us and thats when we have to trust the experts. But i will do what i can to be more vigilant. My lisinopril was put up by 5mg to try and get diastolic lower. But i will see how i go for another month. Thanks for the information it was most helpful.

Lezzers profile image
Lezzers in reply to

I used to keep a spreadsheet also as it came to light the surgery hadn't picked up that it was increasing. Unfortunately it is a balancing act with all the meds because they can all hurt your kidneys. There are alternatives to Spironolactone which is usually given as a first line meds as a preventive. However, if you cant tolerate it then theres furosemide (there are others) which helps remove fluid rather then prevent it. My husband takes furosemide which helped with the fluid but didn't stop it building up completely, so he was reintroduced to Spironolactone gradually 1/2 a tablet every other day and is now on 1 tablet every other day and that has worked for him with no detrimental effect to his kidneys. If potassium becomes an issue it might be worth talking it through with your medical team about reducing the Spironolactone. Good luck

in reply to Lezzers

Thanks for the reply . I will definitely discuss with my doctor or cardiac nurses. The trouble is the figures are all still within limits. But i agree they are creeping up.

10gingercats profile image
10gingercats

My potasssium went up recentlyto 5.6 and I got really bad overt arrythmias when I am usually not aware of having Afib. GP did a second test after a week and it had dropped to 5 which he said was acceptable although high normal. I take Spirolactone (a tiny dose) once daily plus Furosimide to stop heart and lung fluid build up and it works a treat.I am loathe to stop the Spirolactone and hoping i do not get any more nasty arrythmia scares.

in reply to 10gingercats

How much spironolactone do you take ?Mines 25mg and 25mg of lisinopril now. I will have to keep an eye on it. I dont believe i have had arrythmias. But i suppose i will know once i have had them. Thats what i hate about medications you take them to resolve one problem then you get another.

10gingercats profile image
10gingercats

I take half of a 25mg Spirolactone tablet daily and 20mg og Furosimide. Both in the morning around 9 am.

I take mine in the evenings. Here is one for you. Hot off the press i sent a message to doctor about the 5.2 and he said we will worry about it when it get to 6. Oh well i will definitely be keeping a close eye on it. Might contact cardiac nurses next week and double check as it was the cardiac team who put me on these tablets.

Digger0 profile image
Digger0

I'll look at my results as I'm on 12.5 mg!

Digger0 profile image
Digger0

Just checked mine - it's OK! My surgery website shows a graph of my results!

Graph
in reply to Digger0

Thats very interesting. I just wonder if mine will level out. I looked back on past blood tests years ago and mine has always been high. Well in the 5s. Thats was before tablets and my blood pressure was 110/80 but that was back in 2012 ish. But again i have my bee in my bonnet 110/80 was with an old pump up machine at doctors.

Mumtochd profile image
Mumtochd

Hi, I was put on 50mg Spironolactone as 4th drug to bring down BP, I did question at the time the effect on kidneys as I am also on 10mg of Ramipril, 25 mg of Lercandipine and 2.5 mg of Indapamide. I was told the the Indapamide & spironolactone off set each other to control potassium. I have regular kidney function tests which I have been told are okay but never given a figure.

I find your comment on arrhythmia interesting as I have been having fast heart rates and heart feels if it is doing flips. GP diagnosed tachycardia and has referred me now to cardiology, they also started me on a beta blocker to reduce heart rate. The tachycardia has only been since starting all the BP medication’s

in reply to Mumtochd

The trouble is the body has to either get use to the medications which can take weeks. Or we have to try and watch what it is doing. This is what i was told when i was put on spironolactone. Monitoring of Us and Es ( bloods) monthly for 2 months then every 3 months for 1 year, then every 6 months. This has to be repeated after any dose increase. Spironolactone is a mild one as it can be used for acne. But we have to put our trust in the medical teams.

Windmill6 profile image
Windmill6 in reply to Mumtochd

Hi. Yours sounds a similar story to mine! On 4 drugs to reduce BP not really working.Also having arrhythmia on and off and issues with low potassium too.I was constantly thirsty,peeing all the time, weak and achey,having night cramps and digestive problems...turned out (after a long journey) I had an endocrine (hormone) disorder called Conns syndrome. Ask your doctor for a blood test to rule it out. Is very much under diagnosed disease and needs treating asap. Good luck.

Windmill6 profile image
Windmill6

Hi, i also take spironolactone and found the 25microgram dose was too high for me so basically I cut them in half to make 12.5 dose,at my Dr's request. Normal potassium is 3.5--5.0 range ,is dangerous both high and low levels.Bought a pill cutter from my local pharmany to do this.Have normal readings now around 4.2 and eating potassium foods ie banana every day,salmon and green veggies...I almost died with very low potassium levels which my GP ignored,so extra vigilant now!

in reply to Windmill6

Feel not too bad will take on board what you have said. Will have another blood test in January. Iam keeping a graph. Trouble with medication, is it helps one issue then causes another.

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