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The latest Mainline newsletters for the General Public are listed here.


For healthcare professionals we have a Mainline newsletter in a Professional version here.


What will 1 out of every three seniors experience this year? A Fall! Why?

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Volumme 4 February 28, 2008 Number 2     

An Exclusive Continuing Education Publication of Acadiana Consultant Pharmacy Service
Author, Publisher, Editor-in Chief, Typesetter & Printer, Charles S. Feucht,PD,FASCP PharmD candidate

Medication News & Update

Aldactone Use & Increased Hospitalizations


Since the RALES study a few years ago and the JNC VII guidelines for treatment of hypertension were released there has been an increased use of spironolactone for

treating hypertension in patients with heart failure.  This practice has resulted in more hopitalization of patients because of hyperkalemia(high potssium level) problems. The numbers indicate that the rate for hospitalizations for hyperkalemia have more than doubled since this increase in use of spironolactone occurred. The statistics show that for every 1000 patients treated with spironolactone 50 more patients are hospitalized with hyperkalemia.

The explanation for why this wasn't seen in the highly respected RALES study is that the pateints in the study were carefully selected and monitored. Now pateints being given spironolactone are generally older than those in the study and have poorer kideny function. They may also be on other blood pressure medications which can increase potassium levels such as an angiotensin converting enzyme inhibitor like lisinopril, benazepril, fosinopril, monopril, ramipril or captopril. Drugs like ibuprofen, naproxen, celecoxib, sulindac, diclofenac, can also cause elevations in potassium levels.

If you're an elderly pateint and your doctor has prescribed  spironolactone you should have your potassium levels monitored regularly as well as your kidney function. Ask your pharmacist

to check for other medication your are receiving which could increase potassium levels. Use our contact us form if you want a listing of these drugs and alternative therapies.

Herbs that Cause Hyperkalemia

Herbal products may be hidden sources of potassium.

Noni juice, which is obtained from the fruit of Morinda citrifolia, contains 56 mmol/L of potassium.

Hawthorn, Crataegus monogyna or Crataegus laevigata, extract




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