Spironolactone, sold under the brand name Aldactone among others, is a medication that is primarily used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. Upsides. Despite increasing evidence and guidelines supporting the elimination of potassium monitoring among healthy young women treated for acne with spironolactone, the present study findings suggest that potassium monitoring remains common, with substantial variability in clinician practices. For the purpose, the researchers conducted a retrospective cohort study using data from the Optum deidentified Clinformatics Data Mart database. This retrospective cohort study was conducted between January 1, 2008, and June 30, 2019, using data from the Optum deidentified Clinformatics Data Mart database. Has the frequency of potassium level monitoring among healthy young women treated for acne with spironolactone decreased following recent study findings suggesting its low usefulness and updated guideline recommendations for this population? spironolactone, eplerenone (Inspra )] Potassium and renal function (e.g., serum creatinine) • Guidelines: check potassium and renal function baseline, three and seven days after initiation, monthly for three months, then quarterly. Hypotension and Worsening … Raebel MA(1), McClure DL, Chan KA, Simon SR, Feldstein AC, Lafata JE, Andrade SE, Gunter MJ, Nelson WW, Roblin D, Platt R. Author information: (1)Kaiser Permanente Colorado Clinical Research Unit and School of Pharmacy, University of Colorado … Accessibility Statement. There is a need for future implementation and dissemination research to understand underlying factors for this variation and to develop strategies to address this practice gap. This important study shows that healthy women receiving spironolactone for acne do not need routine potassium monitoring. She can be contacted at  editorial@medicaldialogues.in. Has the frequency of potassium level monitoring among healthy young women treated for acne with spironolactone decreased following recent study findings suggesting its low usefulness and updated guideline recommendations for this population? This is occurring despite of increasing evidence and guidelines supporting the elimination of potassium monitoring in this population. To evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. Meaning  It can also have hormonal effects by blocking the action of androgens, “male hormones”, that are normally produced by women in low levels. To know more, see our. Potassium measurements were available for up to 7 years of spironolactone therapy. RESULTS: There were 13 abnormal serum potassium measurements in 1802 measurements obtained among young women receiving spironolactone therapy, yielding a hyperkalemia rate of 0.72%, equivalent to the 0.76% baseline rate of hyperkalemia in this population. The recent studies and guidelines have suggested potassium level monitoring to be of low usefulness for healthy young women being treated with spironolactone for acne. There is one case report of an ovarian cyst in a neonate on spironolactone. Identify all potential conflicts of interest that might be relevant to your comment. Not much is known if these recommendations are being implemented in clinical practice. If hyperkalemia occurs, decrease the dose or discontinue Spironolactone and treat hyperkalemia. Secondary measures included spironolactone prescriber profiles and potassium monitoring practices. Our website uses cookies to enhance your experience. HYPERTENSION . For 108 547 women included in this cohort study, the mean (SD) age at the start of treatment was 30.7 (8.6) years, and the mean (SD) course duration was 159 (218) days. It is a competitive aldosterone antagonist that increases sodium excretion while … It can also have hormonal effects by ... Raised blood levels of potassium levels may occur during treatment with spironolactone. Monitor more frequently if infant is also given potassium. You agree to our use of cookies by continuing to use our site. OBJECTIVE: To estimate the rate of potassium and creatinine evaluation and identify factors associated with conducting these tests among ambulatory patients dispensed spironolactone. Results  Adverse Reactions Hyperkalaemia and metabolic acidosis. "This study finds that potassium level monitoring remains common among with substantial variability in clinician practices in young women treated for acne with spironolactone despite increasing evidence and guidelines supporting the elimination of potassium," wrote the authors. Despite growing evidence and recommendations supporting the removal of potassium monitoring among healthy young women treated with spironolactone for acne, the results of the current study indicate that potassium monitoring remains common, with considerable variability in clinical practice. Spironolactone () Definition (NCI) A synthetic 17-spironolactone corticosteroid with potassium-sparing diuretic, antihypertensive, and antiandrogen activities.Spironolactone competitively inhibits adrenocortical hormone aldosterone activity in the distal renal tubules, myocardium, and vasculature. Avoid using other potassium-sparing diuretics. The majority of subjects (n = 73; 86%) were using spironolactone as an adjunct to estrogen. They may be combined by each other or ACE inhibitors too, taking the necessary precautions and laboratory monitoring. The study titled, "Temporal Trends and Clinician Variability in Potassium Monitoring of Healthy Young Women Treated for Acne With Spironolactone," is published in the journal JAMA Dermatology. Published online January 27, 2021. doi:10.1001/jamadermatol.2020.5468. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. Spironolactone may also be called a potassium-sparing diuretic. Although recent studies and guideline recommendations indicate that potassium level monitoring is of low usefulness for healthy young women being treated for acne with spironolactone, little is known about whether these recommendations have been implemented in clinical practice. The recommended monitoring for potassium … Spironolactone … Participants comprised 108 547 healthy female patients aged 12 to 45 years who were treated for acne with spironolactone. To evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. "There is a need for future implementation and dissemination research to understand underlying factors for this variation and to develop strategies to address this practice gap," they concluded. It is available as a generic medication. There was no significant difference in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). It comes as an oral tablet and an oral suspension. There was no significant difference in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). Some prescribers of spironolactone (CaroSpir, Aldactone) for pimples are nonetheless monitoring sufferers’ potassium ranges regardless of the transfer to eradicate this observe, a brand new examine discovered. Rosen, D.M. Not much is known if these recommendations are being implemented in clinical practice. It is critical to monitor and manage serum potassium in patients with severe heart failure receiving spironolactone. Spironolactone was discovered in 1957, and was introduced in 1959. The proportion of dermatologists who always monitored potassium decreased from 10.6% between 2008 and 2015 to 4.2% between 2016 and 2018. Patients with prior use of spironolactone or potassium level >5 mmol/L were excluded. Despite increasing evidence and guidelines supporting the elimination of potassium monitoring among healthy young women treated for acne with spironolactone, the present study findings suggest that potassium monitoring remains common, with substantial variability in clinician practices. If concurrent use is unavoidable, monitor the diuretic effects of furosemide. Studies of potassium levels in women using spironolactone for hair loss have not been done but there is no … Spironolactone can cause hyperkalaemia and requires close monitoring initially Spironolactone carries the risk of hyperkalaemia which is asymptomatic and potentially hazardous. Despite growing evidence and recommendations supporting the removal of potassium monitoring among healthy young women treated with spironolactone for acne, the results of the current study indicate that potassium monitoring … All Rights Reserved. This study finds that potassium level monitoring remains common among young women treated for acne with spironolactone, suggesting a need for future efforts to address this practice gap. A liquid formulation may be available as a special order if needed. The results should assuage concerns and minimize chronic antibiotic use for hormonally driven acne. Moreover, researchers reported no … As for internists who prescribed spironolactone for acne, the proportion who checked potassium levels within the first 180 days dropped from 39.7% … Terms of Use| Discontinue or interrupt treatment for serum potassium >5 … Only prescribe spironolactone for people whose blood potassium level is 4.5 mmol/l or lower. Serum potassium levels require close monitoring and management if elevated. Contraindicated with potassium-sparing diuretics (such as amiloride and spironolactone) due to increased risk of hyperkalaemia. 3. © 2021 American Medical Association. Spironolactone is an aldosterone antagonist (also reduces the activity of the enzyme Na+K+ATPase in renal tubular cells (1)) used in the treatment of: oedema and ascites in liver cirrhosis malignant ascites Spironolactone is a mineralocorticoid receptor antagonist that is currently indicated for the treatment of primary hyperaldosteronism, ... that serum potassium levels were not found to be elevated above those of the controls and it was concluded that routine potassium monitoring is unnecessary for this relatively young and healthy cohort. 3,4,7,8 Nevertheless, the present study findings indicated that both baseline and routine monitoring of potassium levels remained common in 2018 among dermatologists and internists, with more than 40% of patients having their potass… Monitoring of blood electrolytes is essential when co-prescribing spironolactone, or other potassium-sparing diuretics, with an ACE inhibitor or an angiotensin receptor blocker (ARB) in patients with … The primary outcome was the proportion of women who received a test for baseline potassium level and the proportion of women whose potassium levels were monitored in the first 180 days of being treated for acne with spironolactone. They may be combined by each other or ACE inhibitors too, taking the necessary precautions and laboratory monitoring. NICE do not provide advice on monitoring ACEI/ ARB therapy in hypertension except in when using further diuretic therapy for resistant hypertension at step 4, where they suggest monitor blood sodium and potassium and renal function within 1 … To evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. Rosen et al., 2003 . Antiandrogenic effects include reduced hirsutism and gynecomastia. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. Phenobarbital — concurrent use is not recommended. Spironolactone is indicated in patients with congestive heart failure. For clinicians who had prescribed at least 5 courses of spironolactone, the percentage of clinicians who ordered baseline potassium testing or monitoring and the percentage of clinicians who always monitored potassium were compared between 2008 and 2015 vs between 2016 and 2018. All Rights Reserved, Published online January 27, 2021. doi:10.1001/jamadermatol.2020.5468. DOI: https://jamanetwork.com/journals/jamadermatology/article-abstract/2775574, Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. Breitkopf, M. Nagamani. To address this knowldge gap, John S. Barbieri, University of Pennsylvania, Philadelphia, and colleagues aimed to evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. Some prescribers of spironolactone (CaroSpir, Aldactone) for acne are still monitoring patients’ potassium levels despite the move to eliminate this practice, a new study found. 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Please see our commenting policy for details. Aldactone acts both as a diuretic and as an antihypertensive drug by this mechanism. No significant difference was found in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). The proportion of dermatologists who always monitored potassium decreased from 10.6% between 2008 and 2015 to 4.2% between 2016 and 2018. Laboratory monitoring for patients on spironolactone comprise tests of renal function, complete blood counts, and electrolytes including potassium levels. The primary outcome was the proportion of women who received a test for baseline potassium level and the proportion of women whose potassium levels were monitored in the first 180 days of being treated for acne with spironolactone. Spironolactone as an antihypertensive drug by this mechanism, approval, and who... 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