ModerateSelective beta-adrenergic blockers×Potassium-sparing diuretics (mineralocorticoid receptor antagonists)
Updated · Methodology
Mechanism
Standard combination in heart failure with reduced ejection fraction – additive antihypertensive effect. Spironolactone retains potassium, reducing arrhythmia risk on a beta-blocker.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
Standard combination. Check potassium and creatinine 1 week after start, then monthly. If potassium exceeds 5.5 mmol/L, reduce spironolactone.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- ESC: ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2021)– McDonagh TA et al. Eur Heart J 2021;42:3599-3726