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No increased rate of hyperkalemia in healthy women taking spironolactone for acne

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Potassium monitoring not needed with spironolactone

Many physicians regularly prescribe spironolactone for acne, with great success, but many others may have balked at the potential adverse effects, including hyperkalemia.

This large, well-designed study can assuage those fears – at least in women without cardiac or renal disease, or who are taking medications that may potentiate the risk of hyperkalemia – and reassure physicians that they do not need to check potassium levels in otherwise healthy individuals taking spironolactone.

Dr. Emmy M. Graber, a dermatologist at Boston University, commented in an accompanying editorial (JAMA Dermatology 2015 [doi:10.1001/jamadermatol.2015.35]). There were no conflicts of interest declared.


 

FROM JAMA DERMATOLOGY

References

Young women taking spironolactone for hormonally mediated acne do not need to be monitored for hyperkalemia, say the authors of a study that showed no significant increase in the risk of the condition.

The retrospective study in 974 otherwise healthy women taking spironolactone found the rate of hyperkalemia was 0.72%, compared with 0.76% in women not taking spironolactone, according to data published online March 22 in JAMA Dermatology.

A subset of 13 patients were found to have elevated serum potassium but upon repeat testing in 6, these measurements had all returned to normal, suggesting either incorrect first measurements or that the mild hyperkalemia was transient (JAMA Dermatology 2015 [doi:10.1001/jamadermatol.2015.34].

“The low rate of hyperkalemia may encourage more health care professionals to consider the use of this highly effective drug in their clinical practice,” wrote Dr. Molly Plovanich and her coauthors from Brigham and Women’s Hospital and Harvard Medical School, both in Boston.

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