K-sparing + loop diuretic combination
Spironolactone with furosemide
Brand names: Lasilactone
Adult dose
Dose: 1–4 caps (50/20mg) PO OD
Route: PO
Frequency: OD
Dose adjustments
Renal
Avoid if eGFR <30
Clinical pearls
- Resistant oedema/HF
- Monitor electrolytes closely; gynaecomastia common with spironolactone
Contraindications
- Anuria
- Hyperkalaemia
- Severe renal/hepatic impairment
- Addison's
- Hypersensitivity
Side effects
- Hyperkalaemia
- Hyponatraemia
- Gynaecomastia (spironolactone)
- Renal impairment
- Hypotension
- Ototoxicity (high-dose furosemide)
Interactions
- ACEi/ARB
- Lithium
- NSAIDs
- Digoxin
Monitoring
- U&E
- BP
- Weight
Reference: BNF; NICE NG106; ESC; https://bnf.nice.org.uk/drugs/spironolactone-with-furosemide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines