monitor with ARBs

Monitor

• initial
  • serum K+ & serum creatinine within 1-2 weeks of initiation (within 1 week in the elderly) & after dose increases, then again in 3-4 weeks
  • in low risk patients with serum creatinine of <= 4.5 mmol/L, can wait 3-5 weeks prior to initial assessment
• maintenance
  • serum creatinine, serum urea nitrogen & serum electrolytes every 6 months
  • if serum creatinine increases, check again in 2-3 weeks & again in 3-4 weeks

Management

• discontinue if serum K+ > 5.5 mmol/L
• discontiune if serum creatinine increases > 30 % within 1st 2 months despite dose reduction

More general terms

• monitor with drug