Spironolactone for Hormonal Acne: Is Routine Potassium Monitoring Necessary?

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AAD: Low Rate of Hyperkalemia With Spironolactone Use
AAD: Low Rate of Hyperkalemia With Spironolactone Use

(HealthDay News) — Healthy young women taking spironolactone for acne have no increased rate of hyperkalemia, according to a study published online March 22 in JAMA Dermatology to coincide with the annual meeting of the American Academy of Dermatology, held from March 20 to 24 in San Francisco.

Molly Plovanich, M.D., from Brigham and Women's Hospital in Boston, and colleagues measured the rate of hyperkalemia in healthy young women taking spironolactone for acne or an endocrine disorder with associated acne. Data were included for 974 healthy young women taking spironolactone for acne. To obtain a profile for the baseline rate of hyperkalemia in this population, the authors analyzed 1,165 healthy young women taking and not taking spironolactone.

The researchers identified 13 abnormal serum potassium measurements in 1,802 measurements, yielding a hyperkalemia rate of 0.72 percent among young women receiving spironolactone therapy. This was equivalent to the baseline hyperkalemia rate of 0.76 percent in this population. In six of the 13 patients, repeat testing demonstrated normal values, indicating the measurements may have been incorrect. No action was taken in the remaining seven patients.

"In conclusion, our results suggest that routine potassium monitoring is unnecessary for healthy young women taking spironolactone for acne," the authors write. "The low rate of hyperkalemia may encourage more health care professionals to consider the use of this highly effective drug in their clinical practice."

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