spironolactone and furosemide in treating ascites

Q: 54 years old male patient with cirrhosis is now ready to get transferred out of ICU. What is the preferred ratio of spironolactone and furosemide in treating ascites to maintain eukalemia?

Answer: 100:40

First-line diuretic therapy for cirrhotic ascites is the combined use of spironolactone and furosemide. Both drugs can be titrated as needed. 100: 40 mg ratio of spironolactone to furosemide is generally recommended to maintain normal electrolyte balance. Maximum accepted dosages are 400 and 160 mg/day of spironolactone and furosemide, respectively.

#hepatology

#electrolytes

Reference:

Management of Cirrhotic Ascites: Treatment of Cirrhotic Ascites - Medscape General Medicine. 2002;4(4)