Adverse Reactions to Spironolactone

To the Editor.— Dr. Winter has reiterated the major point of our report. We stressed that the risk of hyperkalemia during spironolactone therapy is greatly increased when renal function is impaired or when potassium chloride is coadministered. Under those circumstances, hyperkalemia is more "predictable" but certainly is no less "adverse" or detrimental to the patient. The results of our study reflect how hospital physicians presently prescribe spironolactone. Adverse reactions to this useful drug would be less common were it always administered with all appropriate precautions. We hoped that our report would help to bring this about.