What should be monitored when initiating and titrating aldosterone antagonists?
When initiating and titrating aldosterone antagonists, renal function and potassium should be monitored within 2 to 3 days and again at 7 days. Subsequent monitoring should occur at least monthly for the first 3 months and every 3 months thereafter. The dose of diuretic agents should also be reduced if there is evidence of hypovolemia, and the ARNI dose may need to be reduced in the setting of renal insufficiency or hypotension. Hyperkalemia may also require changes in medical therapy.