Q: 54 year old male patient with cirrhosis is stabalized and now ready to get transfer out of ICU. What is the preffered ratio of spironolactone and furosemide in the treatment of 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 up as needed. To maintain normal electrolyte balance, the use of the 100 : 40 mg ratio of spironolactone to furosemide is generally recommended. Maximum accepted dosages are 400 and 160 mg/day of spironolactone and furosemide, respectively.



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