Abstract

Spiroprop (Searle) is a combination of spironolactone 50 mg and propranolol 80 mg marketed for the treatment of hypertension. The manufacturer claims that it is effective when given once daily, and that its two constituent drugs are synergistic in lowering blood pressure. Our criticism of the inflexibility of β-blocker + thiazide combinations¹ applies to this combination too. Spironolactone avoids the unwanted effects of the thiazides such as hypokalaemia, impaired glucose tolerance and hyperuricaemia,² but has its own unwanted effects. We recently concluded, however, that thiazide–induced hypokalaemia is not a problem in patients with uncomplicated hypertension;³ and in any case it can be offset by concurrent use of a β-blocker.²