Fig. 2

Suggested potassium monitoring and spironolactone dosing algorithm for potassium. ^aNote that all patients may not need proactive spironolactone. For instance, some patients, particularly those with adrenal disease may not experience substantial increases in cortisol (and associated MR activation) during mifepristone treatment. ^bMR activation with mifepristone may take several days to occur. Direct patient to call clinician’s office to report when the MR antagonist is started to facilitate appropriate follow-up. If spironolactone is not tolerated, consider an alternative MR antagonist, such as eplerenone. ^cCheck for signs of excess MR activation (e.g., edema, elevated blood pressure). Abbreviations: eGFR estimated glomerular filtration rate, MR mineralocorticoid receptor