This handout is for primary aldosteronism (conn syndrome). Your care team identified this based on: resistant htn (≥3 antihypertensives incl diuretic) at goal not achieved (ada 2026).
Other reasons your team may use this plan: spontaneous hypokalemia or thiazide-induced disproportionate hypokalemia (ada 2026); htn onset <30 yr (ada 2026); adrenal incidentaloma with htn (ada 2026).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| spironolactone | 12.5–25 mg | PO | daily, titrate to 100–200 mg | First-line MRA; gynecomastia common (ADA 2026) |
| eplerenone | 25 mg BID | PO | BID, titrate to 100 mg/day | Selective MRA; fewer endocrine SE; renal dose adjust (ADA 2026) |
| amiloride | 5–10 mg | PO | daily | Distal Na+ channel blocker; K-sparing (ADA 2026) |
| triamterene | 50–100 mg | PO | BID | Alternative K-sparing (ADA 2026) |
| chlorthalidone | 12.5–25 mg | PO | daily | Combination for BP control (ADA 2026) |
| amlodipine | 5–10 mg | PO | daily | 2025 AHA HTN combination |
| lisinopril | 10 mg | PO | daily | 2025 AHA HTN |
Plan: Medical management of PA (ADA 2026)
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Endo q3–6 mo; cardiology / nephrology as needed; PASO classification post-op (ADA 2026)
Guideline: Endocrine Society 2016 PA Guideline (Funder); SPARTACUS (Lancet 2016); PASO 2017