From the FDA Drug Label
DOSAGE AND ADMINISTRATION HFrEF Post-MI:Initiate treatment with 25 mg once daily. Titrate to maximum of 50 mg once daily within 4 weeks, as tolerated. Dose adjustments may be required based on potassium levels. ( 2.1) Hypertension:50 mg once daily, alone or combined with other antihypertensive agents. For inadequate response, increase to 50 mg twice daily. Higher dosages are not recommended. ( 2.2) For all patients: Measure serum potassium before starting eplerenone tablets and periodically thereafter. ( 2.3)
The FDA drug label does not answer the question.
From the Research
The optimal dose of potassium for treating hypertension is typically 3,000-4,700 mg (or 3-4.7 grams) of dietary potassium per day, as supported by the most recent and highest quality study 1.
Key Considerations
- Potassium supplementation should be approached cautiously, with prescription supplements generally starting at 10-20 mEq (750-1,500 mg) per day, divided into multiple doses to minimize gastrointestinal side effects.
- Dietary sources are preferred over supplements when possible, with foods rich in potassium including bananas, oranges, potatoes, spinach, tomatoes, and avocados.
- Potassium works by promoting sodium excretion through the kidneys and helping to relax blood vessel walls, which lowers blood pressure.
Important Precautions
- Individuals with kidney disease, those taking certain medications (like ACE inhibitors, ARBs, or potassium-sparing diuretics), or those with adrenal disorders should consult their healthcare provider before increasing potassium intake, as they may be at risk for hyperkalemia (dangerously high potassium levels) 2, 3, 4, 5.
- Regular blood tests to monitor potassium levels are recommended when starting supplementation.
Mechanism and Benefits
- The relationship between potassium intake and blood pressure is nonlinear, with a U-shaped relationship between 24-hour active and control arm differences in potassium excretion and BP levels 1.
- The BP-lowering effects of potassium supplementation are stronger in participants with hypertension and at higher levels of sodium intake.
- An adequate intake of potassium is desirable to achieve a lower BP level, but excessive potassium supplementation should be avoided, particularly in specific subgroups.