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It is a normal reaction as the body adjusts without the medication
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You will learn exactly what causes the color, what range of shades is normal, what warning signs demand immediate attention, and how storage conditions change what you see in the vial
Change history 26 February 2026 A Correction to this paper has been published: Abbreviations HF: Heart Failure RAASi: Renin-angiotensin-aldosterone system inhibitors MRA: Mineralocorticoid receptor antagonist sMRA: Steroidal mineralocorticoid receptor antagonists nsMRA: Non-steroidal mineralocorticoid receptor antagonist CKD: Chronic kidney disease SGLT2: Sodium-glucose cotransporter 2 GDMT: Guideline-directed medical therapy eGFR: Estimated glomerular filtration rate ACEi: Angiotensin-converting enzyme inhibitor ARB: Angiotensin II receptor blocker SCZ: Sodium zirconium cyclosilicate K: Potassium CHF: Congestive heart failure AA: Aldosterone antagonist b.i.d.: Twice daily (bis in die) SE: Standard error RALES: Randomized aldactone evaluation study EMPHASIS-HF: Eplerenone in mild patients hospitalization and survival study in heart failure DCT: Distal convoluted tubule EHR: Electronic health record ENaC: Epithelial sodium channel GLP-1RA: Glucagon-like peptide-1 receptor agonist HFmrEF: Heart failure with mildly reduced ejection fraction HFpEF: Heart failure with preserved ejection fraction HFrEF: Heart failure with reduced ejection fraction HR: Hazard ratio KDIGO: Kidney disease: improving global outcomes LVEF: Left ventricular ejection fraction Maxi-K: High-conductance calcium-activated potassium channel NCC: NaCl cotransporter Na-K ATPase: Sodiumpotassium adenosine triphosphatase NKCC2: Na-K-2Cl cotransporter ROMK: Renal outer medullary potassium channel SZC: Sodium zirconium cyclosilicate T2D: Type 2 diabetes UACR: Urine albumin-to-creatinine ratio ARNI: Angiotensin receptorneprilysin inhibitor References Palmer BF (2015) Regulation of potassium homeostasis
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