This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pharmacology
In patients with decompensated cirrhosis on diuretic therapy with tender gynaecomastia the best diuretic to substitute is: 
Select and explain. 
A. Amiloride for spironolactone, B. Furosemide for spironolactone, C. Spironolactone for amiloride, D. Torsemide for spironolactone
A: Amiloride for spironolactone
Answer: A: Amiloride for spironolactone 
Explanation: Amiloride (10-40 mg/day) can be substituted for spironolactone in patients with tender gynecomastia. Amiloride is more expensive and less effective Ref: HEPATOLOGY, June 2009