These Drugs Can Mess With Your Potassium

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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It’s not being overly dramatic to say that abnormal levels of potassium may actually kill you. Serum (bloodstream) potassium is an electrolyte, and imbalances are called hyperkalemia (when too high) and hypokalemia (when too low). Cardiac arrhythmias are a known serious outcome of both hypo- and hyperkalemia, and national statistics indicate that almost half of 1% of emergency department visits and 2% of hospitalizations for high potassium end in death.

High or low potassium may occur as a result of your medications—and older folks and women are more likely to be affected. Here’s what you need to know.

What are electrolytes?

Electrolytes like sodium, calcium, and potassium control the fluid balance in the body and are important for muscle contraction. You may not have any symptoms when electrolytes are abnormal so your doctor needs to check a basic metabolic panel blood test when you are on medications that may alter these.

What might happen with LOW potassium (hypokalemia)?

Muscle weakness that begins in your lower extremities then moves to your trunk and upper extremities, decreased appetite and nausea, and a variety of heart arrhythmias are seen in patients with hypokalemia. While it’s hard to say how low your potassium has to be to contribute to heart arrhythmias—generally speaking potassium levels lower than 3.0 (normal is 3.5-5.0) put you at much greater risk.

What might happen with HIGH potassium (hyperkalemia)?

The scary truth is high potassium, at levels over 5.5, may present with life-threatening complications that go unrecognized (there are few symptoms) prior to cardiac arrest. Non-cardiac related signs and symptoms include altered mental status, confusion, muscle cramps, and weakness.

Which medications may lower your potassium (hypokalemia)?

Which medications may raise your potassium (hyperkalemia)?

Bottom line: don’t mess with potassium, make sure you are having it monitored.

Dr O.

Reference: HCUPNet: Healthcare Cost and Utilization Project. Rockville , MD : Agency for Healthcare Research and Quality, 2010.

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