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Patients who take certain medications may be at risk of developing hyperkalemia, a condition of high potassium in the blood 1. Although rare, excessive amounts of potassium in the bloodstream can lead to heart complications and sudden death. Patients who take medications that place them at risk for hyperkalemia should have routine monitoring of potassium levels 1.
The normal range of blood potassium is between 3.6 and 4.8 mEq/L. The risk of adverse events increases with escalating potassium levels above this range. Although hyperkalemia often does not present with physical symptoms, in severe cases, patients may experience nausea, weakness, fatigue, paralysis and heart arrhythmias 1. If left untreated, excessive potassium can lead to cardiac arrest and sudden death.
- The normal range of blood potassium is between 3.6 and 4.8 mEq/L.
- The risk of adverse events increases with escalating potassium levels above this range.
- If left untreated, excessive potassium can lead to cardiac arrest and sudden death.
Benicar & Potassium
Many patients who use diuretics may also be taking potassium supplements. Thiazide and loop diuretics block the reabsorption of sodium within the renal tubules of the kidneys. Potassium is exchanged for sodium further down in the renal tubule, resulting in potassium loss. In order to prevent low potassium, many patients take potassium supplements with these diuretics. Unfortunately, excessive potassium supplementation can result in hyperkalemia 1.
- Many patients who use diuretics may also be taking potassium supplements.
- In order to prevent low potassium, many patients take potassium supplements with these diuretics.
Some patients prevent the exchange of potassium and sodium in the renal tubules by taking potassium-sparing diuretics. Medications such as spironolactone work by blocking exchange channels near the end of the renal tubule, thus preserving potassium within the body. Unfortunately, this interferes with the normal regulation and excretion of potassium and can also result in hyperkalemia 1.
ACE Inhibitors and Angiotensin Receptor Blockers
Potassium Chloride & Heart Attacks
Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are common medications for the treatment of high blood pressure and other conditions related to the heart and kidneys 4. The use of these drugs has been associated with the development of hyperkalemia 1. According to a study of 2,331 patients, published in the "Journal of Pathology and Laboratory Medicine International" in 2009, Seyed Ali Sajadi and colleagues found that hyperkalemia was present in 20.4 percent of patients taking an ACE inhibitor and 31 percent of patients taking an angiotensin receptor blocker 14. In addition to the medications listed, other drugs may also cause an increase in potassium levels. Patients should speak to a physician with concerns regarding potassium and medications that can cause hyperkalemia 1.
Benicar & Potassium
Potassium Chloride & Heart Attacks
High Blood Pressure Medications Without Side Effect of Coughing
Digoxin Toxicity & Potassium
Diuretics & Heart Palpitations
High Potassium & Calcium Levels in Blood
Can Too Much Potassium Cause Liver Problems?
What Are the Adverse Side Effects of Magnesium Citrate?
What Causes High Levels of Potassium in the Body?
Effects of Zinc With Potassium
- MayoClinic.com: Hyperkalemia
- CV Pharmacology: Diuretics
- “The Journal of Clinical Hypertension”; Well Tolerated Spironolactone-Related Hyponatremia; Joe Handler M.D; April 2008.
- “Journal Pathology and Laboratory Medicine International”; A Comparative Study of the Prevalence of Hyperkalemia with the Use of Angiotensin Converting Enzyme Inhibitors versus Angiotensin Receptor Blockers; Seyed Ali Sajadi, et al; April 2008.
- Cleveland Clinic. Hyperkalemia (High Blood Potassium). Updated October 19, 2016.
- Kovesdy CP. Updates in hyperkalemia: Outcomes and therapeutic strategies. Rev Endocr Metab Disord. 2017;18(1):41-47. doi:10.1007/s11154-016-9384-x
- US National Library of Medicine. Genetics Home Reference. Pseudohypoaldosteronism type 1. Updated December 2011.
- Pseudohypoaldosteronism Type 2. Genetics Home Reference. U.S. National Library of Medicine.
- National Kidney Foundation. Facts About High Potassium in Patients with Kidney Disease.
- Genetics Home Reference. Pseudohypoaldosteronism Type 1. National Institutes of Health. U.S. National Library of Medicine. April 25, 2018.
- Genetics Home Reference. Pseudohypoaldosteronism Type 2. National Institutes of Health. U.S. National Library of Medicine. April 25, 2018.
- Mayo Clinic Staff. High Potassium (Hyperkalemia). Mayo Clinic. January 11, 2018.
- Mount DB. Causes and Evaluation of Hyperkalemia in Adults. UpToDate. June 5, 2017.
- Sterns RH, Rojas M, Bernstein P, Chennupati S. Ion-exchange Resins for the Treatment of Hyperkalemia: Are They Safe and Effective? Journal of the American Society of Nephrology. May 2010;21(5):733–5. doi:10.1681/ASN.2010010079.
Jacob Seykans began writing online professionally in 2010. He has been a registered pharmacist for over five years. He has practiced pharmacy in both community and hospital settings. Seykans holds a Doctor of Pharmacy degree from the University of Minnesota.