Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

Update on Drugs that Can Cause High Blood Potassium

Worst Pills, Best Pills Newsletter article December, 2008

Last month, we discussed drugs that, especially in combination with each other, can result in hyperkalemia (abnormally elevated blood potassium levels). Hyperkalemia can cause nausea, fatigue, muscle weakness or tingling sensations, as well as heart abnormalities (showing up as an abnormal electrocardiogram). In some cases it can be fatal. This month, we list additional drugs that have been known to cause hyperkalemia on their own. The list this month will incorporate the drugs listed in...

Last month, we discussed drugs that, especially in combination with each other, can result in hyperkalemia (abnormally elevated blood potassium levels). Hyperkalemia can cause nausea, fatigue, muscle weakness or tingling sensations, as well as heart abnormalities (showing up as an abnormal electrocardiogram). In some cases it can be fatal. This month, we list additional drugs that have been known to cause hyperkalemia on their own. The list this month will incorporate the drugs listed in the November issue of Worst Pills, Best Pills News

What You Can Do

If you are taking these drugs, be careful if you have diabetes or kidney disease. If so, you are at increased risk, and your doctor will have to weigh the risk of giving you these drugs. Also, the older you are, the more likely you are to develop hyperkalemia. Also, make sure you are receiving appropriate laboratory monitoring. Serum potassium and kidney function should be followed when taking these drugs. Of course, the intensity of monitoring will be different in different people, because some people are at high risk and others are at low risk.

Table. Drugs that Can Cause Hyperkalemia Alone or In Combination with Other Drugs

 

Potassium-Retaining Diuretics

Eplerenone (INSPRA) ***

Spironolactone (ALDACTONE) **

Triamterene (DYRENIUM)*

Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors)

Benazepril (ETHEX, LOTENSIN) **

Captopril (CAPOTEN) **

Enalapril (VASOTEC) **

Fosinopril (MONOPRIL)**

Lisinopril (PRINIVIL, ZESTRIL) **

Moexipril (UNIVASC) **

quinapril (ACCUPRIL)

ramipril (ALTACE)**

Trandolapril (MAVIK) **

Angiotensin Receptor Blockers (ARBs)

Candesartan (ATACAND) **

Eprosartan (TEVETEN) **

Irbesartan (AVAPRO) **

Losartan (COZAAR) **

Olmesartan (BENICAR) ***

Telmisartan (MICARDIS) **

Valsartan (DIOVAN) **

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Buffered aspirin (ASCRIPTIN, BUFFERIN)*

celecoxib (CELEBREX)*

Diclofenac (VOLTAREN) **

Diflunisal (DOLOBID)*

Etodolac (LODINE) **

Fenoprofen (NALFON) **

Flurbiprofen (ANSAID, OCUFEN)

Ibuprofen (ADVIL, MEDIPREN, MOTRIN, NUPRIN)

Indomethacin (INDOCIN)*

Ketoprofen (ORUDIS)

Ketorolac (TORADOL)*

Meclofenamate (MECLOMEN) **

Mefenamic acid (PONSTEL) **

Meloxicam (MOBIC)*

naproxen (ALEVE, ANAPROX, NAPROSYN)

Oxaprozin (DAYPRO) **

piroxicam (FELDENE)*

rofecoxib (VIOXX)*

salsalate (DISALCID)*

sulindac (CLINORIL)**

tolmetin (TOLECTIN)**

valdecoxib (BEXTRA)*

Other Drugs            

acebutolol (SECTRAL)

atenolol (TENORMIN)

betaxolol (BETOPTIC S, BETOPTIC, KERLONE)

bisoprolol (ZEBETA)

carvedilol (COREG)

cyclosporine (NEORAL, SANDIMMUNE)

digoxin (DIGITEK, LANOXICAPS, LANOXIN)

labetalol (NORMODYNE, TRANDATE)

levobunolol (BETAGAN)

lithium (ESKALITH, LITHOBID, LITHONATE)**

metoprolol (LOPRESSOR, TOPROL XL)

metoprolol and hydrochlorothiazide (LOPRESSOR HCT)**

nadolol (CORGARD)

penbutolol (LEVATOL)

atenolol and chlorthalidone (TENORETIC)**

bisoprolol and hydrochlorothiazide (ZIAC)**

pentamidine

pindolol (VISKEN)

potassium penicillin (PEN VEE K)

potassium supplements (as prescription drugs or salt substitutes)

propranolol (INDERAL LA, INDERAL)

propranolol and hydrochlorothiazide (INDERIDE LA)**

sotalol (BETAPACE)

tacrolimus (PROGRAF, PROTOPIC)

timolol (BLOCADREN, TIMOPTIC)

timolol and hydrochlorothiazide (TIMOLIDE)**

trimethoprim (PROLOPRIM, TRIMPEX)

* Do Not Use in Worst Pills, Best Pills
** Limited Use in Worst Pills, Best Pills
*** Last Choice in Worst Pills, Best Pills