Health Alert 233
Dear Subscriber: If you take medicine for a heart problem or high-blood pressure, you may be putting yourself at a risk even your doctor isn’t aware of.
After the publication of a major heart study promoting the use of a diuretic commonly prescribed for heart problems, prescriptions for the drug increased. Unfortunately, so did cases of the life-threatening condition known as hyperkalemia.1
What happened? The drug interacted with another drug for the same condition, and the combination led to potassium overload. Today we’ll talk about drugs that can cause this condition and what to do if your doctor prescribes them for you.
This is the era of polypharmacy. Treatment with multiple drugs for multiple medical problems makes patients vulnerable to a host of side effects. Potassium overload included.2 In fact, during a one-year study researchers found that drug therapies were a factor in 60% of hyperkalemic episodes, and a direct cause in 25% of them.3
Potassium overload is growing more common.4 The drugs most often linked to it are ACE inhibitors prescribed for high blood pressure. They include Accupril, Altace, Capoten, Lotensin, Monopril, Prinivil, Vasotec and Zestril. These can cause severe reactions including heart fibrillation, kidney failure and death.5 Potassium sparing diuretics, NSAIDS, and cyclosporine prove just as risky. But when combined, as often happens in heart treatments, these drugs offer a prescription for trouble.6s
If you’re diabetic patients or over 60 you’re prone to potassium overload under even the best of circumstances. And you’re especially vulnerable if you’re given the types of drugs I just mentioned.7
Prescription drugs aren’t the only problem, though. Over-the-counter drugs and potassium-based nutritional supplements can trigger hyperkalemia too.8 Especially if there’s an underlying weakness in the renal system. A common complication in heart disease.0
Even though risk factors for potassium overload are well known the traditional medicine continues to ignore them. Even in teaching hospitals. Doctors keep right on prescribing these dangerous drugs to treat heart patients with the most risk of developing the condition.10
If you use any of the medicines I mentioned, it might be time for another visit to your doctor. Go to your appointment armed with this new information. Talk to your doctor about whether you can use an alternate. If not, ask if you should follow a low potassium diet. Find out what other measures you can take to prevent hyperkalemia.11
As always, be careful about combining these or any drugs with other prescriptions, over-the-counter medicines, or nutritional supplements. Your doctor may not be aware of the potential interactions when he’s prescribing medications. To Your Good Health,
Al Sears MD
Sources:
1. Steven Reinberg, Diuretic Not Suited for Everyone With Heart Failure; Health Day, August 4, 2004
2. Cannon-Babb, ML, Schwartz, AB; Drug-induced hyperkalemia; Hosp Pract (Off Ed). 1986 Sep 30;21(9A):99-107, 111, 114-27.
3. Rimmer JM, Horn JF, Genari FJ; Hyerkalemia as a complication of drug therapy; Arch Intern Med. 1987 May; 147(5):867-9
4. Williams, ME; Endocrine Crisis; Crit Care Clin. 1991 Jan;7(1):155-74.
5. Donna Tinerello, MS, RD, CD/N; Potassium in Heart Disease; www.geocities.com/~jenniferjensen/QUESTIONS/potassium.html
6. House LG; Which Drugs Affect Potassium?; Drug Saf., 1995 April12(4):240-4
7. Rigolin VH, Chap L; Extreme hypercalemia induced by drugs; Postgrad Med. 1991 Oct;90(5):129-31
8. Perazella MA; Drug-induced hyperkalemia: old culprits and new offenders; AM J Med. 2002 Mar; 112(4):334-5
9. Gehr TW, Sica DA; Pharmacotherapy in congestive heart failure: Hyperkalemia in congestive heart failure; Pubmed, Congest Heart Fail, 2001 Mar; 7(2); 97-100
10. Ponce SP, Jennings AE, Madias NE, Harrington, JT; Drug-induced hyperkalemia; Medicine (Baltimore). 1985 Nov;64(6):357-70.
11. Donna Tinerello, MS, RD, CD/N; Potassium in Heart Disease; www.geocities.com/~jenniferjensen/QUESTIONS/potassium.html