Medications That May Deplete POTASSIUM
Potassium keeps nerve signals, muscle contractions, and heart rhythm working normally. See which medications carry a reported association, how strong the evidence is, and what to discuss with your pharmacist.
Potassium keeps nerve signals, muscle contractions, and heart rhythm working normally.
Common food sources: Bananas and citrus fruits; Potatoes and sweet potatoes; Beans and lentils; Tomatoes and leafy greens.
Potassium is routinely checked with basic blood work. If you take a medication associated with potassium loss (like some diuretics), ask your provider how often your electrolytes should be monitored.
Caution: Potassium supplementation can be dangerous in kidney disease or alongside potassium-raising medications — this is a decision for your prescriber, guided by lab results.
HelloPharmacist pharmacist-reviewed education. The medication records below are licensed clinical data, shown as published.
Deep dive: Potassium — uses, safety & drug interactions
Medications associated with POTASSIUM depletion
Each record is shown as published in our licensed clinical database. Open a medication for its full nutrient report.
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Acetaminophen, Caffeine, Pyrilamine
Major DepletionBrand names include Midol Max Strength Menstrual
Pyrilamine, the antihistamine ingredient in this combination product, has mild diuretic properties that can cause your kidneys to flush out extra potassium in the urine. Potassium is the mineral your muscles and heart depend on to contract and keep a steady rhythm, so losing too much of it is a real concern. Because this is rated a major depletion, long-term users should talk with their pharmacist or doctor about checking potassium levels and whether a supplement or potassium-rich foods make sense for them.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Acetaminophen, Caffeine, Pyrilamine →
Acetaminophen, Pamabrom, Pyrilamine
Major DepletionBrand names include Midol Max Strength PMS, Pamprin, Pamprin ES
Pamabrom, the diuretic ingredient in this combination product, works by making your kidneys release more water through urine, and unfortunately potassium, a mineral your muscles and heart depend on to work properly, tends to leave the body along with that extra fluid. Because this is rated a major depletion, long-term or frequent users have a real reason to pay attention. If you take this product regularly, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Acetaminophen, Pamabrom, Pyrilamine →
Acetazolamide
Major DepletionBrand names include Diamox, Ak-Zol
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and acetazolamide can cause your kidneys to flush out more of it in your urine than usual. Because this loss can be significant, most people taking acetazolamide long-term will need their potassium levels checked and may need a supplement or extra potassium-rich foods. This is rated a major depletion, so it is worth bringing up with your doctor or pharmacist sooner rather than later.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Amiloride, Hydrochlorothiazide
Major DepletionBrand names include Moduretic, Amilzide, Moduret 25
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. This combination product is a bit of a balancing act: the hydrochlorothiazide side causes your kidneys to flush extra potassium out in the urine, while the amiloride side is specifically added to help hold potassium in. Even so, the overall effect on your potassium levels can still be significant enough that most people taking this medication need their levels checked and may need a supplement or dietary changes. Because the rating here is major, please ask your pharmacist or doctor about getting your potassium monitored regularly.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Ammonium Chloride
Major DepletionPotassium is a mineral your heart, muscles, and nerves depend on to work properly. Ammonium chloride acts as a diuretic, meaning it pushes your kidneys to flush out more fluid, and unfortunately potassium tends to leave the body along with that extra urine. Because this effect is rated as a major depletion, most people taking it regularly will need their potassium levels checked and may need a supplement. Please talk with your pharmacist or doctor about monitoring and whether a potassium supplement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Atenolol, Chlortalidone
Major DepletionBrand names include AtenixCo, Totaretic, Tenoret 50
Chlortalidone is a thiazide diuretic, and one of its known effects is pushing your kidneys to flush out more potassium in the urine than they normally would. Potassium is a mineral your heart, muscles, and nerves depend on to work properly, so running low on it is something worth taking seriously. Because this depletion is rated as major, most people on long-term chlortalidone will need their potassium levels checked regularly and may need a supplement or dietary guidance. Please talk with your pharmacist or doctor about monitoring your levels and whether any changes make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Atenolol, Chlorthalidone
Major DepletionBrand names include Tenoretic
Chlorthalidone is a thiazide-type diuretic, and one of its main side effects is that it causes your kidneys to flush out extra potassium in your urine. Potassium is the mineral your heart rhythm, muscles, and nerves depend on to work properly, so losing too much of it is a real concern. Because this is rated a major depletion, most people taking chlorthalidone long-term will need their potassium levels checked regularly, and many end up needing a supplement or dietary changes. Please talk with your doctor or pharmacist about getting your levels monitored.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Azilsartan, Chlorthalidone
Major DepletionBrand names include Edarbyclor
Chlorthalidone is a thiazide-type diuretic, and one of its well-known trade-offs is that it tells your kidneys to flush out more potassium in the urine than usual. Potassium is a mineral your heart rhythm, muscles, and nerves all depend on, so losing too much of it is something to take seriously. Because this is rated a major depletion, most people on long-term chlorthalidone will need their potassium levels checked with a blood test, and many end up needing a supplement or extra potassium-rich foods. Please talk with your doctor or pharmacist about getting your levels monitored.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Benazepril, Hydrochlorothiazide
Major DepletionBrand names include Lotensin HCT
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and the hydrochlorothiazide in this combination pill is the real concern here. Thiazide diuretics make your kidneys push out extra potassium in the urine, which over time can drop your levels into a range that causes real problems like muscle cramps, weakness, or irregular heartbeat. This is rated a major depletion, meaning low potassium is a genuine, common issue for long-term users, not just a theoretical one. Ask your doctor or pharmacist about getting your potassium levels checked and whether a supplement or dietary changes make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Bendroflumethiazide
Major DepletionBrand names include Naturetin, Aprinox, Neo-NaClex
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and bendroflumethiazide, a thiazide diuretic, causes the kidneys to flush more of it out in the urine than usual. Because this loss is well-documented and can be significant, most people taking this medication long-term do need their potassium levels checked regularly. If yours run low, your doctor or pharmacist can talk with you about whether a supplement or potassium-rich foods make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Bendroflumethiazide, Nadolol
Major DepletionBrand names include Corzide
Potassium keeps your heart rhythm steady and your muscles working properly, so keeping levels in a healthy range genuinely matters. Bendroflumethiazide is a thiazide diuretic, meaning it works partly by telling your kidneys to release more fluid into your urine, and unfortunately potassium gets swept out along with that fluid. This is a well-documented, major concern, not a minor or theoretical one, so most people taking this medication long-term will need their potassium levels checked regularly and may need a supplement or dietary changes. Please bring this up with your doctor or pharmacist so they can decide what is right for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Bendroflumethiazide, Potassium
Major DepletionBrand names include Neo-NaClex-K, Centyl K
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Bendroflumethiazide is a thiazide diuretic, meaning it makes your kidneys produce more urine, and unfortunately your kidneys flush out extra potassium along with that extra fluid. Because this loss is well-documented and clinically significant, most people on this type of diuretic do need their potassium levels monitored and may need a supplement or potassium-rich foods to keep levels in a safe range. Please talk with your pharmacist or doctor about checking your potassium and whether any action is right for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Bendroflumethiazide, Rauwolfia Serpentina
Major DepletionBrand names include Rauzide
Bendroflumethiazide is a thiazide diuretic, and one of its most well-known effects is that it causes the kidneys to flush out more potassium in the urine than they normally would. Potassium is a mineral your heart, muscles, and nerves depend on to function properly, so losing too much of it is a real concern. Because this is rated a major depletion, most people taking this medication long-term are likely to need monitoring and may need a supplement or dietary changes. Please talk with your doctor or pharmacist about having your potassium levels checked.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Bendroflumethiazide, Rauwolfia Serpentina →
Benserazide, Levodopa
Insignificant DepletionBrand names include Prolopa, Madopar
Increased urinary potassium losses occur in some people treated with levodopa. The mechanism isn't clear, but the effect doesn't occur when a peripheral decarboxylase inhibitor, such as carbidopa, is used with levodopa (as in Sinemet). This interaction is therefore unlikely to be clinically significant.
Potassium is a mineral your heart, muscles, and nerves all depend on to work properly. Levodopa alone has been linked to slightly higher potassium loss in the urine in some people, though exactly why is still not well understood. Here is the reassuring part: this effect does not seem to happen when levodopa is paired with a peripheral decarboxylase inhibitor like benserazide, which is exactly how this combination works. For most people taking this medication, potassium is simply not a concern worth worrying about, but if you ever have questions, your pharmacist or doctor is a good first stop.
References (1)
- Granerus AK, Jagenburg R, Svanborg A. Kaliuretic effect of L-dopa treatment in parkinsonian patients. Acta Med Scand 1977;210:291-7.. PubMed
Benzthiazide
Major DepletionBrand names include Exna
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and benzthiazide, a thiazide diuretic, can cause your kidneys to flush out more of it than usual in your urine. Because this loss can be significant, most people taking this medication long-term do need their potassium levels monitored and may need a supplement. Please talk with your doctor or pharmacist about checking your levels and whether a supplement or potassium-rich foods make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Bisoprolol, Hydrochlorothiazide
Major DepletionBrand names include Ziac
Hydrochlorothiazide, the thiazide diuretic in this combination, works partly by telling your kidneys to flush out more fluid, and potassium, a mineral your heart rhythm and muscles depend on, gets swept out along with it. Because this loss is real and ongoing, the evidence here is rated as a major depletion, meaning most people taking this medication long-term genuinely need their potassium levels checked and may need a supplement or dietary changes. This is worth an actual conversation with your doctor or pharmacist, not something to put off.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Bumetanide
Major DepletionBrand names include Burinex
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and bumetanide is a strong loop diuretic that makes your kidneys flush out far more potassium than usual in the urine. Because this loss can be significant, low potassium levels are a real and well-recognized concern with this drug, not just a theoretical one. Most people taking bumetanide long-term will need their potassium levels checked regularly, and many end up needing a supplement or potassium-rich foods to keep levels in a safe range. Please talk with your pharmacist or doctor about whether monitoring or a supplement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Bumetanide, Potassium
Major DepletionBrand names include Burinex K
Bumetanide is a loop diuretic, and one of its biggest real-world effects is that it causes your kidneys to flush out far more potassium in your urine than normal. Potassium is the mineral your heart rhythm, muscles, and nerves depend on to work properly, so this is not a small concern. This depletion is rated major, meaning most people on bumetanide long-term will need their potassium levels checked regularly and may need a supplement or potassium-rich foods added to their routine. Please talk with your pharmacist or doctor about monitoring your levels and whether a supplement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Caffeine, Potassium Salicylate, Salicylamide
Major DepletionBrand names include Trim-Elim
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and this combination product can cause your kidneys to flush more of it out in your urine than usual. Because that loss is rated as a major concern, long-term users are often advised to have their potassium levels checked and to consider a supplement if levels run low. Please talk with your pharmacist or doctor about whether monitoring or supplementation makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Caffeine, Potassium Salicylate, Salicylamide →
Candesartan Cilexetil, Hydrochlorothiazide
Major DepletionBrand names include Atacand HCT
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and the hydrochlorothiazide in this combination pill can meaningfully lower your levels by causing your kidneys to flush extra potassium out in the urine. This is rated a major depletion concern, meaning many people on this medication do need to have their potassium monitored and may need a supplement or dietary changes. Please bring this up with your pharmacist or doctor so they can check your levels and decide what is right for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Candesartan Cilexetil, Hydrochlorothiazide →
Captopril, Hydrochlorothiazide
Major DepletionBrand names include Capozide, Acezide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide can cause your kidneys to flush out more of it than usual through urine. Because this loss is well-documented and rated as a major concern, many people on this medication do need extra potassium, whether from diet or supplements. Your doctor or pharmacist can check your potassium level with a simple blood test and let you know what is right for your situation.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Carbidopa, Levodopa
Insignificant DepletionBrand names include Sinemet CR, Sinemet, Rytary
Increased urinary potassium losses occur in some people treated with levodopa. The mechanism isn't clear, but the effect doesn't occur when a peripheral decarboxylase inhibitor, such as carbidopa, is used with levodopa (as in Sinemet). This interaction is therefore unlikely to be clinically significant.
Potassium helps your muscles contract and keeps your heart rhythm steady, so it matters quite a bit for everyday body function. Levodopa alone has been linked to some extra potassium lost in the urine, though exactly why is still unclear. Here is the reassuring part: that effect does not appear to happen when levodopa is paired with carbidopa, which is how this combination is almost always prescribed. For most people taking carbidopa-levodopa, this is considered insignificant, and no special action is needed, though your pharmacist or doctor can always check if you have concerns.
References (1)
- Granerus AK, Jagenburg R, Svanborg A. Kaliuretic effect of L-dopa treatment in parkinsonian patients. Acta Med Scand 1977;210:291-7.. PubMed
Carbidopa, Levodopa, Entacapone
Insignificant DepletionBrand names include Stalevo
Increased urinary potassium losses occur in some people treated with levodopa. The mechanism isn't clear, but the effect doesn't occur when a peripheral decarboxylase inhibitor, such as carbidopa, is used with levodopa (as in Sinemet). This interaction is therefore unlikely to be clinically significant.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Levodopa alone has been linked to slightly higher potassium loss through the urine in some people, though researchers are still not certain exactly why. Here is the reassuring part: that effect does not appear to happen when levodopa is paired with carbidopa, which is how this combination is prescribed. For most people taking this medication, this is not something that needs any special action, but your pharmacist or doctor can always check in if you have concerns.
References (1)
- Granerus AK, Jagenburg R, Svanborg A. Kaliuretic effect of L-dopa treatment in parkinsonian patients. Acta Med Scand 1977;210:291-7.. PubMed
Chlorothiazide
Major DepletionBrand names include Diuril
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and chlorothiazide can meaningfully lower your levels because it causes your kidneys to flush more potassium out through your urine than usual. This is rated a major depletion, meaning low potassium is a real, common concern for people taking this type of diuretic, not just a theoretical one. Your doctor will likely check your potassium with a blood test and may recommend a supplement or potassium-rich foods, so it is worth bringing up at your next visit.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Chlorothiazide, Methyldopa
Major DepletionBrand names include Aldoclor 150, Aldochlor, Aldoclor 250
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Chlorothiazide is a thiazide diuretic, meaning it makes your kidneys flush out extra fluid through urine, and unfortunately potassium gets swept out along with it. Because this effect is well-documented and rated as a major depletion, most people on this medication long-term will need their potassium levels checked and may need a supplement or dietary changes. Please talk with your pharmacist or doctor about monitoring your levels.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Chlorothiazide, Reserpine
Major DepletionBrand names include Diupres
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and this is a situation worth paying close attention to. Chlorothiazide is a thiazide diuretic, meaning it helps your body shed excess fluid through urine, but in doing so it pulls potassium out through the kidneys along with that fluid. Because this loss is real and ongoing, most people on this medication need their potassium levels checked regularly and may need a supplement or potassium-rich foods added to their routine. Please talk with your pharmacist or doctor about monitoring your levels and whether a supplement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Chlorthalidone
Major DepletionBrand names include Hygroton, Thalitone
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Chlorthalidone is a thiazide-type diuretic, meaning it makes your kidneys produce more urine, and unfortunately potassium gets flushed out along with the extra fluid. Because this loss can be significant, most people taking chlorthalidone long-term will need their potassium levels checked regularly and may need a supplement or potassium-rich foods added to their diet. Ask your doctor or pharmacist about getting your levels tested and whether a supplement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Chlorthalidone, Clonidine
Major DepletionBrand names include Clorpres, Combipres
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and chlorthalidone (the thiazide-type diuretic in this combination) can cause your kidneys to flush out more potassium than usual in your urine. This is rated as a major depletion concern, meaning low potassium levels are a real, well-documented risk for many people on this medication, not just a theoretical one. Your doctor will likely want to check your serum potassium periodically, and some patients do need a supplement or dietary changes to keep levels in a safe range. Please talk with your pharmacist or doctor before adding any potassium on your own.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Cryptenamine, Methyclothiazide
Major DepletionBrand names include Diutensen
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and methyclothiazide (the thiazide diuretic in this combination) can cause your kidneys to flush out more potassium than usual in the urine. Because this loss is real and can be significant, this pairing carries a major depletion rating, meaning most people taking it long-term will need their potassium levels monitored and may need a supplement or dietary adjustments. Please bring this up with your doctor or pharmacist so they can check your levels and decide what is right for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Cyclothiazide
Major DepletionBrand names include Fluidil, Anhydron
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and cyclothiazide, a thiazide-type diuretic, can meaningfully reduce your levels of it. Because thiazide diuretics make your kidneys flush out extra water and sodium, potassium ends up getting carried out in the urine along with it. This is rated a major depletion, meaning most people taking this medication long-term will likely need either a potassium supplement or regular blood tests to keep an eye on their levels. Please talk with your doctor or pharmacist about getting your potassium checked and whether a supplement or dietary changes make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Deserpidine, Hydrochlorothiazide
Major DepletionBrand names include Oreticyl Forte, Oreticyl
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide (the diuretic in this combination) is well known for causing the kidneys to flush out extra potassium in the urine rather than holding onto it. This is rated a major depletion, meaning low potassium is a real concern for most people on this medication long-term, not just a theoretical one. Your doctor will likely want to check your potassium level through a blood test, and a supplement or potassium-rich foods may be recommended. Please talk with your pharmacist or doctor before adding any potassium supplement on your own.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Deserpidine, Methyclothiazide
Major DepletionBrand names include Enduronyl Forte, Enduronyl
Methyclothiazide is a thiazide diuretic, meaning it works by making your kidneys produce more urine, and one side effect of that process is that potassium gets flushed out along with the extra fluid. Potassium is a mineral your heart, muscles, and nerves depend on to work properly, so significant losses matter. Because this is rated a major depletion, most people on long-term thiazide therapy really do need their potassium levels monitored and may need a supplement or diet changes. Please talk with your pharmacist or doctor about having your levels checked.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Enalapril Maleate, Hydrochlorothiazide
Major DepletionBrand names include Vaseretic
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, so keeping it in a healthy range really matters. The hydrochlorothiazide in this combination pill is a thiazide diuretic, meaning it makes your kidneys pass more fluid through urine, and unfortunately potassium gets swept out along with that extra fluid. Because this effect is well-documented and rated as a major concern, most long-term users should have their potassium levels checked regularly and talk with their doctor or pharmacist about whether a supplement or more potassium-rich foods make sense for them.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Enalapril Maleate, Hydrochlorothiazide →
Ethacrynic Acid
Major DepletionBrand names include Edecrin
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and ethacrynic acid is a strong loop diuretic that can cause your kidneys to flush out far more potassium than normal in your urine. This loss is rated as a major depletion, meaning most people taking this medication will likely need a potassium supplement or close monitoring to stay in a safe range. Because low potassium can affect your heart rhythm, this is one to take seriously rather than watch and wait. Please talk with your pharmacist or doctor about checking your potassium levels and whether a supplement or dietary changes make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Fosinopril, Hydrochlorothiazide
Major DepletionBrand names include Monopril HCT
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide (the thiazide diuretic in this combination) can cause your kidneys to flush out more potassium than usual in your urine. This is rated a major depletion, meaning low potassium is a real, well-documented concern for most people on this medication long term, not just a theoretical one. Your doctor will likely want to check your potassium levels periodically, and some patients do end up needing a supplement or dietary changes to keep levels in a safe range. Please talk with your pharmacist or doctor before adding any potassium supplement on your own, since too much can also cause problems.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Furosemide
Major DepletionBrand names include Lasix
Potassium keeps your heart rhythm steady and your muscles working properly, so keeping levels in a healthy range really matters. Furosemide works in the kidneys to pull excess fluid out of the body, but as it does that, it also sends a significant amount of potassium out through the urine along with the fluid. This is a well-documented, major concern, not a minor or theoretical one, and most people taking furosemide long-term will need their potassium levels checked regularly and may need a supplement or potassium-rich foods. Please talk with your pharmacist or doctor about whether monitoring or supplementation makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Furosemide, Potassium
Major DepletionBrand names include Diumide-K Continus, Lasikal
Furosemide is a powerful 'loop' diuretic, meaning it works in the kidneys to pull excess fluid out of the body through urine. The problem is that potassium, a mineral your heart rhythm and muscles depend on, gets swept out along with that fluid. This is a well-documented, major concern, and most people taking furosemide long-term will need their potassium levels monitored and often supplemented. Please talk with your pharmacist or doctor about checking your levels and whether a supplement or potassium-rich foods are right for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Guanethidine, Hydrochlorothiazide
Major DepletionBrand names include Esimil
Hydrochlorothiazide is a thiazide diuretic, and one of its well-known effects is pushing your kidneys to flush out more potassium in your urine than they normally would. Potassium is a mineral your heart, muscles, and nerves depend on to work properly, so losing too much of it is a real concern. This combination carries a major depletion rating, meaning most people taking it long-term will likely need either a potassium supplement or close monitoring of their levels. Please talk with your pharmacist or doctor about checking your potassium and whether a supplement or dietary changes make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Guanethidine, Hydrochlorothiazide →
Hydralazine, Hydrochlorothiazide
Major DepletionBrand names include Apresoline-Esidrix, Apresazide
Hydrochlorothiazide is a thiazide diuretic, meaning it works partly by making your kidneys pass more fluid and, along with it, more potassium than your body would normally lose. Because potassium keeps your heart rhythm steady and your muscles working properly, this is not a small concern. The evidence here is rated as a major depletion, which means most people taking this medication long-term will need to have their potassium levels checked and may need a supplement or dietary changes to keep levels in a safe range. Please talk with your pharmacist or doctor about getting your potassium monitored.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydralazine, Hydrochlorothiazide, Reserpine
Major DepletionBrand names include Ser-Ap-Es, Unipres, Uniserp
Hydrochlorothiazide, the thiazide diuretic in this combination, works by making your kidneys flush out extra fluid, but potassium (a mineral your muscles, heart, and nerves depend on) gets swept out along with it. Because this loss happens through the urine and builds up over time, low potassium is a well-recognized concern with long-term use. If you take this medication regularly, it is worth asking your doctor or pharmacist about checking your potassium level and whether a supplement or potassium-rich foods make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Hydralazine, Hydrochlorothiazide, Reserpine →
Hydrochlorothiazide
Major DepletionBrand names include Esidrix, Hydro, Microzide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide can cause your kidneys to flush significantly more of it out in your urine than normal. Because this loss is well-documented and can be meaningful, most people taking this medication long-term are monitored with blood tests and may need a potassium supplement or dietary changes. This one is worth an actual conversation with your doctor or pharmacist, not just something to keep an eye on casually.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Irbesartan
Major DepletionBrand names include Avalide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide (the diuretic in this combination) causes the kidneys to flush out extra potassium in the urine. Because this is rated a major depletion, low potassium is a real concern for people taking this medication long-term, not just a theoretical one. It is worth asking your doctor or pharmacist about having your potassium levels checked and whether a supplement or more potassium-rich foods make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Labetalol
Major DepletionBrand names include Trandate HCT
Potassium is a mineral your heart rhythm, muscles, and nerves depend on every day. Hydrochlorothiazide is a thiazide diuretic, meaning it works by making your kidneys produce more urine, and unfortunately potassium gets flushed out along with the extra fluid. This is well-documented and rated as a major concern, so most people taking this medication long-term are monitored with blood tests and may need a supplement or extra potassium-rich foods. Please ask your pharmacist or doctor about checking your potassium level if you have not done so recently.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Lisinopril
Major DepletionBrand names include Zestoretic, Prinzide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Hydrochlorothiazide, the diuretic in this combination, tells your kidneys to flush out more fluid, and potassium tends to leave the body along with it. Because this loss is well-documented and can be significant, most people taking this medication long-term will have their potassium levels checked regularly and may need a supplement or dietary changes. Talk with your pharmacist or doctor about where your levels stand and whether any adjustments make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Losartan Potassium
Major DepletionBrand names include Hyzaar
Potassium is a mineral your heart rhythm, muscles, and nerves depend on to work properly. The hydrochlorothiazide in this combination tells your kidneys to flush out more fluid, and unfortunately potassium gets carried out with it in the urine. Because this loss is well-documented and rated as a major concern, long-term users should have their potassium levels checked regularly. Ask your doctor or pharmacist whether a potassium-rich diet or a supplement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Hydrochlorothiazide, Losartan Potassium →
Hydrochlorothiazide, Methyldopa
Major DepletionBrand names include Aldoril 15, Methazide, Aldoril 25
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Hydrochlorothiazide is a thiazide diuretic, meaning it pushes your kidneys to flush out more fluid through urine, and unfortunately potassium gets swept out along with it. Because this loss is rated as a major depletion, most people on this medication long-term genuinely need their potassium levels checked and may need a supplement or dietary changes. Please talk with your pharmacist or doctor about getting your levels monitored.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Metoprolol
Major DepletionBrand names include Lopressor HCT
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Hydrochlorothiazide is a thiazide diuretic, meaning it tells your kidneys to flush out extra fluid, and unfortunately potassium gets swept out along with it. This is a well-documented, major concern, so if you take this medication regularly, your doctor will likely want to check your potassium levels through a blood test and may recommend a supplement or potassium-rich foods. Please talk with your pharmacist or doctor before adding any potassium supplement on your own.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Moexipril
Major DepletionBrand names include Uniretic
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide (the diuretic in this combination) is well known for causing the kidneys to flush more potassium out in the urine than they should. This is rated a major depletion, meaning low potassium is a real, documented concern for most people taking this medication long-term, not just a theoretical one. Your doctor will likely want to check your potassium level through a blood test, and some patients do need a supplement or dietary changes. Please talk with your pharmacist or doctor before adding any potassium on your own, since the right amount depends on your labs and other medications.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Pindolol
Major DepletionBrand names include Viskazide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Hydrochlorothiazide is a thiazide diuretic, meaning it makes your kidneys push out more water and sodium through urine, and unfortunately potassium gets flushed out along with it. This is rated a major depletion, so it is not just a theoretical concern. Most people on this medication long-term will want their potassium levels checked regularly, and a supplement or potassium-rich foods may be recommended. Please talk with your pharmacist or doctor about whether your levels need monitoring.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Propranolol
Major DepletionBrand names include Inderide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide is well known for causing real, significant losses of it. This thiazide diuretic makes your kidneys flush out far more potassium than usual through the urine, and this is not a minor or theoretical concern. The evidence here is rated major, meaning most people on this medication long-term genuinely need their potassium levels checked and may need a supplement or dietary adjustments. Please bring this up with your doctor or pharmacist so they can look at your labs and decide what is right for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Quinapril
Major DepletionBrand names include Accuretic
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydrochlorothiazide (the thiazide diuretic in this combination) can cause your kidneys to flush out more potassium than usual in the urine. Because this is rated a major depletion, low potassium is a real, well-documented concern for people on this medication long-term, not just a theoretical one. Your doctor will likely want to check your potassium levels periodically, and some patients do end up needing a supplement or dietary changes to keep levels in a safe range. Please talk with your pharmacist or doctor before adding any potassium supplement on your own.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Reserpine
Major DepletionBrand names include Hydropres, Serpasil-Esidrix, Serpasil-Esidrix #1
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Hydrochlorothiazide is a thiazide diuretic, and it works by making your kidneys flush out more fluid through urine. The problem is that potassium gets pulled out along with that fluid, and the loss can be significant enough that most people taking this medication long-term will need their potassium levels checked and may need a supplement or dietary changes to keep levels in a safe range. This is rated a major depletion, so it is worth talking with your pharmacist or doctor about monitoring and whether a potassium supplement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Spironolactone
Major DepletionBrand names include Spirozine, Aldactazide, Aldactide 25
Here is something worth paying close attention to with this combination. Hydrochlorothiazide is a thiazide diuretic, and it causes the kidneys to flush out extra potassium in the urine, which is a well-documented concern. Spironolactone works differently and actually helps the body hold onto potassium, so together these two drugs can pull in opposite directions. Because the net effect on your potassium levels is hard to predict, most people on this combination need regular blood tests to keep an eye on things, and some may still need a supplement. Please talk with your doctor or pharmacist about whether your levels have been checked recently.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Full nutrient report for Hydrochlorothiazide, Spironolactone →
Hydrochlorothiazide, Timolol
Major DepletionBrand names include Timolide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. The hydrochlorothiazide in this combination works as a thiazide diuretic, meaning it makes your kidneys push out more fluid through urine, and unfortunately potassium gets flushed out along with it. Because this loss is well-documented and rated as a major concern, long-term users should have their potassium levels checked regularly. Ask your doctor or pharmacist whether you need a supplement or dietary changes to keep your levels in a safe range.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Triamterene
Major DepletionBrand names include Maxzide, Dyazide, Maxzide-25
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Here is the interesting wrinkle with this combination: hydrochlorothiazide (the thiazide diuretic) causes your kidneys to flush extra potassium out in your urine, but triamterene (the potassium-sparing component) is added specifically to pull that loss back. Even so, this is rated a major depletion concern, so the balance does not always hold perfectly, and your doctor will likely want to keep an eye on your potassium levels through periodic blood tests. If you are on this combination long-term, it is worth asking your pharmacist or doctor whether your levels have been checked recently.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydrochlorothiazide, Valsartan
Major DepletionBrand names include Diovan HCT
Potassium is a mineral your heart rhythm, muscles, and nerves depend on, and this combination is worth taking seriously on that front. The hydrochlorothiazide component is a thiazide diuretic, meaning it makes your kidneys flush out extra fluid through urine, and potassium gets carried out along with it. The rating here is Major Depletion, so low potassium is a real concern for long-term users, not just a theoretical one. Please talk with your doctor or pharmacist about whether your levels should be checked and whether a supplement or potassium-rich foods make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydroflumethiazide
Major DepletionBrand names include Saluron
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Hydroflumethiazide is a thiazide diuretic, and like others in that class it causes the kidneys to flush out more potassium in the urine than usual, which can bring levels down meaningfully over time. Because this is rated a major depletion, most people taking this medication long-term are encouraged to have their potassium levels checked and may need a supplement or dietary changes. Please talk with your pharmacist or doctor about whether monitoring or supplementation makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Hydroflumethiazide, Reserpine
Major DepletionBrand names include Salutensin-Demi, Salutensin
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and hydroflumethiazide (the thiazide diuretic in this combination) actively causes your kidneys to flush more potassium out in the urine than usual. Because this loss is well-documented and rated as a major depletion, most long-term users genuinely need their levels watched and often need a supplement. Please talk with your doctor or pharmacist about getting your potassium checked regularly.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Indapamide
Major DepletionBrand names include Lozol, Lozide
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and indapamide can cause your kidneys to flush out more of it than usual in your urine. Because this is rated a major depletion, low potassium is a real concern for most people on this medication long-term, not just a theoretical one. Your doctor will likely want to check your potassium level with a blood test, and some people do need a supplement or dietary changes to keep levels in a healthy range. Please talk with your pharmacist or prescriber before adding any potassium supplement on your own.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Irbesartan, Hydrochlorothiazide
Major DepletionBrand names include CoAprovel
Hydrochlorothiazide, the diuretic (water pill) in this combination, works partly by pushing your kidneys to flush out more fluid, and potassium, a mineral your muscles and heart depend on to work properly, gets swept out along with it. Because irbesartan is an ARB that can actually help retain some potassium, the two drugs partly offset each other, but the thiazide effect often wins, and potassium can still drop to a meaningful degree. This is rated as a major depletion concern, meaning many people on this combination do need their levels monitored and may need extra potassium. Please talk with your pharmacist or doctor about checking your serum potassium and whether a supplement or potassium-rich foods make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Levodopa
Insignificant DepletionBrand names include Larodopa, Inbrija
Increased urinary potassium losses occur in some people treated with levodopa. The mechanism isn't clear, but the effect doesn't occur when a peripheral decarboxylase inhibitor, such as carbidopa, is used with levodopa (as in Sinemet). This interaction is therefore unlikely to be clinically significant.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Levodopa alone has been linked to slightly higher potassium losses through the urine in some people, though exactly why is still unclear. Interestingly, this effect seems to disappear when levodopa is combined with carbidopa (as in Sinemet), which is how most people take it today. The evidence rates this as insignificant, so for most patients no special action is needed, but mention it to your pharmacist or doctor if you have any concerns.
References (1)
- Granerus AK, Jagenburg R, Svanborg A. Kaliuretic effect of L-dopa treatment in parkinsonian patients. Acta Med Scand 1977;210:291-7.. PubMed
Levodopa, Carbidopa
Insignificant DepletionBrand names include Duodopa
Increased urinary potassium losses occur in some people treated with levodopa. The mechanism isn't clear, but the effect doesn't occur when a peripheral decarboxylase inhibitor, such as carbidopa, is used with levodopa (as in Sinemet). This interaction is therefore unlikely to be clinically significant.
Potassium is a mineral your muscles and heart depend on to work properly. On its own, levodopa has been linked to some extra potassium leaving through the urine, though nobody is entirely sure why. Here is the reassuring part: that effect appears to go away when levodopa is paired with carbidopa, which is exactly how most people take it. For the vast majority of patients on this combination, this is considered an insignificant concern, but your pharmacist or doctor can always check in if you have questions.
References (1)
- Granerus AK, Jagenburg R, Svanborg A. Kaliuretic effect of L-dopa treatment in parkinsonian patients. Acta Med Scand 1977;210:291-7.. PubMed
Mannitol
Major DepletionBrand names include Osmitrol, Bronchitol
Potassium keeps your heart rhythm steady and your muscles working properly, so keeping levels in a healthy range really matters. Mannitol is an osmotic diuretic, meaning it pulls fluid through your kidneys very quickly, and that rapid fluid flush carries potassium out in the urine along with it. Because this loss is considered major, most people receiving mannitol will need their potassium levels watched closely and may require a supplement. Please talk with your doctor or pharmacist about monitoring and whether you need extra potassium.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Methazolamide
Major DepletionBrand names include Neptazane
Potassium is a mineral your muscles and heart depend on to contract and keep a steady rhythm. Methazolamide is a carbonic anhydrase inhibitor that works partly like a diuretic, and one of its effects is pushing the kidneys to flush out more potassium in the urine than normal. Because this is rated a major depletion, low potassium is a real concern for most people on this medication, not just a theoretical one. Talk with your doctor or pharmacist about having your potassium level checked and whether a supplement or potassium-rich foods are right for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Methyclothiazide
Major DepletionBrand names include Enduron, Aquatensen
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and methyclothiazide, a thiazide diuretic, causes your kidneys to flush more of it out in your urine than usual. Because this loss is real and meaningful, the evidence rates it as a major depletion, meaning most people taking this medication long-term will likely need potassium monitoring or supplementation. This is one worth having an honest conversation with your doctor or pharmacist about, since low potassium can have noticeable effects on how you feel.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Methyclothiazide, Pargyline
Major DepletionBrand names include Eutron
Potassium is a mineral your muscles and heart depend on to work properly, and methyclothiazide, a thiazide diuretic, can cause your kidneys to flush out more of it than usual through your urine. This is rated a major depletion, meaning it is a well-documented concern rather than just a theoretical one, and most long-term users will need to have their potassium levels checked regularly. Please talk with your pharmacist or doctor about whether a potassium supplement or dietary changes make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Methyclothiazide, Reserpine
Major DepletionBrand names include Diutensen-R
Potassium is a mineral your heart rhythm, muscles, and nerves depend on to work properly. Methyclothiazide is a thiazide diuretic, meaning it makes your kidneys flush out extra fluid through urine, and unfortunately potassium gets swept out along with it. This is a well-documented, major concern, so most people taking this medication long-term will need their potassium levels checked regularly and may need a supplement or dietary changes. Please talk with your pharmacist or doctor about monitoring and whether potassium replacement makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Metolazone
Major DepletionBrand names include Diulo, Zaroxolyn, Mykrox
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and metolazone, a thiazide-type diuretic, causes your kidneys to flush out more of it in the urine than they normally would. This is rated a major depletion, meaning most people taking metolazone long-term are likely to need extra potassium, either from their diet or a supplement. Please talk with your pharmacist or doctor about having your potassium level checked and whether supplementation makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Polythiazide
Major DepletionBrand names include Renese
Polythiazide is a thiazide diuretic, meaning it works by telling your kidneys to flush out extra fluid through urine. The problem is that potassium, a mineral your heart rhythm and muscles depend on, gets swept out along with that fluid. Because this loss can be significant, most people taking polythiazide long-term will need their potassium levels checked regularly, and many will need a supplement or dietary changes to keep up. This is rated a major depletion, so it is worth a real conversation with your doctor or pharmacist about monitoring and whether supplementation makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Polythiazide, Prazosin
Major DepletionBrand names include Minizide
Polythiazide is a thiazide diuretic, meaning it works by making your kidneys remove extra fluid through urine, and unfortunately potassium gets flushed out along with it. Potassium is a mineral your heart rhythm, muscles, and nerve signals all depend on, so this loss is taken seriously. Because this combination carries a major depletion rating, most long-term users do need their potassium levels checked, and many end up needing a supplement or dietary adjustments. Please bring this up with your doctor or pharmacist so they can check a blood level and figure out the right next step for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Polythiazide, Reserpine
Major DepletionBrand names include Renese R
Polythiazide is a thiazide diuretic, meaning it works by making your kidneys flush out extra fluid through urine. The problem is that potassium, a mineral your heart rhythm and muscles depend on, gets swept out along with that fluid. Because this loss is real and consistent, most people taking this medication long-term need their potassium levels checked regularly and may need a supplement or dietary changes. Please talk with your pharmacist or doctor about monitoring your levels.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Quinethazone
Major DepletionBrand names include Hydromox
Potassium is a mineral your heart rhythm, muscles, and nerves depend on every day. Quinethazone is a thiazide-type diuretic, and it works in the kidneys in a way that causes them to flush out more potassium than usual in the urine, which can meaningfully lower your levels over time. Because this is rated a major depletion, most people taking quinethazone long-term will need their potassium monitored and may need a supplement or dietary changes. Please talk with your pharmacist or doctor about checking your levels.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Quinethazone, Reserpine
Major DepletionBrand names include Hydromox R
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Quinethazone is a thiazide-type diuretic, and like other thiazides, it causes the kidneys to flush out more potassium in the urine than normal, which can drive levels too low over time. This combination carries a major depletion rating, meaning most people taking it long-term will likely need a potassium supplement or regular blood level checks. Please talk with your pharmacist or doctor before adding anything, since getting the dose right matters.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Reserpine, Trichlormethiazide
Major DepletionBrand names include Naquival, Metatensin #2, Metatensin #4
Trichlormethiazide is a thiazide diuretic, and one of its well-known trade-offs is that it causes the kidneys to flush out more potassium in the urine than normal. Potassium is a mineral your muscles, heart, and nerves depend on to work properly, so losing too much of it is a real concern. Because this is rated a major depletion, most people taking this combination long-term will likely need either a potassium supplement or close monitoring of their blood potassium levels. Please ask your doctor or pharmacist about checking your levels and whether a supplement or potassium-rich foods make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Sacubitril, Valsartan
Major DepletionBrand names include Entresto
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, so keeping levels in a healthy range really matters. Sacubitril/valsartan contains valsartan, which blocks a hormone system that normally tells the kidneys to hold onto sodium and water. That same hormone also plays a role in retaining potassium, so when the drug quiets that signal, the kidneys can end up releasing more potassium than usual into the urine. Because this is rated a major depletion, most long-term users should ask their doctor or pharmacist whether their potassium levels are being checked and whether a supplement or dietary changes make sense for them.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Spironolactone
Major DepletionBrand names include Aldactone, Spiroton, Carospir
Here is something worth paying attention to: spironolactone is actually a potassium-sparing diuretic, meaning it works by blocking a hormone signal in the kidneys that would normally cause potassium to be flushed out in urine. Because of this, spironolactone tends to raise potassium levels rather than lower them, and taking extra potassium on your own could push levels dangerously high. This is rated as a major concern, so please talk with your doctor or pharmacist before taking any potassium supplement while on this medication.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Theobromine
Major DepletionTheobromine acts as a mild diuretic, meaning it nudges your kidneys to produce more urine, and potassium, a mineral your muscles and heart depend on to work properly, gets flushed out along with that extra fluid. Because this effect is rated as a major depletion, long-term users may genuinely be losing enough potassium to matter, and a supplement is considered appropriate for most people taking it. Please talk with your pharmacist or doctor about checking your potassium level and whether you need to replace it.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Torsemide
Major DepletionBrand names include Demadex, Soaanz
Torsemide is a loop diuretic, meaning it works in the kidneys to flush out extra fluid, and unfortunately potassium goes right along with that fluid into the urine. Potassium is the mineral your heart rhythm, muscles, and nerve signals depend on, so losing too much is a real concern. Because this effect is well-documented and significant, most people taking torsemide long-term will need their potassium levels checked regularly and may need a supplement or dietary changes. Talk with your pharmacist or doctor about what makes sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Trichlormethiazide
Major DepletionBrand names include Metahydrin, Naqua, Marazide II
Potassium is a mineral your heart rhythm, muscles, and nerves depend on to work properly. Trichlormethiazide is a thiazide diuretic, meaning it tells your kidneys to flush out extra fluid, and unfortunately potassium gets swept out in that process along with the water. Because this loss is real and significant, most people taking this medication long-term will need regular blood tests to check potassium levels, and many will need a supplement or dietary changes. Please talk with your doctor or pharmacist about getting your levels checked.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Urea
Major DepletionBrand names include Ureaphil
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Urea is a diuretic, meaning it pulls extra fluid out through the kidneys, and in the process the kidneys tend to flush out potassium in the urine as well. Because this loss is rated as a major depletion, most people using urea long-term will need their potassium levels monitored and may need a supplement. Please talk with your doctor or pharmacist about checking your levels and whether a potassium supplement or dietary changes make sense for you.
References (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
Acetaminophen, Aspirin, Caffeine
Moderate DepletionBrand names include Excedrin Migraine, Excedrin, Excedrin Extra Strength
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
The caffeine component in this combination product belongs to a family of compounds called methylxanthines, and there is decent evidence that methylxanthines can nudge potassium levels downward by prompting your cells to pull more potassium inside them, which lowers the amount circulating in your blood. Potassium is a mineral your heart, muscles, and nerves all count on to work properly. This is rated as moderate, meaning it is worth paying attention to, especially if you have other reasons your potassium might already run low. If you take this product regularly, it is a reasonable thing to bring up with your pharmacist or doctor.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Acetaminophen, Butalbital, Caffeine
Moderate DepletionBrand names include Tecnal, Esgic Plus, Fiogesic
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a class of compounds called methylxanthines, and there is good evidence that methylxanthines can nudge potassium, a mineral your muscles and heart depend on for steady electrical signaling, into your cells and away from the bloodstream. This effect is usually mild at normal doses, but it can become more pronounced if caffeine levels run high or if you already have other reasons your potassium might be on the low side. Because the rating here is moderate, long-term users, especially those with heart conditions or who take diuretics, are worth a closer look. It is a reasonable thing to bring up with your pharmacist or doctor at your next visit.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Acetaminophen, Butalbital, Caffeine →
Acetaminophen, Butalbital, Caffeine, Codeine
Moderate DepletionBrand names include Esgic with Codeine, Fioricet w/ Codeine
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart and muscles depend on to work properly, and the caffeine component of this combination medication is worth paying attention to here. Caffeine belongs to a group of compounds called methylxanthines, which can nudge potassium out of your bloodstream and into your cells, temporarily lowering the level that shows up on a blood test. At regular doses this effect is usually mild, but it can be more significant if you already have other reasons your potassium might run low. If you take this medication regularly, it is worth mentioning to your pharmacist or doctor so they can decide whether your levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Acetaminophen, Butalbital, Caffeine, Codeine →
Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine
Moderate DepletionBrand names include Hycomine Compound
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a class called methylxanthines, and research shows it can nudge potassium (the mineral your muscles and heart depend on for steady rhythm) from the bloodstream into cells, which lowers the level circulating in your blood. With regular therapeutic use the effect is usually modest, but it can become more noticeable if you already have other reasons your potassium might run low. This combination product carries a moderate depletion rating, so long-term users or anyone with risk factors for low potassium should bring it up with their pharmacist or doctor.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine →
Acetaminophen, Caffeine, Codeine
Moderate DepletionBrand names include Gesic C8, Gesic C15, Lenoltec 2
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a class called methylxanthines, and one known effect of these compounds is nudging potassium to shift from your bloodstream into your cells, which can quietly lower the level circulating in your blood. Potassium is a mineral your heart rhythm, muscles, and nerves depend on, so keeping it in a healthy range matters. The risk is most pronounced at high doses, but lower levels have been reported even with regular therapeutic use, especially if you have other factors working against you, like a diuretic or a low-potassium diet. Because this is rated as moderate, it is worth bringing up with your pharmacist or doctor, particularly if you take this combination regularly.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Acetaminophen, Caffeine, Codeine, Salicylamide
Moderate DepletionBrand names include Codalan No.1, Codalan No.2, Codalan No.3
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a class of compounds called methylxanthines, and research shows it can nudge potassium, a mineral your muscles and heart depend on, from your bloodstream into your cells, which quietly lowers the level circulating in your blood. This effect is most dramatic in overdose situations, but lower-than-normal potassium levels have also been reported at regular doses, and the risk goes up if you already have other things working against your potassium. If you use this combination regularly or have risk factors like kidney issues or diuretic use, it is worth bringing up at your next pharmacist or doctor visit to decide whether monitoring or dietary adjustments make sense for you.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Acetaminophen, Caffeine, Codeine, Salicylamide →
Acetaminophen, Caffeine, Dihydrocodeine
Moderate DepletionBrand names include Panlor DC, Panlor SS, DHC Plus
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a class called methylxanthines, and one thing this group of compounds can do is shift potassium, a mineral your muscles and heart depend on, from your bloodstream into your cells. That shift can nudge blood potassium levels lower, and the effect appears more pronounced at higher doses. Because this combination product contains caffeine, it is worth being aware of, especially if you have other reasons your potassium might run low. Ask your pharmacist or doctor whether your levels should be checked periodically.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Acetaminophen, Caffeine, Dihydrocodeine →
Acetaminophen, Caffeine, Isometheptene
Moderate DepletionBrand names include Migralam
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a family of compounds called methylxanthines, and one thing those compounds can do is push potassium, the mineral your muscles and heart depend on for steady rhythms and contractions, from the bloodstream into cells, which lowers the measurable level circulating in your blood. This combination medication contains caffeine, so that same effect is possible here. The rating is moderate, meaning it is not something everyone will experience, but it is worth paying attention to, especially if you have other reasons your potassium might already run low. If you use this medication regularly, it is a good idea to bring it up with your pharmacist or doctor so they can decide whether monitoring or any dietary changes make sense for you.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Acetaminophen, Caffeine, Isometheptene →
Albuterol
Moderate DepletionBrand names include Proventil, Volmax, Ventolin (U.S.)
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium helps your heart stay in a steady rhythm and keeps your muscles working properly. Albuterol activates certain receptors that essentially push potassium out of your bloodstream and into your cells, so the level circulating in your blood can drop. This effect is most noticeable with higher doses or frequent use, and it does tend to ease up over time with regular use. Because this is rated as a moderate concern, it is worth mentioning to your pharmacist or doctor if you use albuterol often, have heart disease, or take other medications that also lower potassium.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Albuterol Sulfate
Moderate DepletionBrand names include Proair Respiclick
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. When you take albuterol, it activates certain receptors that essentially signal your cells to pull extra potassium in from the bloodstream, which can nudge your blood potassium level lower. This effect is most noticeable with high doses or during acute use, and it tends to ease off with regular, ongoing use. Because the rating here is moderate, it is worth mentioning to your pharmacist or doctor, especially if you have heart concerns or take other medications that also affect potassium.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Aminophylline
Moderate DepletionMethylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and aminophylline belongs to a drug class that can nudge potassium to shift from your bloodstream into your cells, lowering the level that shows up on a blood test. This effect tends to be mild at normal doses but becomes more pronounced as drug levels in the blood climb higher. Because the rating here is moderate, long-term users or anyone with other reasons for low potassium should ask their pharmacist or doctor about having their potassium level checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Aminophylline, Amobarbital, Ephedrine
Moderate DepletionBrand names include Amesec
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Aminophylline belongs to a class of drugs called methylxanthines, and one thing these medicines can do is shift potassium, a mineral your muscles and heart depend on to work properly, from the bloodstream into your cells. That shift drops the measurable level of potassium in your blood, and the effect appears to grow as the drug level in your system rises. Because this is rated as moderate depletion, it is worth paying attention to, especially if you have other things that also lower potassium. Ask your pharmacist or doctor whether your levels should be checked or whether any dietary or supplement changes make sense for you.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Aminophylline, Amobarbital, Ephedrine →
Amoxicillin
Moderate DepletionBrand names include Amoxil Capsules, Trimox, Wymox
Penicillins, which are formulated as sodium salts, present a large sodium load to the kidneys. Increased amounts of sodium are reabsorbed, and the penicillin moiety acts as a non-reabsorbable anion, promoting urinary potassium excretion. Monitor serum potassium levels and give potassium supplements, or switch to an alternative antibiotic, as necessary. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Amoxicillin belongs to the penicillin family, and these antibiotics are made as sodium salts, so your kidneys end up handling a bigger sodium load than usual. As the kidneys manage that extra sodium, they can end up flushing out more potassium in the urine than normal. This is a moderate concern, meaning some people on amoxicillin do need their potassium levels checked, so if you are taking it regularly or for a longer course, it is worth asking your pharmacist or doctor whether any monitoring makes sense for you.
References (1)
- Isaac G, Holland OB. Drug-induced hypokalamia: A cause for concern. Drugs & Aging 1992;2:35-41.
Amoxicillin, Omeprazole Magnesium, Rifabutin
Moderate DepletionBrand names include Talicia
Penicillins, which are formulated as sodium salts, present a large sodium load to the kidneys. Increased amounts of sodium are reabsorbed, and the penicillin moiety acts as a non-reabsorbable anion, promoting urinary potassium excretion. Monitor serum potassium levels and give potassium supplements, or switch to an alternative antibiotic, as necessary. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Amoxicillin belongs to the penicillin family, and when those antibiotics are processed by the kidneys, they can cause the body to flush out more potassium in the urine than usual. This is rated moderate, meaning it does not affect everyone but is worth watching, especially during a course of treatment. If you are taking this combination long-term or feel muscle weakness or cramping, bring it up with your pharmacist or doctor so they can check whether your levels need attention.
References (1)
- Isaac G, Holland OB. Drug-induced hypokalamia: A cause for concern. Drugs & Aging 1992;2:35-41.
Full nutrient report for Amoxicillin, Omeprazole Magnesium, Rifabutin →
Armodafinil
Moderate DepletionBrand names include Nuvigil
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your muscles, heart, and nerves depend on to work properly. Armodafinil is a wakefulness-promoting agent, not a laxative, so the mechanism described in this record actually applies to stimulant laxatives rather than to armodafinil directly. If this pairing was flagged for you, it may reflect a broader database category, and the evidence here is worth a conversation with your pharmacist or doctor, especially if you are using armodafinil long-term, so they can decide whether any monitoring makes sense for your situation.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Aspirin, Butalbital, Caffeine
Moderate DepletionBrand names include Fiorinal
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a class of compounds called methylxanthines, and one thing these compounds can do is nudge potassium, a mineral your heart rhythm and muscles depend on, from the bloodstream into your cells, which lowers the level circulating in your blood. With regular therapeutic use this effect is usually mild, but it can become more significant if your caffeine intake is high or if you already have other reasons your potassium might run low. Because this is rated as a moderate concern, long-term users, especially those with heart conditions or taking other medications that affect potassium, are worth keeping an eye on. It is worth a quick conversation with your pharmacist or doctor to find out whether checking your potassium level makes sense for you.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Aspirin, Butalbital, Caffeine, Codeine Phosphate
Moderate DepletionBrand names include Fiorinal w/ Codeine
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a family of compounds called methylxanthines, and research suggests it may cause potassium, a mineral your muscles and heart depend on for normal function, to shift from your bloodstream into your cells, nudging blood levels lower. This effect is most pronounced after large doses, but some drop in potassium can happen even at regular therapeutic amounts. Given the moderate rating here, long-term users who have other reasons to watch their potassium (such as taking a diuretic or having kidney concerns) should bring it up with their doctor or pharmacist to see whether any monitoring or dietary changes make sense.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Aspirin, Butalbital, Caffeine, Codeine Phosphate →
Aspirin, Butalbital, Caffeine, Phenacetin
Moderate DepletionBrand names include Marnal
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a group of compounds called methylxanthines, and one thing these compounds can do is shift potassium, a mineral your heart and muscles depend on, from your bloodstream into your cells, which lowers the measurable level in your blood. At normal doses this effect is usually modest, but the concern grows if you have other risk factors that already put your potassium on the low side. Because the evidence here is rated moderate, it is worth mentioning this combination to your pharmacist or doctor, especially if you take it regularly, so they can decide whether your potassium levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Aspirin, Butalbital, Caffeine, Phenacetin →
Aspirin, Caffeine
Moderate DepletionBrand names include Anacin
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a chemical family called methylxanthines, and one well-recognized effect of these compounds is that they can push potassium out of the bloodstream and into cells, which lowers the level circulating in your blood. Potassium is a mineral your heart, muscles, and nerves depend on to work properly. This is rated as a moderate concern, meaning it is worth paying attention to, especially if you use caffeine regularly or already have other reasons your potassium might run low. Worth a quick conversation with your pharmacist or doctor if you are a long-term user.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Aspirin, Caffeine, Codeine Phosphate
Moderate DepletionBrand names include Anacin w/ Codeine
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a family of compounds called methylxanthines, and one thing those compounds can do is nudge potassium, a mineral your muscles and heart depend on for steady, normal function, to shift from your bloodstream into your cells. That shift can lower the potassium level your bloodstream shows on a lab test. This is rated a moderate concern, meaning it does not affect everyone, but long-term users or anyone with other risk factors for low potassium are worth watching. If you take this combination regularly, it is reasonable to ask your pharmacist or doctor whether your potassium level should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Aspirin, Caffeine, Codeine Phosphate →
Aspirin, Caffeine, Dihydrocodeine Bitartrate
Moderate DepletionBrand names include Synalgos DC
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. The caffeine in this combination acts like other methylxanthines and can nudge potassium out of the bloodstream and into your cells, which lowers the level your body has readily available. This is rated a moderate concern, so while most people using this medication as directed won't develop a serious problem, those with other risk factors for low potassium are worth watching more closely. It's a good idea to mention this to your pharmacist or doctor, especially if you take it regularly.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Aspirin, Caffeine, Dihydrocodeine Bitartrate →
Aspirin, Caffeine, Dover's Pwd
Moderate DepletionBrand names include Acedoval, Dovacet
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a family of compounds called methylxanthines, and one thing these compounds can do is shift potassium, the mineral your muscles and heart depend on for steady electrical signals, from your bloodstream into your cells. That shift can nudge blood potassium levels lower, especially at higher doses or in people who already have reasons to run low. Because this combination product contains caffeine, it is worth keeping in mind if you use it regularly or have other risk factors. Talking with your pharmacist or doctor about whether your potassium levels should be checked is a reasonable step.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Aspirin, Caffeine, Hydrocodone
Moderate DepletionBrand names include Damason-P
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. The caffeine in this combination product is a methylxanthine, and methylxanthines like caffeine can nudge potassium out of the bloodstream and into cells, which quietly lowers the level circulating in your blood. This is rated a moderate concern, meaning it is something worth paying attention to, especially if you use this medication regularly or have other reasons your potassium might already run low. It is worth asking your pharmacist or doctor whether your levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin
Moderate DepletionBrand names include Lanorinal
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and the caffeine component in this combination product is a methylxanthine that may nudge potassium from the bloodstream into cells, which can modestly lower the level circulating in your blood. Serious dips are more common with high or toxic doses, but even regular therapeutic use has been linked to lower potassium readings, especially in people who already have risk factors. Because this is rated a moderate concern, long-term users are worth keeping an eye on, and it is a reasonable thing to bring up with your pharmacist or doctor.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin →
Aspirin, Caffeine, Orphenadrine
Moderate DepletionBrand names include Norgesic Forte, Invagesic, Invagesic Forte
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a chemical family called methylxanthines, and one known effect of these compounds is that they can nudge potassium, a mineral your muscles and heart depend on for normal rhythm and function, to shift from the bloodstream into your cells. This can quietly lower the amount of potassium circulating in your blood. At normal doses the effect is usually modest, but it is worth paying attention to if you already have other reasons your potassium might run low. Long-term users, or anyone with kidney concerns or taking other medications that also affect potassium, would do well to mention this to their pharmacist or doctor.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Aspirin, Caffeine, Phenacetin, Propoxyphene
Moderate DepletionBrand names include Margesic Comp. 65
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a group of compounds called methylxanthines, and one thing those compounds can do is push potassium, the mineral your muscles and heart depend on for steady rhythm and function, from your bloodstream into your cells, which lowers the level circulating in your blood. At normal doses this shift is usually small, but it becomes more significant if you have other risk factors for low potassium, such as taking certain diuretics or eating a low-potassium diet. Because this combination is rated as moderate depletion, long-term users and those with heart concerns would do well to ask their pharmacist or doctor whether their potassium levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Aspirin, Caffeine, Phenacetin, Propoxyphene →
Azelastine Hydrochloride, Fluticasone Propionate
Moderate DepletionBrand names include Dymista
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Fluticasone is a corticosteroid, and one known effect of corticosteroids is that they can signal the kidneys to flush out more potassium than usual in the urine. Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Because this combination product contains fluticasone, this is rated a moderate concern, meaning it is worth keeping an eye on rather than ignoring. If you use this medication regularly, it is reasonable to ask your doctor or pharmacist whether your potassium level should be checked.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Azelastine Hydrochloride, Fluticasone Propionate →
Beclometasone dipropionate
Moderate DepletionBrand names include Becotide
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Beclometasone is a corticosteroid, and corticosteroids can signal the kidneys to hold onto sodium, which as a side effect causes the kidneys to flush out more potassium in the urine. This effect is dose-related, so it tends to matter more for people using higher doses over longer periods. Given the moderate rating here, it is worth asking your pharmacist or doctor whether your potassium levels should be checked periodically.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Beclomethasone
Moderate DepletionBrand names include Beclovent, Vanceril
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Beclomethasone belongs to a class of steroids that can signal the kidneys to flush out more potassium in the urine than usual, and this effect tends to be more noticeable at higher doses. Because the evidence here is rated as moderate, this is worth taking seriously, especially for long-term users. Ask your pharmacist or doctor whether your potassium level should be checked periodically.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Beclomethasone dipropionate
Moderate DepletionBrand names include Qvar, QNASL
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Beclomethasone dipropionate is a corticosteroid, and corticosteroids can signal the kidneys to hold onto sodium while flushing extra potassium out in the urine, which can gradually bring potassium levels down. This is rated a moderate concern, meaning it does not affect everyone but is worth keeping an eye on, especially with regular or higher-dose use. Ask your doctor or pharmacist whether periodic potassium monitoring makes sense for you.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Belladonna, Caffeine, Ergotamine, Pentobarbital
Moderate DepletionBrand names include Micomp PB
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a group of compounds called methylxanthines, and research suggests it can nudge potassium, the mineral your heart rhythm and muscles depend on, from your bloodstream into your cells, which lowers the measurable level in your blood. At normal doses this shift is usually modest, but the effect can become more significant with higher caffeine levels or if you already have other reasons your potassium might run low. Because this combination product carries a moderate depletion rating, it is worth a conversation with your pharmacist or doctor about whether your levels should be checked periodically, especially with long-term use.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Belladonna, Caffeine, Ergotamine, Pentobarbital →
Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital
Moderate DepletionBrand names include Cafergot PB
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Caffeine belongs to a group of compounds called methylxanthines, and one thing these compounds can do is nudge potassium, the mineral your heart rhythm and muscles depend on, to shift from your bloodstream into your cells. That internal shift can cause serum potassium to read lower than it should, and the risk appears to climb at higher levels of the drug in your body. Because this combination product contains caffeine, your doctor or pharmacist may want to keep an eye on your potassium if you have other risk factors for running low. It is worth bringing up at your next visit, especially if you use this medication regularly.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital →
Betamethasone
Moderate DepletionBrand names include Celestone, Diprolene AF, Diprosone
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and betamethasone can cause your kidneys to flush out more of it than usual in your urine. This happens because betamethasone has some mineralocorticoid activity, meaning it signals the kidneys to hold onto sodium and, in exchange, release extra potassium. At a moderate level of concern, this is something worth taking seriously if you are using betamethasone regularly or at higher doses. Ask your doctor or pharmacist whether your potassium levels should be checked, since some people on this medication do need a supplement or dietary adjustment.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Betamethasone Dipropionate
Moderate DepletionBrand names include Sernivo
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Betamethasone dipropionate is a corticosteroid, and corticosteroids can signal the kidneys to hold onto sodium while flushing out more potassium in the urine than usual. This is rated moderate, meaning it is a real enough concern that some long-term users may need their levels checked or even a supplement. If you use this medication regularly, it is worth asking your pharmacist or doctor whether monitoring your potassium makes sense for you.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Betamethasone Dipropionate, Calcipotriene
Moderate DepletionBrand names include Enstilar, Wynzora
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Betamethasone dipropionate is a corticosteroid, and corticosteroids can signal the kidneys to hold onto sodium while flushing out more potassium in the urine, which can gradually pull levels down over time. Because this combination product carries a moderate depletion rating, long-term users are worth watching, and some people do end up needing a supplement. It is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Betamethasone Dipropionate, Calcipotriene →
Betamethasone valerate
Moderate DepletionBrand names include Luxiq
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to keep a steady rhythm and function properly. Betamethasone valerate is a corticosteroid, and corticosteroids can signal the kidneys to hold onto sodium while flushing out extra potassium in the urine, which can gradually pull levels down. Because this is rated as a moderate concern, it is worth keeping on your radar, especially with longer or higher-dose use. Ask your pharmacist or doctor whether your potassium levels should be checked periodically.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Budesonide
Moderate DepletionBrand names include Entocort EC, Pulmicort, Uceris
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Budesonide is a corticosteroid, and some corticosteroids signal the kidneys to hold onto sodium, which causes extra potassium to get flushed out in the urine as a trade-off. This is rated a moderate concern, so it is worth keeping on your radar, especially if you use budesonide long-term or at higher doses. Ask your pharmacist or doctor whether checking your potassium level makes sense for you.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Caffeine (OTC drug)
Moderate DepletionBrand names include Vivarin, Overtime, Molie
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Caffeine belongs to a class of compounds called methylxanthines, and research suggests these compounds may nudge potassium out of the bloodstream and into cells, which can push blood levels lower. This rating is 'moderate,' meaning it does not affect everyone but is worth paying attention to, especially if you drink large amounts of caffeine regularly or already have other reasons your potassium might run low. If that sounds like you, it is worth a quick conversation with your pharmacist or doctor.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Caffeine (prescription drug)
Moderate DepletionBrand names include Dextrophin, Caffeine
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium keeps your heart rhythm steady and your muscles working properly, so keeping levels in a healthy range genuinely matters. Prescription caffeine belongs to a drug class called methylxanthines, and these medications appear to shift potassium from the bloodstream into your cells, which can nudge circulating levels lower. This is rated a moderate concern, meaning it does not happen to everyone but is worth paying attention to, especially if you have other reasons your potassium might run low. If you are using prescription caffeine regularly, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Caffeine , Sodium Benzoate
Moderate DepletionBrand names include Caffeine and Sodium Benzoate
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and caffeine and sodium benzoate belongs to a drug class called methylxanthines that can nudge potassium out of the bloodstream and into your cells, effectively lowering the level your body has readily available. This effect is more pronounced at higher doses, but it has also been reported at normal therapeutic doses, and a 'Moderate Depletion' rating means this is worth taking seriously rather than brushing aside. If you have other reasons your potassium might already run low (such as taking a water pill or not eating many potassium-rich foods), it is worth bringing up with your doctor or pharmacist so your levels can be kept an eye on.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Caffeine, Diphenhydramine, Ergotamine (prescription drug)
Moderate DepletionBrand names include Ergodryl
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is the mineral your muscles and heart depend on to keep a steady rhythm and contract properly. Caffeine belongs to a drug class called methylxanthines, and research shows these compounds can nudge potassium from your bloodstream into your cells, which lowers the level circulating in your blood. At normal doses this shift is usually mild, but it is worth knowing about, especially if you have other reasons your potassium might already run low. If you use this medication regularly, it is reasonable to ask your pharmacist or doctor whether your potassium levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Caffeine, Diphenhydramine, Ergotamine (prescription drug) →
Caffeine, Ergotamine (prescription drug)
Moderate DepletionBrand names include Migergot
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Caffeine and ergotamine belong to a drug class called methylxanthines, and research suggests they can nudge potassium from the bloodstream into cells, which quietly lowers the level circulating in your blood. At normal doses this effect is usually modest, but it is worth paying attention to if you already have other reasons your potassium might run low, such as taking a diuretic or not eating much. If you use this medication regularly, it is a reasonable thing to bring up with your pharmacist or doctor so they can decide whether any monitoring makes sense for you.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Caffeine, Ergotamine (prescription drug) →
Caffeine, Ergotamine Tartrate (prescription drug)
Moderate DepletionBrand names include Cafergot, Wigraine
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart rhythm, muscles, and nerve signals all depend on. This medication contains caffeine, which belongs to a drug class called methylxanthines, and research suggests these compounds can push potassium from the bloodstream into cells, nudging serum levels down. The rating here is moderate, meaning low potassium is a real enough concern that some long-term users do need monitoring or a supplement, especially if you have other risk factors. Worth a conversation with your pharmacist or doctor about whether your levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Caffeine, Ergotamine Tartrate (prescription drug) →
Clobetasol
Moderate DepletionBrand names include Temovate, Clobex
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Clobetasol is a potent corticosteroid, and corticosteroids can prompt the kidneys to flush out more potassium than usual in the urine, which is how levels can quietly drop over time. This is rated a moderate concern, meaning it does not happen to everyone but it is real enough that regular monitoring makes sense, especially with longer-term or widespread use. If you use clobetasol regularly, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Cortisone Acetate
Moderate DepletionBrand names include Cortone, Cortisone Tablets
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, so keeping levels in a healthy range really does matter. Cortisone acetate acts somewhat like a hormone that tells the kidneys to hold onto sodium, and as a trade-off, the kidneys end up flushing out more potassium in the urine than normal. This is a moderate concern, meaning it is well-documented enough that your doctor will likely want to check your potassium levels periodically, and some people on this medication do need a supplement or dietary changes to keep levels steady. If you are taking cortisone acetate long-term, it is worth asking your pharmacist or doctor whether routine monitoring makes sense for you.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Danthron , Docusate
Moderate DepletionBrand names include Co-Danthrusate (UK)
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Danthron combined with docusate acts as a stimulant laxative, and when that type of laxative is used regularly or in large amounts, it can cause your intestines to move contents through so quickly that potassium gets flushed out in the stool before the body can absorb enough. This combination carries a moderate depletion rating, meaning it is a real concern for people using it long-term, not just a theoretical one. If you take this regularly, it is worth asking your pharmacist or doctor whether your potassium level should be checked.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Dehydrocholic Acid
Moderate DepletionBrand names include Decholin
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your muscles and heart depend on to keep a steady rhythm and function properly. Dehydrocholic acid is a stimulant laxative, and when stimulant laxatives are used heavily or over a long period, they can speed up movement through the gut so much that potassium gets swept out through the stool before the body can absorb enough of it. The 'moderate depletion' rating here is a real one to take seriously, especially for anyone using this regularly rather than just occasionally. If you use this medication more than short-term, it is worth asking your pharmacist or doctor whether your potassium level should be checked.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Dehydrocholic Acid , Docusate
Moderate DepletionBrand names include Bilax
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Stimulant laxatives like dehydrocholic acid can cause your intestines to move contents through faster than normal, which means the gut has less time to absorb potassium before it is lost in stool. With regular or high-dose use, that loss can add up enough to matter. If you have been using this type of laxative for more than a short stretch, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Dexamethasone
Moderate DepletionBrand names include Decadron, Hexadrol, Dexone
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and dexamethasone can cause your kidneys to flush more of it out in your urine than usual. This happens because dexamethasone has some mineralocorticoid activity, meaning it signals the kidneys to hold onto sodium, and potassium gets pushed out in exchange. With a moderate depletion rating, this is a real concern worth watching, especially on higher doses or long-term use. Ask your doctor or pharmacist whether your levels should be checked and whether you need any dietary changes or a supplement.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Dicloxacillin Sodium
Moderate DepletionBrand names include Dynapen, Pathocil, Dycill
Penicillins, which are formulated as sodium salts, present a large sodium load to the kidneys. Increased amounts of sodium are reabsorbed, and the penicillin moiety acts as a non-reabsorbable anion, promoting urinary potassium excretion. Monitor serum potassium levels and give potassium supplements, or switch to an alternative antibiotic, as necessary. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Dicloxacillin belongs to the penicillin family, and these antibiotics are made as sodium salts, so your kidneys receive a heavy sodium load while you take them. To balance that sodium, the kidneys end up flushing extra potassium out in the urine. This is rated a moderate concern, meaning most short-term users are fine, but people on longer courses should ask their pharmacist or doctor whether their potassium levels need to be checked.
References (1)
- Isaac G, Holland OB. Drug-induced hypokalamia: A cause for concern. Drugs & Aging 1992;2:35-41.
Docusate Calcium, Phenolphthalein
Moderate DepletionBrand names include Doxidan (Canadian)
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart rhythm, muscles, and nerves all depend on, so keeping levels in a healthy range really matters. Phenolphthalein is a stimulant laxative, meaning it pushes the gut to move things along quickly, and when it does that too often or at high doses, fluid and potassium get swept out through the stool before the body can hold onto them. This is rated a moderate concern, so it mainly applies to people using this type of laxative regularly or at high doses rather than occasionally. If you use it more than short-term, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Docusate Calcium, Phenolphthalein →
Docusate Sodium, Phenolphthalein
Moderate DepletionBrand names include Correctol, Modane Plus
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Phenolphthalein is a stimulant laxative, and when these types of laxatives are used regularly or at high doses, they can speed up movement through the gut so much that potassium gets flushed out in stool before the body can hold onto it. This is a real concern with long-term or heavy use, not just an occasional dose, so if you take this medication regularly, it is worth asking your pharmacist or doctor whether your potassium level should be checked.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Dyphylline
Moderate DepletionBrand names include Neothylline, Dyflex, Dilor
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your muscles and heart depend on to keep a steady rhythm and work properly. Dyphylline belongs to a drug class called methylxanthines, and these medications appear to shift potassium from the bloodstream into cells, which can nudge serum potassium levels lower. This is a moderate concern, meaning it does not affect everyone but is worth taking seriously, especially if you have other reasons your potassium might already run low. Ask your pharmacist or doctor whether your levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Dyphylline, Ephedrine, Guaifenesin, Phenobarbital
Moderate DepletionBrand names include Lufyllin-EPG
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Dyphylline belongs to a class of drugs called methylxanthines, and one thing this class is known to do is push potassium from the bloodstream into your cells, which can nudge your serum potassium lower. Potassium is the mineral your heart rhythm, muscles, and nerves depend on to work properly, so a significant drop matters. This is rated a moderate concern, meaning it does not happen to everyone but is worth watching, especially if you have other reasons your potassium might run low. If you have been on this combination long-term, it is worth asking your pharmacist or doctor whether your potassium level should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Dyphylline, Ephedrine, Guaifenesin, Phenobarbital →
Dyphylline, Guaifenesin
Moderate DepletionBrand names include Panfil G, Neothylline-GG, Lufyllin-GG
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to fire correctly, and dyphylline (the active xanthine in this combination) can nudge potassium from your bloodstream into your cells, causing blood levels to dip. This effect is generally modest at normal doses, but it becomes more of a concern as doses climb or if you already have other reasons your potassium might run low. Because this carries a moderate depletion rating, it is worth keeping an eye on, especially with long-term use. Ask your pharmacist or doctor whether monitoring your potassium levels makes sense for your situation.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Ephedrine Sulfate, Hydroxyzine, Theophylline
Moderate DepletionBrand names include Hydroxy Compound
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Theophylline, a medication in this combination, can nudge potassium out of your bloodstream and into your cells, which quietly lowers the level circulating in your blood. Potassium is the mineral your muscles and heart depend on to contract and keep a steady rhythm, so this is worth keeping an eye on. The risk is rated moderate, meaning it does not affect everyone but is real enough that your doctor may want to check your potassium levels periodically, especially if you have other reasons your potassium might already run low. Ask your pharmacist or doctor whether any monitoring or dietary changes make sense for you.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Ephedrine Sulfate, Hydroxyzine, Theophylline →
Ephedrine, Guaifenesin, Phenobarbital, Theophylline
Moderate DepletionBrand names include Mudrane GG
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Theophylline, the active ingredient driving this concern, belongs to a class called methylxanthines, and one of its known effects is pushing potassium out of the bloodstream and into cells, which can nudge your serum potassium lower. Potassium is the mineral your heart rhythm, muscles, and nerves depend on to fire correctly, so even a modest drop matters for some people. This is rated a moderate concern, meaning it does not affect everyone but is worth paying attention to, especially at higher theophylline levels or if you already have other risk factors for low potassium. If you take theophylline regularly, it is a reasonable thing to bring up with your pharmacist or doctor so they can decide whether your levels need monitoring.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Ephedrine, Guaifenesin, Phenobarbital, Theophylline →
Ephedrine, Hydroxyzine, Theophylline
Moderate DepletionBrand names include Marax, Ami Rax
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Theophylline, the methylxanthine in this combination, can nudge potassium out of your bloodstream and into your cells, which brings the overall circulating level down. This effect is generally mild at normal doses, but it becomes more of a concern as theophylline levels climb higher, or if you already have other reasons your potassium might run low. Because the rating here is moderate, long-term users should ask their doctor or pharmacist whether periodic potassium monitoring makes sense for them.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Ephedrine, Hydroxyzine, Theophylline →
Ephedrine, Phenobarbital, Potassium Iodide, Theophylline
Moderate DepletionBrand names include Quadrinal, Mudrane
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Theophylline, the methylxanthine in this combination, can nudge potassium from your bloodstream into your cells, which quietly lowers the level circulating in your blood. Potassium is something your heart, muscles, and nerves depend on to keep a steady rhythm and signal properly. This effect is more pronounced at higher theophylline levels, but it can show up even at normal doses, which is why this is rated a moderate concern worth keeping an eye on. If you take theophylline regularly, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Ephedrine, Phenobarbital, Potassium Iodide, Theophylline →
Ephedrine, Phenobarbital, Theophylline
Moderate DepletionBrand names include Tedral
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Theophylline appears to push potassium out of the bloodstream and into cells, which can lower the amount your body has available to use. This is a moderate concern, meaning low potassium does not happen to everyone, but the risk goes up as theophylline levels in the blood rise. If you take theophylline long-term, it is worth asking your doctor or pharmacist whether your potassium levels should be checked.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Full nutrient report for Ephedrine, Phenobarbital, Theophylline →
Fludrocortisone
Moderate DepletionBrand names include Florinef Acetate
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Fludrocortisone is a powerful mineralocorticoid, meaning one of its main jobs in the body is to help retain sodium, and as a side effect of that process, your kidneys end up flushing out extra potassium in the urine. Potassium is something your heart, muscles, and nerves depend on to function properly, so this is a real concern worth tracking. Because this effect is rated as moderate depletion, people taking fludrocortisone long-term often have their potassium levels checked regularly, and some do end up needing a supplement or dietary changes. Ask your doctor or pharmacist whether routine monitoring makes sense for you.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Fluticasone
Moderate DepletionBrand names include Flovent, Flonase, Flixotide
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Fluticasone is a corticosteroid, and some corticosteroids signal the kidneys to hold onto sodium, which causes the kidneys to release extra potassium in the urine instead. Because this risk is rated moderate, long-term users are worth keeping an eye on, and some people do end up needing a supplement. If you use fluticasone regularly, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Fluticasone Furoate, Umeclidinium, Vilanterol
Moderate DepletionBrand names include Trelegy Ellipta
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. The fluticasone furoate in this inhaler is a corticosteroid, and corticosteroids can nudge the kidneys into flushing out more potassium than usual through the urine, especially at higher doses or with long-term use. This is rated a moderate concern, meaning it does not affect everyone but is worth watching, so if you use this inhaler regularly, it is a good idea to ask your doctor or pharmacist whether your potassium level should be checked.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Fluticasone Furoate, Umeclidinium, Vilanterol →
Fluticasone Furoate, Vilanterol Trifenatate
Moderate DepletionBrand names include Breo Ellipta
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. The fluticasone component in this inhaler is a corticosteroid, and corticosteroids can signal the kidneys to flush out more potassium in the urine than usual, which over time may cause levels to dip. Because this is rated as a moderate concern, long-term users are often advised to have their potassium checked periodically, and some people do end up needing a supplement. It is worth bringing up with your doctor or pharmacist, especially if you use this inhaler regularly.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Fluticasone Furoate, Vilanterol Trifenatate →
Fluticasone Proprionate, Salmeterol
Moderate DepletionBrand names include Airduo Respiclick
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Salmeterol, the long-acting bronchodilator in this combination inhaler, works by activating beta-2 receptors in the body. One side effect of that activation is that it nudges potassium, a mineral your heart and muscles depend on, to move from the bloodstream into cells, which can lower the level circulating in your blood. This concern is rated moderate, meaning it is real enough to keep an eye on, particularly for people using high doses, taking other medications that also lower potassium, or who have heart conditions. If you use this inhaler regularly, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Full nutrient report for Fluticasone Proprionate, Salmeterol →
Guaifenesin, Oxtriphylline
Moderate DepletionBrand names include Brondecon
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Oxtriphylline belongs to a class of medications called methylxanthines, and one thing worth knowing is that these drugs can push potassium out of the bloodstream and into your cells, which lowers the level your blood test picks up. Potassium keeps your heart rhythm steady and your muscles working properly, so a real drop matters. This is rated moderate, meaning low potassium does not happen to everyone, but it is more of a concern if your doses are higher or if you have other reasons your potassium might already run low. If you are a long-term user, it is worth asking your doctor or pharmacist whether your potassium levels should be checked periodically.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Guaifenesin, Theophylline
Moderate DepletionBrand names include Mudrane GG-2, Bronchial, Theolair-Plus
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Theophylline, the active bronchodilator in this combination, can nudge potassium (the mineral your muscles and heart depend on for steady, normal contractions) to shift from your bloodstream into your cells, which lowers the level measured in a blood test. At typical doses this effect is usually modest, but it tends to grow as theophylline levels in the blood climb higher. Because this is rated a moderate concern, long-term users or anyone with other reasons to run low on potassium should ask their doctor or pharmacist whether periodic monitoring makes sense for them.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Hydrocortisone
Moderate DepletionBrand names include Cortef, Hydrocortone, Carmol HC cream
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Hydrocortisone has both glucocorticoid and mineralocorticoid activity, meaning it signals the kidneys to hold onto sodium, and as a side effect the kidneys flush out more potassium in the urine than usual. This is a moderate concern, particularly at higher doses or with long-term use, so doctors often check potassium levels periodically in people on this medication. If you are taking hydrocortisone regularly, it is worth asking your pharmacist or doctor whether your levels should be monitored.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Ipratropium, Albuterol
Moderate DepletionBrand names include Combivent, Combivent Respimat
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to fire correctly. The albuterol in this combination works by activating certain receptors that essentially push potassium out of the bloodstream and into your cells, temporarily lowering the level circulating in your blood. This is rated a moderate concern, meaning it is real enough to take seriously, especially at higher doses or if you have heart disease or take other medications that also lower potassium. If you use this inhaler regularly, it is worth asking your pharmacist or doctor whether your potassium level should be checked.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Isoproterenol
Moderate DepletionBrand names include Isuprel
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart and muscles depend on to work properly, and isoproterenol can nudge levels lower in a specific way: it activates receptors that signal your cells to pull extra potassium in from the bloodstream, so less of it stays circulating where it is needed. This is a moderate concern, not just a theoretical one, and the risk is highest during high doses or short-term intensive use. If you take isoproterenol regularly, or if you have heart disease or use other medications that also lower potassium, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Levalbuterol
Moderate DepletionBrand names include Xopenex
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart and muscles depend on to work properly, and levalbuterol has a well-known way of nudging levels lower. When this medication activates certain receptors in your body, it essentially signals your cells to pull extra potassium in from the bloodstream, so less is circulating where it needs to be. This is rated moderate, meaning it is real enough that long-term or high-dose users, especially those with heart conditions or taking other medications that affect potassium, may want to have levels checked. It is worth a conversation with your pharmacist or doctor about whether any monitoring makes sense for you.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Magnesium Hydroxide (OTC drug)
Moderate DepletionBrand names include Milk of Magnesia (MOM)
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Magnesium hydroxide acts as a laxative by drawing water into the intestines and speeding up movement through the gut, and when that happens frequently or at high doses, potassium can be carried out of the body through loose stools before it is fully absorbed. This is rated as a moderate concern, so it is not something to ignore if you use it regularly. If you take magnesium hydroxide often or in large amounts, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Metaproterenol
Moderate DepletionBrand names include Metaprel
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart and muscles depend on to keep a steady rhythm and work properly. Metaproterenol belongs to a class of bronchodilators that activates certain receptors, and one side effect of that activation is that cells pull extra potassium out of the bloodstream and hold it inside, dropping the level in your blood. This matters most at higher doses or during intense treatment, and the concern is real enough that your doctor or pharmacist may want to check your potassium level, especially if you have heart disease or take other medications that also lower potassium. If you use metaproterenol regularly, it is worth asking your care team whether any monitoring makes sense for you.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Methylprednisolone
Moderate DepletionBrand names include Medrol, Medrol Dosepak
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Methylprednisolone can prompt your kidneys to flush out more potassium than usual through the urine, a side effect tied to how corticosteroids signal the kidneys to hold onto sodium. Because this is rated a moderate depletion concern, long-term users in particular are worth watching, and some people do end up needing a supplement or dietary changes. It is worth asking your doctor or pharmacist whether your potassium level should be checked while you are on this medication.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Olopatadine Hydrochloride, Mometasone Furoate
Moderate DepletionBrand names include Ryaltris
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. The mometasone furoate in this combination is a corticosteroid, and corticosteroids can signal the kidneys to flush out more potassium than usual through the urine, especially at higher doses or with longer use. Because this effect is rated moderate, it is worth keeping on your radar: if you use this medication regularly, ask your doctor or pharmacist whether checking your potassium level makes sense for you.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Olopatadine Hydrochloride, Mometasone Furoate →
Oxtriphylline
Moderate DepletionBrand names include Choledyl, Choledyl SA
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart rhythm, muscles, and nerves depend on to work properly. Oxtriphylline belongs to a drug class called methylxanthines, and these medications appear to nudge potassium to shift from the bloodstream into cells, which can pull measured potassium levels down even at normal therapeutic doses. This is rated a moderate concern, meaning it does not affect everyone but is worth keeping an eye on, especially if you have other reasons your potassium might run low. Ask your pharmacist or doctor whether your levels should be checked periodically.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Phenolphthalein
Moderate DepletionBrand names include Modane, Evac-Q-Tab, Modane Mild
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Phenolphthalein is a stimulant laxative, meaning it pushes your intestines to move faster, and when that happens repeatedly or at high doses, potassium gets swept out through the gut before your body can hold onto it. This is rated a moderate concern, so most short-term users at normal doses are fine, but people who use it regularly over time may need monitoring or even a supplement. If that sounds like your situation, it is worth a conversation with your pharmacist or doctor.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Prednisolone
Moderate DepletionBrand names include Sterane, Delta Cortef, Cortalone
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Prednisolone belongs to a class of steroids that can signal the kidneys to hold onto sodium, and as a side effect the kidneys end up flushing out extra potassium in the urine. This is a well-recognized effect, especially at higher doses or with long-term use, so your doctor may check your potassium levels periodically. If you are taking prednisolone regularly, it is worth asking your pharmacist or doctor whether monitoring or a potassium supplement makes sense for you.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Prednisone
Moderate DepletionBrand names include Deltasone, Cortan, Orasone
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your muscles and heart depend on to work properly, and prednisone can nudge the kidneys into flushing out more of it than usual through the urine. Prednisone has some mineralocorticoid activity, meaning it signals the body to hold onto sodium, and the kidneys often respond by releasing extra potassium in exchange. At the moderate level, this is a real enough concern that doctors do watch for it, especially at higher doses or with long-term use. Ask your doctor or pharmacist whether your potassium levels should be checked periodically while you are on this medication.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Psyllium , Senna (OTC drug)
Moderate DepletionBrand names include Perdiem
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Senna is a stimulant laxative, meaning it pushes the bowel to contract and move things along quickly, and that speed can sweep potassium out of the body through the stool before it has a chance to be absorbed. This is rated a moderate concern, so it really only becomes a practical issue with heavy or prolonged use. If you find yourself reaching for this product regularly, that is worth a conversation with your pharmacist or doctor.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Psyllium Hydrophilic Mucilloid , Senna (OTC drug)
Moderate DepletionBrand names include Prodiem Plus
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is the mineral your muscles and heart depend on to contract and keep a steady rhythm. Senna works by stimulating the intestines to move things along faster, and when it is used too often or at high doses, the gut can flush out potassium before the body has a chance to absorb it properly. This is rated a moderate concern, meaning most people who use senna occasionally and at the recommended dose are fine, but those who rely on it regularly over a long stretch may be at real risk of low potassium levels. If you find yourself reaching for it often, that is a good reason to bring it up with your pharmacist or doctor.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Psyllium Hydrophilic Mucilloid , Senna (OTC drug) →
Psyllium Hydrophilic Mucilloid , Sennosides (OTC drug)
Moderate DepletionBrand names include Prompt
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. The sennosides in this combination product are stimulant laxatives, and when they are used heavily or over a long period, they can push the gut to move contents through so fast that potassium gets lost in the stool before the body can absorb it. This is a moderate concern, not just a theoretical one, so long-term or frequent users are worth watching. If this is something you reach for regularly, it is a good idea to bring it up with your pharmacist or doctor.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Psyllium Hydrophilic Mucilloid , Sennosides (OTC drug) →
Sennosides (OTC drug)
Moderate DepletionBrand names include Senokot XTRA, Senokot
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Sennosides works by stimulating the intestines to move things along faster, and when that happens repeatedly or at high doses, the gut can push out potassium before the body has a chance to absorb it. This is a moderate concern, meaning it is not just theoretical but also not a worry for someone using sennosides occasionally as directed. If you take it regularly or have used it for a while, it is worth asking your pharmacist or doctor whether your potassium levels should be checked.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Sodium Phosphate (OTC drug)
Moderate DepletionBrand names include Fleet Phospho-Soda, Fleet Accu-Prep
Use of high doses (> 45 mL in 24 hours), such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypokalemia. Avoid large doses, especially in the elderly and people with other risk factors for electrolyte disturbances. Advise people to avoid using high doses of these products for self-treatment of constipation.
Potassium is the mineral your heart rhythm, muscles, and nerves depend on to work properly. When sodium phosphate is taken in large amounts, such as the high doses used to clean out the bowel before a procedure, it can pull potassium out of balance by causing the body to lose it through the gut faster than normal intake can replace it. At the smaller doses used for occasional constipation relief this is much less of a concern, but at high doses the drop can be significant enough that some people need monitoring or even a supplement. If you are using this product at a high dose or have any heart or kidney conditions, it is worth a conversation with your pharmacist or doctor before you proceed.
References (2)
- Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
- Beloosesky Y, Grinblat J, Weiss A, et al. Electrolyte disorders following oral sodium phosphate administration for bowel cleansing in elderly patients. Arch Int Med 2003;163:803-8.. PubMed
Sodium Phosphate (prescription drug)
Moderate DepletionBrand names include Visicol
Use of high doses (> 45 mL in 24 hours), such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypokalemia. Avoid large doses, especially in the elderly and people with other risk factors for electrolyte disturbances. Advise people to avoid using high doses of these products for self-treatment of constipation.
Potassium is the mineral your heart rhythm and muscle function depend on, so keeping levels in a healthy range really matters. When sodium phosphate is used in high doses for bowel preparation, it pulls a large amount of fluid and electrolytes, including potassium, out of the body very quickly, which can drop potassium to a dangerously low level. This is a well-documented concern, not just a theoretical one, and older adults or people with certain health conditions face extra risk. If you are using a prescription sodium phosphate prep, your doctor or pharmacist should be monitoring your electrolytes and will let you know whether you need any replacement.
References (2)
- Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
- Beloosesky Y, Grinblat J, Weiss A, et al. Electrolyte disorders following oral sodium phosphate administration for bowel cleansing in elderly patients. Arch Int Med 2003;163:803-8.. PubMed
Full nutrient report for Sodium Phosphate (prescription drug) →
Sodium Picosulfate, Citric Acid, Magnesium Oxide (OTC drug)
Moderate DepletionBrand names include Pico-Salax
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia. Advise people to only use stimulant laxatives short-term at recommended doses.
Potassium is a mineral your heart rhythm and muscles depend on, and this bowel-prep product can flush a meaningful amount of it out through your intestines. Because it works by pushing fluid rapidly through the gut, potassium gets swept along with that fluid and lost in the stool rather than absorbed into your body. For a one-time bowel cleanse this is usually manageable, but the concern is real enough that some people do need a supplement afterward. It is worth asking your doctor or pharmacist whether your levels should be checked, especially if you take other medications that also affect potassium.
References (3)
- Ritsema GH, Ellers G. Potassium supplements prevent serious hypokalemia in colon cleansing. Clin Radiol 1994;49;874-6.
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Full nutrient report for Sodium Picosulfate, Citric Acid, Magnesium Oxide (OTC drug) →
Terbutaline
Moderate DepletionBrand names include Bricanyl, Brethine, Bricanyl Injection
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves all depend on to work properly. Terbutaline activates certain receptors that prompt your cells to pull extra potassium in from the bloodstream, which can nudge blood levels lower, especially at higher doses or during short-term intensive use. This is a moderate concern, so long-term or high-dose users are worth watching, and some people do end up needing a supplement. If you take terbutaline regularly, it is worth asking your pharmacist or doctor whether your potassium level should be checked.
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
Theophylline
Moderate DepletionBrand names include T-Phyl, Duraphyl, Aerolate JR
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Theophylline appears to push potassium from the bloodstream into your body's cells, which can nudge blood potassium levels lower, and that effect tends to be more noticeable at higher drug levels. This is a moderate concern, not just a theoretical one, so if you take theophylline regularly, it is worth asking your doctor or pharmacist whether your potassium levels should be checked, especially if you have other reasons your potassium might already run low.
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
Triamcinolone
Moderate DepletionBrand names include Aristocort, Kenacort, Adcortyl Intra-articular / Intradermal
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, so keeping levels in a healthy range really does matter. Triamcinolone is a corticosteroid that can act a bit like a hormone called aldosterone, signaling the kidneys to hold onto sodium while flushing extra potassium out in the urine. This is a moderate concern, meaning it does not affect everyone but is worth taking seriously, especially with longer-term or higher-dose use. If you use triamcinolone regularly, ask your pharmacist or doctor whether your potassium level should be checked.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
Triamcinolone Acetonide
Moderate DepletionBrand names include Zilretta, Xipere
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Triamcinolone acetonide is a corticosteroid that can act a bit like a hormone your body uses to manage salt balance, and one side effect of that is your kidneys may flush out more potassium than usual in the urine. Because this is rated as a moderate concern, people using this medication regularly are worth watching closely, and some do end up needing a supplement or dietary changes. Ask your doctor or pharmacist whether your potassium level should be checked.
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
POTASSIUM & medications: FAQs
Which medications can lower POTASSIUM?
I take one of these medications — am I deficient in POTASSIUM?
Should I start a POTASSIUM supplement?
Where does this information come from?
Other commonly implicated nutrients
Wondering about your POTASSIUM levels?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Medication associations with POTASSIUM are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.