Drug-induced nutrient depletion

Medications That May Deplete SODIUM

Sodium maintains fluid balance, blood pressure, and nerve/muscle function. See which medications carry a reported association, how strong the evidence is, and what to discuss with your pharmacist.

117Medications
117Depletion records
About SODIUM

Sodium maintains fluid balance, blood pressure, and nerve/muscle function.

Common food sources: Table salt and most processed foods — dietary shortage is rare; medication-related loss is about balance, not intake.

Sodium is part of routine blood work. If you take an associated medication (like certain diuretics or antidepressants), ask how often your electrolytes should be checked — especially if you feel confused, weak, or unusually tired.

Caution: Significant symptoms of low sodium (confusion, severe weakness) warrant prompt medical attention.

HelloPharmacist pharmacist-reviewed education. The medication records below are licensed clinical data, shown as published.

Deep dive: Sodium — uses, safety & drug interactions

The evidence

Medications associated with SODIUM depletion

Each record is shown as published in our licensed clinical database. Open a medication for its full nutrient report.

Agomelatine

Moderate Depletion

Brand names include Valdoxan

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Agomelatine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so low levels are worth paying attention to. Agomelatine, like other antidepressants, can in some people trigger the body to hold onto too much water by causing an overproduction of a hormone that tells the kidneys to keep fluid rather than flush it out. That extra water dilutes the sodium in your blood, which is called hyponatremia. This is a moderate concern, especially for older adults, so if you are on agomelatine long term, it is worth asking your pharmacist or doctor whether your sodium level should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Agomelatine →

Amitriptyline

Moderate Depletion

Brand names include Elavil

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Amitriptyline? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle function running properly, so when levels drop too low it can cause real problems. Amitriptyline, like other antidepressants, can trigger your body to hold onto too much water by causing the release of excess antidiuretic hormone, which dilutes the sodium in your blood. This is a moderate concern, and older adults appear to be at the highest risk. If you are taking amitriptyline long-term, it is worth asking your pharmacist or doctor whether your sodium levels should be checked periodically.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Amitriptyline →

Amitriptyline, Chlordiazepoxide

Moderate Depletion

Brand names include Limbitrol DS

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Amitriptyline, Chlordiazepoxide? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals running properly, so when levels drop too low it can cause real problems. Amitriptyline, a tricyclic antidepressant, can interfere with how your kidneys handle water by triggering a hormone that tells the body to hold onto too much fluid, which dilutes the sodium in your blood. This risk is considered moderate, and older adults are especially worth watching. If you notice symptoms like nausea, headache, or unusual confusion, bring it up with your doctor or pharmacist right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Amitriptyline, Chlordiazepoxide →

Amitriptyline, Perphenazine

Moderate Depletion

Brand names include Triavil, Etrafon, Etrafon-A

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Amitriptyline, Perphenazine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real problems. Amitriptyline, a tricyclic antidepressant, may interfere with this by triggering a hormonal chain reaction where the body holds onto too much water, which dilutes the sodium already in your bloodstream rather than truly losing sodium itself. Research suggests roughly 1 in 11 older adults on antidepressants like this one may be affected, so this is worth taking seriously, especially for seniors. If you are 65 or older, or if you notice unusual fatigue, headache, or confusion while taking this medication, bring it up with your pharmacist or doctor.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Amitriptyline, Perphenazine →

Amoxapine

Moderate Depletion

Brand names include Asendin

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Amoxapine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid levels balanced and help nerves and muscles fire properly, so low levels are worth taking seriously. Amoxapine, like other antidepressants, can trigger a hormonal chain reaction where the body holds onto too much water, which dilutes the sodium already in your bloodstream rather than actually draining it away. This risk is rated moderate, meaning it does not affect everyone but is real enough that certain patients, especially older adults, need monitoring. If you notice unusual symptoms like headache, confusion, or nausea while taking this medication, bring it up with your doctor or pharmacist right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Amoxapine →

Brexanolone

Moderate Depletion

Brand names include Zulresso

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Brexanolone? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid balance in check and to help nerves and muscles work properly. Brexanolone is a newer antidepressant, and like other drugs in that class, it may interfere with how the body regulates water by causing too much antidiuretic hormone to be released, which tells the kidneys to hold onto water. That extra water dilutes the sodium in your blood, which can bring levels down. This is rated a moderate concern, meaning it does not happen to everyone, but long-term users, especially older adults, are worth watching. If you notice symptoms like headache, confusion, or unusual fatigue while taking this medication, bring it up with your doctor or pharmacist right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Brexanolone →

Bupropion

Moderate Depletion

Brand names include Wellbutrin, Wellbutrin SR, Zyban

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Bupropion? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle contractions working properly, so when levels drop too low it can cause real problems. Bupropion, like other antidepressants, can sometimes cause the body to hold onto too much water by triggering a hormone that tells the kidneys to stop releasing fluid. That dilutes the sodium in your blood even though you have not lost any salt directly. This is more of a concern for older adults, so if you are in that group or notice symptoms like headache, confusion, or unusual fatigue while taking bupropion, it is worth bringing up with your pharmacist or doctor.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Bupropion →

Bupropion, Naltrexone

Moderate Depletion

Brand names include Contrave

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Bupropion, Naltrexone? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so low levels are worth taking seriously. Bupropion acts on the brain similarly to antidepressants, and antidepressants as a class can sometimes cause the body to hold onto too much water by triggering a hormone signal that tells the kidneys to stop releasing fluid. That dilutes the sodium in your bloodstream, which is the mechanism behind a condition called SIADH. This is rated as a moderate concern, meaning it does not happen to everyone but it is worth watching for, especially in older adults. If you notice symptoms like nausea, headache, confusion, or unusual fatigue while taking this medication, let your pharmacist or doctor know right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Bupropion, Naltrexone →

Buproprion, Dextromethorphan

Moderate Depletion

Brand names include Auvelity

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Buproprion, Dextromethorphan? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and blood pressure steady, so when levels drop too low it can cause real problems. This combination medication works on serotonin in the brain, and some antidepressants can trigger a hormone imbalance that causes the kidneys to hold onto water, which dilutes sodium in the blood rather than the body running short of sodium itself. The risk is rated moderate and is more of a concern for older adults or those on other medications that affect sodium. If you are a long-term user, it is worth asking your pharmacist or doctor whether your sodium level should be checked periodically.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Buproprion, Dextromethorphan →

Citalopram

Moderate Depletion

Brand names include Celexa

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Citalopram? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that helps keep your body's fluid balance steady and your nerves firing properly, so when it drops too low it can cause real symptoms like confusion, headache, or feeling off. Citalopram, like other SSRIs, can trigger the body to hold onto too much water by causing a hormonal glitch that tells the kidneys to keep water even when they shouldn't, which dilutes the sodium in your blood. This is rated a moderate concern, and older adults are at the highest risk. If you are taking citalopram long-term, especially as a senior, it is worth asking your pharmacist or doctor whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Citalopram →

Clomipramine

Moderate Depletion

Brand names include Anafranil, Anafranil SR

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Clomipramine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and blood pressure working properly, so running low on it is worth paying attention to. Clomipramine, like other antidepressants, can prompt the body to hold onto too much water by triggering the release of a hormone that tells the kidneys to stop flushing fluid out. That extra water dilutes the sodium already in your blood, which is how the level drops. This is rated a moderate concern, especially for older adults, so if you have been on clomipramine for a while it is worth mentioning to your doctor or pharmacist so they can decide whether any monitoring makes sense for you.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Clomipramine →

Desipramine

Moderate Depletion

Brand names include Norpramin, Pertofrane

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Desipramine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real symptoms. Desipramine, like other antidepressants, can trigger the body to hold onto too much water by causing an abnormal release of a hormone that tells the kidneys to stop flushing fluid out. That dilutes the sodium in your blood. This is a moderate concern, especially for older adults, and some people do need monitoring or treatment. If you are taking desipramine long-term, it is worth asking your doctor or pharmacist whether your sodium levels should be checked periodically.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Desipramine →

Desvenlafaxine

Moderate Depletion

Brand names include Pristiq, Khedezla

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Desvenlafaxine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to control fluid balance, nerve signals, and blood pressure, so keeping it in a healthy range really matters. Desvenlafaxine, like other antidepressants in its class, can cause the body to hold onto too much water by triggering a hormone signal that tells the kidneys to stop releasing fluid. That extra water dilutes the sodium in your blood, which is called hyponatremia. This is rated a moderate concern, especially for older adults, so if you notice symptoms like headache, confusion, or unusual fatigue while taking this medication, let your pharmacist or doctor know right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Desvenlafaxine →

Doxepin

Moderate Depletion

Brand names include Sinequan, Zonalon

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Doxepin? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real problems. Doxepin, a tricyclic antidepressant, may interfere with how your kidneys handle water by triggering the release of too much antidiuretic hormone, a signal that tells the kidneys to hold onto water. That extra water dilutes the sodium in your blood, which is a condition called hyponatremia. This is a moderate concern, especially in older adults, so if you have been on doxepin long-term it is worth asking your doctor or pharmacist whether your sodium level should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Doxepin →

Duloxetine

Moderate Depletion

Brand names include Cymbalta, Drizalma Sprinkle, Irenka

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Duloxetine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real symptoms. Duloxetine, like other antidepressants, can sometimes cause the body to hold onto too much water by triggering a hormone signal that tells the kidneys to stop releasing fluid normally. That dilutes the sodium in your bloodstream, which is called hyponatremia. This is a moderate concern, especially for older adults, so if you are taking duloxetine long-term it is worth mentioning to your pharmacist or doctor, particularly if you ever feel unusually confused, dizzy, or nauseated.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Duloxetine →

Escitalopram

Moderate Depletion

Brand names include Lexapro

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Escitalopram? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real symptoms. Escitalopram appears to interfere with how the body regulates water retention: it can trigger a hormonal signal that tells the kidneys to hold onto too much water, which dilutes the sodium in your blood. This is rated a moderate concern, and while most people on escitalopram do not develop a problem, older adults are at notably higher risk and should be aware of warning signs like unusual headaches, confusion, or nausea. If you or a family member are in that group, it is worth bringing up with your pharmacist or doctor.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Escitalopram →

Esketamine

Moderate Depletion

Brand names include Spravato

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Esketamine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and blood pressure working properly, so when levels drop too low it can cause real symptoms. Esketamine, used as an antidepressant, may trigger the body to hold onto too much water by causing an overrelease of a hormone that tells the kidneys to keep fluid in, and that extra fluid dilutes the sodium in your blood. This is a moderate concern, meaning it does not affect everyone but is worth watching for, especially in older adults. If you notice unusual headache, confusion, nausea, or swelling while using esketamine, bring it up with your doctor or pharmacist right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Esketamine →

Fluoxetine

Moderate Depletion

Brand names include Prozac, Sarafem

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Fluoxetine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it becomes a real concern. Fluoxetine, like other SSRIs, can cause the body to hold onto too much water by triggering the release of a hormone that tells the kidneys to stop flushing fluids out. That dilutes the sodium in your blood, and in some people, especially older adults, it can drop to a clinically significant level. If you are 65 or older or notice symptoms like unusual headaches, confusion, or nausea while taking fluoxetine, it is worth bringing up with your pharmacist or doctor.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Fluoxetine →

Fluvoxamine

Moderate Depletion

Brand names include Luvox

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Fluvoxamine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can become a real problem. Fluvoxamine, like other SSRIs, can trigger a hormonal chain reaction where the body holds onto too much water, which dilutes the sodium in your blood rather than directly draining it. This is rated a moderate concern, and older adults appear to be at the greatest risk. If you are elderly or taking other medications that also affect sodium, it is worth bringing this up with your pharmacist or doctor so they can decide whether any monitoring makes sense for you.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Fluvoxamine →

Gepirone

Moderate Depletion

Brand names include Exxua

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Gepirone? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so low levels can make you feel off in noticeable ways. Gepirone is related to antidepressants that act on serotonin, and those drugs can cause the body to hold onto too much water by triggering a hormone that tells the kidneys to stop releasing fluid. That dilutes the sodium in your blood rather than draining it out directly. This is a moderate concern, especially in older adults, so if you notice unusual fatigue, headache, or confusion while taking gepirone, let your pharmacist or doctor know right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Gepirone →

Imipramine

Moderate Depletion

Brand names include Tofranil, Tofranil PM

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Imipramine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so low levels are worth catching early. Imipramine, like other antidepressants, can nudge the body into holding too much water by triggering a hormone signal that tells the kidneys to stop releasing fluid normally. That dilutes the sodium in your blood even without you losing any. This is a moderate concern, especially for older adults, so if you take imipramine long-term it is worth mentioning to your pharmacist or doctor so they can decide whether any monitoring makes sense for you.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Imipramine →

Isocarboxazid

Moderate Depletion

Brand names include Marplan

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Isocarboxazid? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can become a real problem. Isocarboxazid, like other antidepressants, may trigger the body to hold onto too much water by prompting an overrelease of a hormone called ADH, which dilutes the sodium in your blood. This is rated a moderate concern, and older adults appear to be at higher risk. If you have been on this medication for a while, it is worth asking your doctor or pharmacist whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Isocarboxazid →

Lofepramine

Moderate Depletion

Brand names include Feprapax, Lomont, Gamanil

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Lofepramine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that keeps your body's fluid balance and nerve signals working properly, so when levels drop too low it can cause real symptoms. Lofepramine, a tricyclic antidepressant, has been linked to low sodium through a process where the body holds onto too much water, diluting sodium in the blood rather than the drug blocking sodium from food. This is rated a moderate concern, and older adults appear to be at higher risk, with roughly 1 in 10 elderly patients on antidepressants affected. If you are on lofepramine long term, especially if you notice unusual headaches, confusion, or fatigue, it is worth bringing that up with your pharmacist or doctor.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Lofepramine →

Maprotiline

Moderate Depletion

Brand names include Ludiomil

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Maprotiline? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it is a real concern. Maprotiline, like other antidepressants, can cause the body to hold onto too much water by triggering a hormone that tells the kidneys to stop releasing it, and that extra water dilutes the sodium in your blood. This is rated as a moderate concern, and older adults appear to be at higher risk. If you are on maprotiline long-term, it is worth asking your pharmacist or doctor whether your sodium levels should be checked periodically.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Maprotiline →

Mirtazapine

Moderate Depletion

Brand names include Remeron

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Mirtazapine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid balance in check and help nerves and muscles fire properly. Mirtazapine, like other antidepressants, can in some people cause the body to hold onto too much water by triggering an overproduction of a hormone that tells the kidneys to stop releasing fluid. That extra water dilutes the sodium in your blood, which can drive levels too low. This is more of a concern for older adults taking the medication long term, so if that sounds like you, it is worth having a conversation with your pharmacist or doctor about whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Mirtazapine →

Moclobemide

Moderate Depletion

Brand names include Manerix

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Moclobemide? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels dip too low it can cause real symptoms. Moclobemide is an antidepressant, and antidepressants as a class have been linked to low sodium in some patients, most often older adults. The likely reason is that the drug can trigger the body to hold onto too much water by releasing extra amounts of a hormone called ADH, which dilutes the sodium in your blood. This is rated a moderate concern, so if you are elderly or have other risk factors, it is worth asking your pharmacist or doctor whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Moclobemide →

nefazodone

Moderate Depletion

Brand names include Serzone

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking nefazodone? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to control fluid balance, nerve signaling, and blood pressure, so keeping levels in a healthy range really matters. Nefazodone, like other antidepressants, can cause the body to release too much of a hormone called ADH, which tells the kidneys to hold onto water rather than flush it out. That extra water dilutes the sodium in your blood, which is why low sodium levels have been reported with this drug class, particularly in older adults. This is rated a moderate concern, so if you are taking nefazodone long-term, it is worth asking your pharmacist or doctor whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for nefazodone →

Nortriptyline

Moderate Depletion

Brand names include Pamelor, Aventyl, Allegron

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Nortriptyline? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that keeps your body's fluid balance and nerve signals working properly, so when levels drop too low it can cause real problems. Nortriptyline, like other antidepressants, can sometimes cause the body to hold onto too much water by triggering the release of a hormone that tells your kidneys to stop flushing fluid out. That dilutes the sodium in your blood, rather than the drug blocking sodium from food. This is a moderate concern, meaning most people do fine, but older adults in particular are worth watching more closely. If you have been on nortriptyline long-term, it is worth asking your pharmacist or doctor whether checking your sodium level makes sense for you.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Nortriptyline →

Oxcarbazepine

Moderate Depletion

Brand names include Trileptal, Oxtellar XR

Taking oxcarbazepine might increase the risk of hyponatremia.
Clinical research shows that the incidence of hyponatremia in patients using oxcarbazepine is 24.7%, with 8.2% of patients experiencing severe hyponatremia. For each 1 mg increase in oxcarbazepine dose, the risk of hyponatremia appears to increase by 0.2%. Serum sodium levels should be measured in patients showing symptoms of hyponatremia, such as headache, malaise, somnolence, and gait disturbances.
Taking Oxcarbazepine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that helps regulate fluid balance and keeps your nerves and muscles firing correctly, so when levels drop too low it can affect how you feel and even how you walk. Oxcarbazepine appears to cause the body to retain too much water, which dilutes the sodium in your blood rather than actually flushing the mineral out. This is a well-documented concern: studies suggest roughly one in four people taking this medication experience some degree of low sodium, so it is not something to brush off. If you are on oxcarbazepine long-term, it is worth asking your pharmacist or doctor whether periodic sodium checks make sense for you, especially if you notice headaches, unusual tiredness, or feel unsteady on your feet.

References (1)
  1. Lin CH, Lu CH, Wang FJ, et al. Risk factors of oxcarbazepine-induced hyponatremia in patients with epilepsy. Clin Neuropharmacol 2010;33(6):293-296. PubMed

Full nutrient report for Oxcarbazepine →

Paroxetine

Moderate Depletion

Brand names include Paxil CR, Paxil, Brisdelle

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Paroxetine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance steady and helps your nerves and muscles fire correctly, so when levels drop too low it can cause real problems. Paroxetine, like other SSRIs, can trigger the body to hold onto too much water by causing a hormone called ADH to be released in excess, which dilutes the sodium in your bloodstream. This is rated as a moderate concern, meaning it does not happen to everyone but is worth taking seriously, especially for older adults. If you are on paroxetine long-term, it is a good idea to ask your doctor or pharmacist whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Paroxetine →

Phenelzine Sulfate

Moderate Depletion

Brand names include Nardil

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Phenelzine Sulfate? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that helps control fluid balance and keeps your nerves and muscles firing properly, so keeping it in a healthy range really matters. Phenelzine, like other antidepressants, can sometimes cause the body to hold onto too much water by triggering a hormone signal that tells the kidneys to stop releasing fluid. That dilutes the sodium in your blood, which is called hyponatremia. This is a moderate concern, especially for older adults, so let your doctor or pharmacist know right away if you notice symptoms like unusual headaches, confusion, or nausea while taking this medication.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Phenelzine Sulfate →

Protriptyline

Moderate Depletion

Brand names include Vivactil

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Protriptyline? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real problems. Protriptyline, like other tricyclic antidepressants, may interfere with how your kidneys handle water by triggering a hormone signal that tells the body to hold on to too much fluid, which dilutes the sodium in your bloodstream. This is a recognized concern, especially in older adults, so if you have been taking protriptyline long-term and notice symptoms like headache, confusion, or unusual fatigue, it is worth bringing up with your doctor or pharmacist.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Protriptyline →

Selegiline

Moderate Depletion

Brand names include Carbex, Eldepryl, Emsam

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Selegiline? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance steady and helps your nerves and muscles fire correctly, so low levels are worth catching early. Selegiline is used as an antidepressant, and antidepressants as a class can sometimes cause the body to hold onto too much water by triggering an overproduction of antidiuretic hormone, which dilutes the sodium in your blood. This is rated a moderate concern, meaning it does not happen to everyone but it is real enough to watch for, especially in older adults. If you are on selegiline long-term, it is worth asking your pharmacist or doctor whether your sodium level should be checked periodically.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Selegiline →

Sertraline

Moderate Depletion

Brand names include Zoloft

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Sertraline? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance and nerve signals working properly, so when levels drop too low it can cause real symptoms like confusion, headache, or weakness. Sertraline, as an SSRI, can trigger the body to release too much of a hormone that tells the kidneys to hold onto water, which dilutes the sodium in your blood rather than actually draining sodium out. This is a moderate concern, meaning most people are fine, but older adults are at higher risk and deserve closer watching. If you are taking sertraline long-term, it is worth asking your pharmacist or doctor whether your sodium level should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Sertraline →

Tranylcypromine

Moderate Depletion

Brand names include Parnate

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Tranylcypromine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real problems. Tranylcypromine, like other antidepressants, may trigger a hormone imbalance that tells your kidneys to hold onto water instead of releasing it, which dilutes the sodium already in your bloodstream. This is a moderate concern, especially for older adults, and some people on this medication do need monitoring or even supplementation. If you are taking tranylcypromine long-term, it is worth asking your doctor or pharmacist whether your sodium level should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Tranylcypromine →

Trazodone

Moderate Depletion

Brand names include Desyrel, Oleptro

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Trazodone? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid balance in check and help nerves and muscles fire correctly, so low levels are worth taking seriously. Trazodone, like other antidepressants, can cause the body to hold onto too much water by triggering a hormone signal that tells the kidneys to stop releasing fluid. That dilutes the sodium in your blood even though you are not losing salt directly. Older adults appear to be at higher risk, so if you are taking trazodone long-term, it is worth asking your pharmacist or doctor whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Trazodone →

Trazodone HCl

Moderate Depletion

Brand names include Trazorel

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Trazodone HCl? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the electrolyte your body uses to keep fluid balance steady and your nerves firing properly, so low levels can cause real symptoms. Trazodone, like other antidepressants, can sometimes trigger a hormonal glitch where the body holds onto too much water, which dilutes sodium in the blood rather than the drug blocking sodium from food or flushing it through the kidneys. This is rated a moderate concern, and older adults appear to be at the greatest risk. If you take trazodone regularly, it is worth asking your doctor or pharmacist whether your sodium level should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Trazodone HCl →

Trimipramine

Moderate Depletion

Brand names include Surmontil, Trimip, Rhotrimine

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Trimipramine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so when levels drop too low it can cause real problems. Trimipramine, a tricyclic antidepressant, may interfere with this by triggering the body to release too much of a hormone that tells the kidneys to hold onto water, which dilutes the sodium in your blood. This is a moderate concern, particularly for older adults, and not everyone on this medication will be affected. If you are taking trimipramine long-term, it is worth asking your pharmacist or doctor whether your sodium levels should be checked periodically.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Trimipramine →

Venlafaxine

Moderate Depletion

Brand names include Effexor XR, Effexor

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Venlafaxine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that keeps your body's fluid balance steady and helps your nerves and muscles fire correctly, so when levels drop too low it can cause real problems. Venlafaxine, like other antidepressants in its class, can sometimes cause the body to hold onto too much water by triggering a hormone signal that tells the kidneys to keep fluid in rather than pass it out. That extra water dilutes the sodium in your blood, which is how the level falls. This is a moderate concern, especially for older adults, so if you take venlafaxine long-term it is worth asking your pharmacist or doctor whether your sodium levels should be checked.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Venlafaxine →

Vilazodone

Moderate Depletion

Brand names include Viibryd

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Vilazodone? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so low levels are worth taking seriously. Vilazodone works similarly to SSRIs, and these medications can cause the body to release too much of a hormone called ADH, which tells the kidneys to hold onto water. That extra water dilutes the sodium in your blood, sometimes to a level that causes symptoms. This pattern is rated moderate, meaning it does not happen to everyone but is common enough, especially in older adults, that your doctor or pharmacist should know if you develop headache, confusion, or unusual fatigue while taking it.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Vilazodone →

Vortioxetine

Moderate Depletion

Brand names include Trintellix, Brintellix, Sehippy

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Vortioxetine? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and blood pressure working properly, so low levels are worth catching early. Vortioxetine, like other serotonin-based antidepressants, can trigger a hormonal chain reaction where the body holds onto too much water, diluting sodium in the blood rather than actually losing sodium itself. This risk is real enough that it carries a moderate rating, and older adults appear to be most vulnerable. If you are on vortioxetine long-term, it is worth asking your doctor or pharmacist whether your sodium level should be checked periodically.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Vortioxetine →

Zuranolone

Moderate Depletion

Brand names include Zurzuvae

Taking antidepressant drugs might increase the risk of hyponatremia.
In humans, antidepressant drugs, including the selective serotonin reuptake inhibitors (SSRIs) sertraline, escitalopram, fluoxetine, and paroxetine, increase the risk of hyponatremia in some patients, particularly the elderly. Clinical evidence shows that the risk of hyponatremia in elderly patients taking antidepressants such as SSRIs or tricyclic antidepressants is approximately 9%. Antidepressant-induced hyponatremia appears to be due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by over-secretion of antidiuretic hormone.
Taking Zuranolone? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that keeps your body's fluid balance and nerve signaling working properly, so when levels drop too low it can cause symptoms like confusion, headache, or weakness. Zuranolone works on the brain similarly to other antidepressants, and those drugs have been linked to a condition where the body holds onto too much water, which dilutes sodium in the blood. This is a real enough concern that your doctor or pharmacist should be watching for it, especially if you are older or taking other medications that affect sodium. If you notice unusual fatigue, nausea, or mental fogginess while taking zuranolone, let your healthcare team know right away.

References (3)
  1. Giorlando F, Teister J, Dodd S, Udina M, Berk M. Hyponatraemia: an audit of aged psychiatry patients taking SSRIs and SNRIs. Curr Drug Saf 2013;8(3):175-80. PubMed
  2. Wilkinson TJ, Begg EJ, Winter AC, Sainsbury R. Incidence and risk factors for hyponatraemia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol 1999;47(2):211-217. PubMed
  3. Mannesse CK, Jansen PA, Van Marum RJ, Sival RC, Kok RM, Haffmans PM, Egberts TC. Characteristics, prevalence, risk factors, and underlying mechanism of hyponatremia in elderly patients treated with antidepressants: a cross-sectional study. Maturitas 2013; PubMed

Full nutrient report for Zuranolone →

Acetaminophen, Caffeine, Pyrilamine

Insufficient Evidence

Brand names include Midol Max Strength Menstrual

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Acetaminophen, Caffeine, Pyrilamine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid balance steady and help nerves and muscles fire correctly. This combination product contains pyrilamine, an antihistamine with some mild diuretic-like properties, and the concern here is purely theoretical: there is a thought that any drug nudging the kidneys toward losing more sodium could, in rare cases, lower blood sodium levels. That said, the evidence for this specific product is simply too limited to know whether it matters at all in real life, so most people taking it occasionally have nothing to worry about. If you use it regularly or have questions about your sodium levels, a quick chat with your pharmacist or doctor is always a reasonable step.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Acetaminophen, Caffeine, Pyrilamine →

Acetaminophen, Pamabrom, Pyrilamine

Insufficient Evidence

Brand names include Midol Max Strength PMS, Pamprin, Pamprin ES

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Acetaminophen, Pamabrom, Pyrilamine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Pamabrom, the mild diuretic ingredient in this combination product, works by nudging your kidneys to release more fluid, and there is a theoretical concern that this process could also carry some sodium out of the body. Sodium is the mineral that keeps your fluid balance, nerve signals, and muscle function on track. That said, pamabrom is a very gentle diuretic, and right now there simply is not enough evidence to know whether this combination meaningfully affects sodium levels in real patients. Most people using this occasional product do not need to worry, but if you have any questions about your sodium levels, it is worth a quick chat with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Acetaminophen, Pamabrom, Pyrilamine →

Acetazolamide

Insufficient Evidence

Brand names include Diamox, Ak-Zol

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Acetazolamide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it carefully. Acetazolamide works differently from the loop and thiazide diuretics most often linked to low sodium, but because it is still a diuretic that affects how your kidneys handle fluid and electrolytes, a theoretical concern exists. Right now the evidence is too limited to know whether this is a real problem in practice, so most people taking acetazolamide do not need to worry about this specifically. That said, if you notice unusual symptoms like headache, confusion, or swelling while on this medication, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Acetazolamide →

Amiloride, Hydrochlorothiazide

Insufficient Evidence

Brand names include Moduretic, Amilzide, Moduret 25

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Amiloride, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so having too little of it is a real concern. The hydrochlorothiazide portion of this combination works in the kidneys to push more sodium out through your urine, which is actually how it lowers blood pressure. That said, the evidence linking this specific combination to a meaningful drop in sodium levels is considered insufficient, meaning researchers simply do not have enough data yet to know how often it truly matters in practice. If you take this medication long-term, it is worth mentioning to your pharmacist or doctor, especially if you ever feel unusually tired, confused, or nauseated.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Amiloride, Hydrochlorothiazide →

Ammonium Chloride

Insufficient Evidence
Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Ammonium Chloride? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body control fluid balance, blood pressure, and nerve signaling, so keeping it in a healthy range really matters. Ammonium chloride is a diuretic, meaning it nudges the kidneys to release more fluid, and in theory that process could also cause some extra sodium to be lost in the urine. That said, the evidence for this specific drug is too limited to know whether it is a real concern in practice. If you are taking ammonium chloride regularly, it is worth mentioning to your pharmacist or doctor, but there is no clear reason for alarm right now.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Ammonium Chloride →

Atenolol, Chlortalidone

Insufficient Evidence

Brand names include AtenixCo, Totaretic, Tenoret 50

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Atenolol, Chlortalidone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so having too little of it can make you feel weak, dizzy, or confused. Chlortalidone is a thiazide-type diuretic, meaning it works partly by telling your kidneys to release more sodium into the urine, and in rare cases that process can push sodium levels too low. That said, the evidence here is rated insufficient, so this is more of a theoretical watch-out than a well-proven concern for most people. If you take this combination long-term, it is worth mentioning to your pharmacist or doctor so they can keep an eye on your labs if appropriate.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Atenolol, Chlortalidone →

Atenolol, Chlorthalidone

Insufficient Evidence

Brand names include Tenoretic

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Atenolol, Chlorthalidone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that keeps your body's fluid balance and nerve signals working properly. Chlorthalidone is a thiazide-type diuretic, and diuretics work by telling your kidneys to release more sodium into the urine, which is actually how they help lower blood pressure. In rare cases this can tip sodium levels too low, a condition called hyponatremia, but the evidence here is rated insufficient, meaning there simply is not enough data yet to know how often or how seriously this applies to most people. If you ever feel unusually dizzy, confused, or fatigued while taking this medication, that is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Atenolol, Chlorthalidone →

Azilsartan, Chlorthalidone

Insufficient Evidence

Brand names include Edarbyclor

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Azilsartan, Chlorthalidone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid levels balanced and nerves firing properly. The chlorthalidone component of this combination is a thiazide-type diuretic, meaning it works partly by telling your kidneys to release more sodium into the urine. While that action is actually how it helps lower blood pressure, there is a theoretical concern that it could, in some people, push sodium levels too low. The evidence here is rated insufficient, so this is more of a watch-out than a proven problem. If you ever feel unusually dizzy, confused, or nauseated while taking this medication, that is worth mentioning to your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Azilsartan, Chlorthalidone →

Benazepril, Hydrochlorothiazide

Insufficient Evidence

Brand names include Lotensin HCT

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Benazepril, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to balance fluids and keep your muscles and nerves firing properly. The hydrochlorothiazide part of this combination works in the kidneys to push sodium out through urine, which is actually part of how it lowers blood pressure. In rare cases, that same action can drop sodium levels too far, a condition called hyponatremia. The evidence here is still insufficient to say how often this is a real concern, so if you notice symptoms like unusual fatigue, nausea, or confusion while taking this medication, let your pharmacist or doctor know right away.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Benazepril, Hydrochlorothiazide →

Bendroflumethiazide

Insufficient Evidence

Brand names include Naturetin, Aprinox, Neo-NaClex

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Bendroflumethiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to control fluid balance, blood pressure, and nerve signaling. Bendroflumethiazide is a thiazide diuretic, meaning it works in the kidneys to push more sodium out through urine, which is actually part of how it lowers blood pressure. In a small number of people, especially older adults or those on higher doses, this can occasionally lead to sodium levels dropping too low. Right now the evidence is too limited to know exactly how often this is a real concern, but if you ever feel unusually tired, nauseated, confused, or dizzy while taking this medication, that is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Bendroflumethiazide →

Bendroflumethiazide, Nadolol

Insufficient Evidence

Brand names include Corzide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Bendroflumethiazide, Nadolol? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to balance fluids and keep nerves and muscles firing properly. Bendroflumethiazide is a thiazide diuretic, and thiazides work by telling the kidneys to release more sodium into the urine rather than holding onto it. In rare cases that can tip sodium levels too low, but right now the evidence is considered insufficient, meaning we simply do not have enough data to know how meaningful this is for most people. If you have been on this medication long-term, it is worth mentioning to your pharmacist or doctor so they can decide whether any monitoring makes sense for you.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Bendroflumethiazide, Nadolol →

Bendroflumethiazide, Potassium

Insufficient Evidence

Brand names include Neo-NaClex-K, Centyl K

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Bendroflumethiazide, Potassium? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that helps control fluid balance and keeps your muscles and nerves working properly. Bendroflumethiazide is a thiazide diuretic, meaning it works in the kidneys to push out extra fluid, and sodium leaves the body along with that fluid. The evidence here is rated insufficient, so we do not have a clear picture of how often this matters in practice, though in rare cases thiazide diuretics have been linked to low sodium levels. If you have been on this medication long term, it is worth asking your pharmacist or doctor whether any routine blood work to check your sodium levels makes sense for you.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Bendroflumethiazide, Potassium →

Brand names include Rauzide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Bendroflumethiazide, Rauwolfia Serpentina? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so having too little of it can cause real problems. Bendroflumethiazide is a thiazide diuretic, meaning it works on your kidneys to push out extra fluid by reducing how much sodium they hold onto. Because of that mechanism, there is a theoretical concern that sodium levels could dip too low in some people, though the actual evidence for this combination product is not strong enough to draw firm conclusions. If you take this medication long-term, it is worth mentioning to your pharmacist or doctor, especially if you ever feel unusually tired, confused, or nauseated.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Bendroflumethiazide, Rauwolfia Serpentina →

Benzthiazide

Insufficient Evidence

Brand names include Exna

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Benzthiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is something your body uses to control fluid balance, nerve signals, and muscle function, so keeping levels in a normal range really matters. Benzthiazide is a thiazide-type diuretic, and drugs in this class work partly by signaling the kidneys to release more sodium into the urine rather than holding onto it. In rare cases, that extra sodium loss can drop blood levels low enough to cause a problem called hyponatremia. That said, the evidence for benzthiazide specifically is too thin to know how often this is a real concern, so if you have any questions about your sodium levels, bring them up with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Benzthiazide →

Bisoprolol, Hydrochlorothiazide

Insufficient Evidence

Brand names include Ziac

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Bisoprolol, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body control fluid balance, nerve signals, and blood pressure, so keeping levels in a healthy range really matters. The hydrochlorothiazide portion of this combination works in the kidneys to push out extra sodium through urine, which is actually part of how it lowers blood pressure. In a small number of people, this process can tip sodium levels too low. The evidence here is still limited, so there is no clear action most patients need to take, but if you ever feel unusually tired, confused, or nauseated while on this medication, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Bisoprolol, Hydrochlorothiazide →

Bumetanide

Insufficient Evidence

Brand names include Burinex

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Bumetanide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and blood pressure working properly, so your body guards it carefully. Bumetanide is a loop diuretic, meaning it works in the kidneys to push extra fluid out through urine, and sodium goes along with it. The evidence here is listed as insufficient, so we honestly do not know how often this matters in practice. Severe sodium loss is uncommon, but if you take bumetanide long-term and notice symptoms like unusual fatigue, headache, or confusion, that is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Bumetanide →

Bumetanide, Potassium

Insufficient Evidence

Brand names include Burinex K

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Bumetanide, Potassium? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles firing properly, so keeping levels in a healthy range matters. Bumetanide is a loop diuretic, meaning it works in the kidneys to push out extra fluid, and sodium rides along with that fluid out of your body. Right now the evidence is too limited to know how often this actually causes a problem, so there is no reason to worry, but if you are on this medication long term it is worth asking your pharmacist or doctor whether your sodium has been checked.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Bumetanide, Potassium →

Brand names include Trim-Elim

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Caffeine, Potassium Salicylate, Salicylamide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body control fluid balance, nerve signals, and muscle function, so keeping it in a normal range matters. This combination product has a theoretical diuretic effect, meaning it could nudge the kidneys to release more sodium in the urine. That said, the evidence here is rated insufficient, so researchers simply do not know whether this is a real concern in practice. If you use this product regularly and ever feel unusually dizzy, weak, or confused, those are good reasons to mention it to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Caffeine, Potassium Salicylate, Salicylamide →

Brand names include Atacand HCT

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Candesartan Cilexetil, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body control fluid balance, blood pressure, and nerve signals, so keeping levels in a healthy range matters. The hydrochlorothiazide portion of this combination works in the kidneys to push sodium out through urine, which is actually part of how it lowers blood pressure. Dropping sodium too low is uncommon, but it has been reported with thiazide diuretics in some people. Right now the evidence is not strong enough to know how often this is a real concern with this specific combination, so just mention it to your pharmacist or doctor if you feel unusually tired, dizzy, or unwell.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Candesartan Cilexetil, Hydrochlorothiazide →

Captopril, Hydrochlorothiazide

Insufficient Evidence

Brand names include Capozide, Acezide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Captopril, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so levels that drop too low can cause real problems. Hydrochlorothiazide, the thiazide diuretic in this combination, works partly by telling the kidneys to release more sodium into the urine, which is actually part of how it lowers blood pressure. In some people, especially older adults or those on higher doses, this can occasionally push sodium levels too low, a condition called hyponatremia. That said, the overall evidence here is rated insufficient, meaning there is not enough data to say how often or how seriously this affects most patients, so bring it up with your doctor or pharmacist if you have questions or notice symptoms like unusual fatigue or confusion.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Captopril, Hydrochlorothiazide →

Chlorothiazide

Insufficient Evidence

Brand names include Diuril

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Chlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it carefully. Chlorothiazide is a thiazide diuretic that works in the kidneys by reducing how much sodium gets pulled back into the bloodstream, which means more sodium leaves the body through urine. For most people this stays within a safe range, but in some cases sodium can drop low enough to cause symptoms. The evidence here is still thin, so researchers aren't sure how often this is truly a concern. If you take this medication long-term, it's worth asking your pharmacist or doctor whether your sodium level should be checked periodically.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Chlorothiazide →

Chlorothiazide, Methyldopa

Insufficient Evidence

Brand names include Aldoclor 150, Aldochlor, Aldoclor 250

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Chlorothiazide, Methyldopa? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it closely. Chlorothiazide is a thiazide diuretic, meaning it tells your kidneys to release more sodium into the urine as part of how it lowers blood pressure. In rare cases this can push sodium levels too low, a condition called hyponatremia. That said, the evidence here is rated insufficient, so the clinical importance is genuinely unclear. If you are taking this medication long term, it is worth asking your doctor or pharmacist whether your sodium levels have been checked.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Chlorothiazide, Methyldopa →

Chlorothiazide, Reserpine

Insufficient Evidence

Brand names include Diupres

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Chlorothiazide, Reserpine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your muscles contract, your nerves fire, and your body hold the right amount of fluid, so keeping levels balanced matters. Chlorothiazide is a thiazide diuretic, and this type of medication works partly by telling your kidneys to release more sodium into your urine rather than holding onto it. That said, the current evidence on this combination is too limited to know how meaningful it really is in practice, and most people taking it do not need to worry. If you have any concerns, it is worth a quick conversation with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Chlorothiazide, Reserpine →

Chlorthalidone

Insufficient Evidence

Brand names include Hygroton, Thalitone

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Chlorthalidone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that helps control fluid balance and keeps nerves and muscles firing properly. Chlorthalidone works by telling the kidneys to release more sodium into the urine, which is actually how it lowers blood pressure, but that same action could theoretically tip sodium levels too low in some people. The evidence here is rated insufficient, meaning researchers have noted this possibility but do not yet have enough data to say how often or how seriously it applies. Severe drops in sodium are uncommon, but if you take chlorthalidone long-term and notice symptoms like unusual confusion, headache, or muscle weakness, that is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Chlorthalidone →

Chlorthalidone, Clonidine

Insufficient Evidence

Brand names include Clorpres, Combipres

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Chlorthalidone, Clonidine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is something your body depends on for fluid balance, nerve signals, and muscle function. Chlorthalidone is a thiazide-like diuretic, meaning it works partly by telling your kidneys to release more sodium into your urine. That process is actually the point of the medication, but in rare cases it can push sodium levels too low. The evidence here is rated insufficient, so this is something worth mentioning to your doctor or pharmacist if you ever feel unusually fatigued, confused, or dizzy while taking it.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Chlorthalidone, Clonidine →

Cryptenamine, Methyclothiazide

Insufficient Evidence

Brand names include Diutensen

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Cryptenamine, Methyclothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle contractions working properly, so having too little of it can cause real problems. Methyclothiazide is a thiazide diuretic, meaning it works on the kidneys to push out extra sodium in your urine as part of how it lowers blood pressure. Severe drops in sodium are uncommon, but they have been reported with this class of drug. The evidence here is rated insufficient, so there is no clear guidance on routine monitoring, but if you ever feel unusually tired, confused, or nauseated while taking this medication, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Cryptenamine, Methyclothiazide →

Cyclothiazide

Insufficient Evidence

Brand names include Fluidil, Anhydron

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Cyclothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles working properly, so keeping it in a healthy range matters. Cyclothiazide is a thiazide diuretic, meaning it works partly by telling your kidneys to release more sodium into the urine rather than holding onto it. That said, the evidence connecting this specific drug to a meaningful sodium drop is currently rated as insufficient, so we simply do not have enough data to know how often or how seriously this occurs in practice. If you are a long-term user, it is worth mentioning to your pharmacist or doctor so they can decide whether any monitoring makes sense for you.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Cyclothiazide →

Deserpidine, Hydrochlorothiazide

Insufficient Evidence

Brand names include Oreticyl Forte, Oreticyl

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Deserpidine, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly. The hydrochlorothiazide in this combination is a thiazide diuretic, meaning it works by telling the kidneys to release more sodium into the urine, which is actually part of how it lowers blood pressure. In rare cases that can tip sodium levels too low, a condition called hyponatremia. The evidence here is rated insufficient, so there is no clear reason to worry, but if you ever feel unusually dizzy, confused, or nauseated while on this medication, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Deserpidine, Hydrochlorothiazide →

Deserpidine, Methyclothiazide

Insufficient Evidence

Brand names include Enduronyl Forte, Enduronyl

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Deserpidine, Methyclothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so keeping it in a healthy range matters. Methyclothiazide is a thiazide diuretic, meaning it works in the kidneys to push more sodium out through your urine, which is actually part of how it lowers blood pressure. Severe drops in sodium are uncommon, but they have been reported with this class of drug in some people. Right now the evidence is not strong enough to say how often this is a real concern with this specific combination, so if you ever feel unusually tired, dizzy, or confused while taking it, bring that up with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Deserpidine, Methyclothiazide →

Brand names include Vaseretic

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Enalapril Maleate, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to balance fluids and keep nerves and muscles firing properly. The hydrochlorothiazide in this combination pill works in the kidneys to push out extra sodium through urine, which is actually part of how it lowers blood pressure. In rare cases, that process can drop sodium levels too low, a condition called hyponatremia. That said, evidence for this being a meaningful concern is still considered insufficient, so most people on this medication do not need to worry, but if you ever feel unusually weak, dizzy, or confused, let your doctor or pharmacist know right away.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Enalapril Maleate, Hydrochlorothiazide →

Ethacrynic Acid

Insufficient Evidence

Brand names include Edecrin

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Ethacrynic Acid? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to balance fluids and keep nerves and muscles firing properly. Ethacrynic acid is a loop diuretic, meaning it works in the kidneys to push extra fluid out through urine, and sodium gets swept out along with that fluid. Right now there is not enough solid evidence to say how often this becomes a real problem for most people, though low sodium levels have been reported with this class of drug in some cases. If you are on ethacrynic acid long term, it is worth asking your pharmacist or doctor whether your sodium levels should be checked.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Ethacrynic Acid →

Fosinopril, Hydrochlorothiazide

Insufficient Evidence

Brand names include Monopril HCT

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Fosinopril, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it carefully. The hydrochlorothiazide in this combination works in the kidneys to push more sodium out through your urine, which is actually part of how it helps lower blood pressure. Serious sodium drops are uncommon, but they have been reported with thiazide diuretics in some people. The evidence here is still considered insufficient, meaning researchers haven't pinned down exactly how often or how much this matters for most patients, so if you ever feel unusually tired, confused, or nauseated while taking this medication, it's worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Fosinopril, Hydrochlorothiazide →

Furosemide

Insufficient Evidence

Brand names include Lasix

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Furosemide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to control fluid balance, blood pressure, and nerve signaling, so keeping levels in a healthy range really matters. Furosemide is a loop diuretic, meaning it works in the kidneys to push out extra fluid by blocking sodium from being reabsorbed back into the bloodstream. In some people, especially at higher doses or over a long time, this can lead to sodium levels dropping too low, a condition called hyponatremia. That said, the evidence here is rated insufficient, so the clinical picture is still unclear. If you take furosemide regularly, it is worth asking your doctor or pharmacist whether your sodium levels should be checked periodically.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Furosemide →

Furosemide, Potassium

Insufficient Evidence

Brand names include Diumide-K Continus, Lasikal

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Furosemide, Potassium? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral that helps control fluid balance and keeps your nerves and muscles firing properly. Furosemide is a loop diuretic, meaning it works in the kidneys to push more fluid out through urine, and sodium goes along with that fluid. The evidence here is listed as insufficient, so the clinical significance simply is not known yet. Severe drops in sodium are uncommon, but if you are on furosemide long-term it is worth asking your pharmacist or doctor whether routine monitoring makes sense for you.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Furosemide, Potassium →

Guanethidine, Hydrochlorothiazide

Insufficient Evidence

Brand names include Esimil

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Guanethidine, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles firing properly, so keeping levels in a healthy range really matters. Hydrochlorothiazide, the diuretic in this combination, works in your kidneys and can cause them to release more sodium into your urine than usual. That said, the current evidence for labeling this a meaningful concern is rated insufficient, meaning researchers haven't established how clinically important it is for most people. If you're on this medication long-term and notice symptoms like unusual fatigue, nausea, or muscle weakness, that's worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Guanethidine, Hydrochlorothiazide →

Hydralazine, Hydrochlorothiazide

Insufficient Evidence

Brand names include Apresoline-Esidrix, Apresazide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydralazine, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to control fluid balance, blood pressure, and nerve signaling, so keeping levels in a healthy range matters quite a bit. Hydrochlorothiazide, the diuretic in this combination, works by telling your kidneys to release more sodium into your urine, and in some people that can push sodium levels lower than normal. That said, the evidence here is rated insufficient, meaning we do not yet have enough solid data to know how often this is a real concern. If you have been on this medication long-term, it is worth asking your doctor or pharmacist whether your sodium has been checked recently.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydralazine, Hydrochlorothiazide →

Brand names include Ser-Ap-Es, Unipres, Uniserp

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydralazine, Hydrochlorothiazide, Reserpine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles firing properly, so when levels drop too low it can cause real problems. The hydrochlorothiazide in this combination works on the kidneys to push out excess sodium in the urine, which is actually part of how it lowers blood pressure. Severe drops in sodium are uncommon, but they have been reported with thiazide diuretics. Because the evidence here is still considered insufficient, most people on this combination do not need to worry, though it is worth mentioning to your pharmacist or doctor if you ever feel unusually dizzy, confused, or weak.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydralazine, Hydrochlorothiazide, Reserpine →

Hydrochlorothiazide

Insufficient Evidence

Brand names include Esidrix, Hydro, Microzide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle contractions working properly, so your body guards it carefully. Hydrochlorothiazide works in the kidneys by blocking the spot where sodium gets pulled back into the bloodstream, which means more sodium leaves in the urine. Severe drops in sodium are uncommon, but they have been reported with thiazide diuretics in some people. Because the evidence here is still limited, most users do not need to worry, but if you ever feel unusually tired, confused, or nauseated while taking this medication, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide →

Hydrochlorothiazide, Irbesartan

Insufficient Evidence

Brand names include Avalide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Irbesartan? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body control fluid balance, nerve signals, and blood pressure, so keeping it in a healthy range matters. Hydrochlorothiazide, the diuretic component in this combination, works in the kidneys by blocking the reabsorption of sodium, which is how it lowers blood pressure but also how it can, in some cases, cause sodium levels to drop too low. That said, the evidence here is rated as insufficient, meaning we simply do not have enough data to know how often or how seriously this applies to most people. If you have been on this medication long-term, it is worth mentioning to your pharmacist or doctor, especially if you ever feel unusually tired, confused, or nauseated.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Irbesartan →

Hydrochlorothiazide, Labetalol

Insufficient Evidence

Brand names include Trandate HCT

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Labetalol? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is something your body works hard to keep in balance, and it plays a key role in fluid levels, nerve signals, and muscle function. Hydrochlorothiazide is a thiazide diuretic, meaning it works in the kidneys to push sodium out through the urine, which is actually part of how it lowers blood pressure. For most people this does not cause a problem, but in some cases sodium levels can drop lower than they should. The evidence here is listed as insufficient, so this is more of a heads-up than a concern to act on right now. If you ever feel unusually tired, confused, or have muscle cramps while on this medication, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Labetalol →

Hydrochlorothiazide, Lisinopril

Insufficient Evidence

Brand names include Zestoretic, Prinzide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Lisinopril? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles firing properly, so low levels can make you feel off in noticeable ways. The hydrochlorothiazide part of this combination works in the kidneys to push sodium out through urine, which is actually how it lowers blood pressure. True sodium depletion from this medication is uncommon, and right now the evidence is too limited to know how meaningful this risk really is for most people. If you ever feel unusually fatigued, confused, or nauseated while on this medication, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Lisinopril →

Brand names include Hyzaar

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Losartan Potassium? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to regulate fluid balance, nerve signaling, and blood pressure. Hydrochlorothiazide, the diuretic component in this combination, works by telling the kidneys to release more sodium into the urine, which is actually part of how it lowers blood pressure. In rare cases, this can push sodium levels too low, a condition called hyponatremia. That said, the evidence here is rated insufficient, meaning we simply do not have enough data to know how often this is a real concern, so most people do not need to worry, but if you ever feel unusually confused, dizzy, or nauseated, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Losartan Potassium →

Hydrochlorothiazide, Methyldopa

Insufficient Evidence

Brand names include Aldoril 15, Methazide, Aldoril 25

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Methyldopa? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles working properly. Hydrochlorothiazide is a thiazide diuretic, meaning it works in the kidneys to push more sodium out through your urine, which is actually part of how it lowers blood pressure. In rare cases this can lead to sodium levels dropping too low, but the overall evidence here is still considered insufficient to know how often this is truly a problem. If you have been taking this medication long-term and notice symptoms like unusual fatigue, nausea, or confusion, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Methyldopa →

Hydrochlorothiazide, Metoprolol

Insufficient Evidence

Brand names include Lopressor HCT

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Metoprolol? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle function working properly, so your body guards it closely. Hydrochlorothiazide, the diuretic component in this combination, works in the kidneys by blocking a pathway that normally pulls sodium back into the bloodstream, meaning more sodium leaves the body through urine. Severe drops in sodium levels are uncommon but have been reported with thiazide diuretics in certain patients. The evidence here is still considered insufficient to draw firm conclusions, so most people taking this medication do not need to worry, but if you ever feel unusually fatigued, confused, or nauseated, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Metoprolol →

Hydrochlorothiazide, Moexipril

Insufficient Evidence

Brand names include Uniretic

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Moexipril? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it carefully. Hydrochlorothiazide, a thiazide diuretic in this combination, works in the kidneys to push excess fluid out, and sodium goes along with it. There is not enough solid evidence right now to know how often this is truly a problem, and serious sodium drops are uncommon. Still, if you ever feel unusually dizzy, confused, or weak while on this medication, that is worth mentioning to your doctor or pharmacist promptly.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Moexipril →

Hydrochlorothiazide, Pindolol

Insufficient Evidence

Brand names include Viskazide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Pindolol? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so having too little of it can actually be a serious problem. Hydrochlorothiazide is a thiazide diuretic, meaning it works in the kidneys to push sodium out through the urine, and that mechanism is the reason a drop in sodium levels is something to be aware of. That said, the current evidence for this combination is rated as insufficient, so we don't have a clear picture of how often or how meaningfully this happens in practice. If you're on this medication long term, it's worth asking your pharmacist or doctor whether any monitoring makes sense for you.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Pindolol →

Hydrochlorothiazide, Propranolol

Insufficient Evidence

Brand names include Inderide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Propranolol? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle function working properly, so your body guards it carefully. Hydrochlorothiazide, the thiazide diuretic in this combination, works on the kidneys to push out extra fluid, and sodium can leave along with it. That said, the evidence here is rated insufficient, meaning we simply do not have enough data to know how often this is a real concern. Severe drops in sodium are uncommon but have been reported with thiazide diuretics, so if you ever feel unusually tired, confused, or nauseated while on this medication, mention it to your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Propranolol →

Hydrochlorothiazide, Quinapril

Insufficient Evidence

Brand names include Accuretic

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Quinapril? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid balance steady and help your nerves and muscles fire correctly. Hydrochlorothiazide, the thiazide diuretic in this combination, works partly by telling your kidneys to release more sodium into the urine, so in theory it could nudge sodium levels lower over time. That said, the evidence here is rated insufficient, meaning we simply do not have enough data to know how meaningful this is for most people. If you have been on this medication long-term, it is worth mentioning sodium to your doctor or pharmacist at your next visit, just so they can decide whether a routine check makes sense for you.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Quinapril →

Hydrochlorothiazide, Reserpine

Insufficient Evidence

Brand names include Hydropres, Serpasil-Esidrix, Serpasil-Esidrix #1

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Reserpine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to balance fluids and keep nerves and muscles firing properly. Hydrochlorothiazide is a thiazide diuretic, meaning it works in the kidneys to push extra sodium out through the urine, which is actually part of how it lowers blood pressure. The evidence on whether this meaningfully depletes sodium levels is still considered insufficient, and true low sodium is uncommon, though it has been reported in some people on thiazide diuretics. If you have been on this medication long term and notice symptoms like unusual fatigue, confusion, or nausea, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Reserpine →

Hydrochlorothiazide, Spironolactone

Insufficient Evidence

Brand names include Spirozine, Aldactazide, Aldactide 25

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Spironolactone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle contractions working properly, so keeping it in a healthy range matters. Both hydrochlorothiazide and spironolactone are diuretics, and hydrochlorothiazide in particular works partly by telling the kidneys to release more sodium into the urine rather than hold onto it. That can, in some cases, push sodium levels lower than they should be. The evidence here is still considered insufficient, meaning this is more of a 'keep it on your radar' situation than a clear-cut concern, but if you take either of these medications long-term, it is worth mentioning to your pharmacist or doctor, especially if you ever feel unusually weak, confused, or nauseated.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Spironolactone →

Hydrochlorothiazide, Timolol

Insufficient Evidence

Brand names include Timolide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Timolol? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and muscle contractions working properly, so having too little of it can make you feel off in noticeable ways. Hydrochlorothiazide, the diuretic part of this combination, works in the kidneys to push extra sodium out through urine, and in some people that process can tip sodium levels lower than they should be. That said, the current evidence on how often or how seriously this actually happens is still considered insufficient to draw firm conclusions. If you have been on this medication long-term or feel unusual symptoms like fatigue, nausea, or confusion, it is worth bringing up with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Timolol →

Hydrochlorothiazide, Triamterene

Insufficient Evidence

Brand names include Maxzide, Dyazide, Maxzide-25

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Triamterene? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles firing properly, so levels that dip too low can cause real problems. Hydrochlorothiazide works in the kidneys to push sodium out through your urine, which is actually part of how it lowers blood pressure. That same action means sodium levels could theoretically fall too far in some people, though the evidence here is rated insufficient, so we do not have a clear picture of how often this is truly a concern with the triamterene combination. If you have been on this medication long-term or feel unusually tired, nauseated, or confused, it is worth bringing up with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Triamterene →

Hydrochlorothiazide, Valsartan

Insufficient Evidence

Brand names include Diovan HCT

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydrochlorothiazide, Valsartan? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance, nerve signals, and blood pressure throughout your body. The hydrochlorothiazide portion of this combination works in the kidneys to push sodium out through urine, which is actually part of how it lowers blood pressure. Severe sodium loss from this process is uncommon, and right now the evidence is too limited to know how meaningful this is for most people. If you ever feel unusually tired, confused, or nauseated while taking this medication long-term, it is worth mentioning to your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydrochlorothiazide, Valsartan →

Hydroflumethiazide

Insufficient Evidence

Brand names include Saluron

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydroflumethiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to keep fluid balance stable, support nerve signals, and help muscles contract properly. Hydroflumethiazide is a thiazide diuretic, meaning it works by telling the kidneys to release more sodium into the urine rather than holding onto it. That mechanism could, in theory, nudge sodium levels lower over time. The evidence here is rated insufficient, so this is not a well-established concern, but if you are on this medication long-term it is worth mentioning to your pharmacist or doctor, especially if you ever feel unusually tired, dizzy, or off-balance.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydroflumethiazide →

Hydroflumethiazide, Reserpine

Insufficient Evidence

Brand names include Salutensin-Demi, Salutensin

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Hydroflumethiazide, Reserpine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body regulate fluid balance, nerve signals, and blood pressure, so keeping it in a healthy range matters. Hydroflumethiazide is a thiazide diuretic, meaning it works in the kidneys to push out extra sodium through your urine, which is actually part of how it lowers blood pressure. There is not enough research yet to say how often this leads to a meaningful drop in sodium levels for most people, though severe cases have been reported rarely. If you have been on this medication long-term or feel unusually tired, dizzy, or confused, it is worth bringing up with your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Hydroflumethiazide, Reserpine →

Indapamide

Insufficient Evidence

Brand names include Lozol, Lozide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Indapamide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it carefully. Indapamide is a thiazide-like diuretic, meaning it works in the kidneys to push more sodium out through your urine, which is actually part of how it lowers blood pressure. The evidence here is rated insufficient, so we do not know how clinically meaningful this is for most people, though low sodium has been reported with this class of drug in some cases. If you feel unusually fatigued, nauseated, or confused while taking indapamide, that is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Indapamide →

Irbesartan, Hydrochlorothiazide

Insufficient Evidence

Brand names include CoAprovel

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Irbesartan, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so levels that drop too low can cause real problems. The hydrochlorothiazide portion of this combination pill works in the kidneys to push more sodium out through urine, which is part of how it lowers blood pressure. That said, the evidence on whether this meaningfully depletes sodium over time is rated insufficient, meaning we simply don't have enough data to know how common or serious this is for most people. Severe drops in sodium are uncommon, but if you notice symptoms like unusual fatigue, nausea, or confusion while taking this medication, mention it to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Irbesartan, Hydrochlorothiazide →

Mannitol

Insufficient Evidence

Brand names include Osmitrol, Bronchitol

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Mannitol? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance, nerve signals, and muscle function throughout your body. Mannitol is an osmotic diuretic, meaning it pulls water through your kidneys in a way that can also carry some sodium out with it. Right now, the evidence for this specific effect with mannitol is too limited to know how much it really matters in practice, so most people do not need to worry, but if you are on mannitol for any length of time, it is worth asking your doctor or pharmacist whether your sodium levels should be checked.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Mannitol →

Methazolamide

Insufficient Evidence

Brand names include Neptazane

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Methazolamide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance, blood pressure, and nerve signaling throughout your body. Methazolamide is a carbonic anhydrase inhibitor used mainly for glaucoma, and like other diuretics it can cause the kidneys to release more fluid, which might theoretically affect sodium levels. That said, the evidence here is rated as insufficient, meaning researchers simply do not have enough data yet to know whether this is a real concern for people taking methazolamide. If you are on this medication long term, it is worth mentioning to your pharmacist or doctor, especially if you ever feel unusually fatigued or dizzy.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Methazolamide →

Methyclothiazide

Insufficient Evidence

Brand names include Enduron, Aquatensen

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Methyclothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so having too little of it can be a real problem. Methyclothiazide is a thiazide diuretic, meaning it works in the kidneys to push extra fluid out of the body, and sodium goes along for the ride. The evidence here is rated insufficient, so there is no clear proof this is a common concern for most people taking this drug, though rare cases of low sodium have been reported with thiazide medications as a class. If you have been on this medication long-term or feel unusually tired, nauseated, or lightheaded, it is worth bringing up with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Methyclothiazide →

Methyclothiazide, Pargyline

Insufficient Evidence

Brand names include Eutron

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Methyclothiazide, Pargyline? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles firing properly, so your body guards its levels carefully. Methyclothiazide is a thiazide diuretic, meaning it works in the kidneys to push out extra fluid and salt through urine, and that process can occasionally pull out more sodium than the body wants to lose. That said, the evidence here is rated insufficient, so we simply do not know how meaningful this is for most people. If you are taking this medication long-term, it is worth asking your pharmacist or doctor whether your sodium levels should be checked periodically.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Methyclothiazide, Pargyline →

Methyclothiazide, Reserpine

Insufficient Evidence

Brand names include Diutensen-R

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Methyclothiazide, Reserpine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it carefully. Methyclothiazide is a thiazide diuretic, meaning it works in the kidneys to push extra fluid out in your urine, and some sodium can leave along with it. The evidence here is rated insufficient, so there is no clear proof this is a meaningful problem for most people taking this combination. That said, if you ever notice symptoms like unusual fatigue, headache, or confusion, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Methyclothiazide, Reserpine →

Metolazone

Insufficient Evidence

Brand names include Diulo, Zaroxolyn, Mykrox

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Metolazone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance, nerve signals, and muscle function throughout your body. Metolazone is a thiazide-type diuretic, meaning it works in the kidneys to push more sodium out through your urine, which is actually part of how it lowers blood pressure. There is not yet enough evidence to know how often this becomes a real problem, and most people do not experience it. That said, if you take metolazone long-term, it is worth asking your pharmacist or doctor whether your sodium level has been checked.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Metolazone →

Polythiazide

Insufficient Evidence

Brand names include Renese

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Polythiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is something your body relies on to keep fluid balance steady and help nerves and muscles work properly. Polythiazide is a thiazide diuretic, meaning it works in the kidneys to push out more sodium through your urine, which is exactly how it helps lower blood pressure. The current evidence is simply not strong enough to know whether this is a real concern for most people, so right now this sits in the 'we're not sure' category. If you have any questions about your sodium levels, a quick conversation with your pharmacist or doctor is the best place to start.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Polythiazide →

Polythiazide, Prazosin

Insufficient Evidence

Brand names include Minizide

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Polythiazide, Prazosin? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body control fluid balance, blood pressure, and nerve signals, so keeping it in a healthy range matters. The polythiazide in this combination is a thiazide diuretic, meaning it works partly by telling the kidneys to release more sodium into the urine. Whether this actually lowers sodium to a clinically meaningful level in most people taking Minizide is not well established, and the evidence is currently rated insufficient. That said, if you ever feel unusually tired, confused, or nauseated while on this medication, mention it to your doctor or pharmacist, since those can sometimes be signs that sodium levels have shifted.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Polythiazide, Prazosin →

Polythiazide, Reserpine

Insufficient Evidence

Brand names include Renese R

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Polythiazide, Reserpine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance, nerve signals, and muscle function throughout your body. Polythiazide is a thiazide diuretic, meaning it works partly by telling your kidneys to release more sodium into the urine, and in some people that process can go further than intended. That said, the evidence for a clinically meaningful problem here is rated insufficient, so this is more of a theoretical concern than a proven one. If you have been on this medication long-term and ever notice symptoms like unusual fatigue, nausea, or confusion, it is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Polythiazide, Reserpine →

Quinethazone

Insufficient Evidence

Brand names include Hydromox

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Quinethazone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is something your body depends on to keep fluid balance steady, support nerve signals, and help muscles work properly. Quinethazone is a thiazide-type diuretic, meaning it works in the kidneys to push more sodium out through the urine, which is actually part of how it lowers blood pressure. The evidence here is rated insufficient, so we really do not know how clinically meaningful this is for most people taking quinethazone. That said, if you ever feel unusually fatigued, confused, or nauseated while on this medication, those are worth mentioning to your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Quinethazone →

Quinethazone, Reserpine

Insufficient Evidence

Brand names include Hydromox R

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Quinethazone, Reserpine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles firing properly, so having too little of it can leave you feeling weak or confused. Quinethazone is a thiazide-type diuretic, meaning it works in the kidneys to push more sodium out through the urine, which is actually part of how it lowers blood pressure. That said, the evidence linking this combination to a meaningful drop in sodium is currently listed as insufficient, so we simply do not know how often it matters in practice. If you ever feel unusually tired, dizzy, or "off" while taking this medication, that is worth mentioning to your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Quinethazone, Reserpine →

Reserpine, Trichlormethiazide

Insufficient Evidence

Brand names include Naquival, Metatensin #2, Metatensin #4

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Reserpine, Trichlormethiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps your body control fluid balance, blood pressure, and nerve signals, so keeping it in a healthy range really matters. Trichlormethiazide is a thiazide diuretic, meaning it works in the kidneys to push extra sodium out through your urine, which is actually part of how it lowers blood pressure. That said, the evidence on whether this combination meaningfully depletes sodium over time is currently rated as insufficient, so we simply do not know how clinically important this is for most people. If you notice symptoms like unusual fatigue, headache, or confusion while taking this medication, those are worth mentioning to your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Reserpine, Trichlormethiazide →

Sacubitril, Valsartan

Insufficient Evidence

Brand names include Entresto

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Sacubitril, Valsartan? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles working properly, so keeping levels in a healthy range matters. Sacubitril/valsartan contains a neprilysin inhibitor paired with a blood pressure drug, and while it is not a traditional diuretic, there is some theoretical concern that any medication affecting kidney fluid handling could nudge sodium levels lower in certain people. Right now the evidence is too limited to know whether this is a real concern in practice, so most people taking this combination do not need to worry about it. That said, if you ever feel unusually tired, confused, or nauseated while on this medication, it is worth mentioning to your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Sacubitril, Valsartan →

Spironolactone

Insufficient Evidence

Brand names include Aldactone, Spiroton, Carospir

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Spironolactone? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium helps control fluid balance and keeps your nerves and muscles working properly, so keeping levels in a healthy range really does matter. Spironolactone is a diuretic that works differently from loop or thiazide water pills, and while it can theoretically affect how your kidneys handle sodium, there is not enough solid evidence yet to know how meaningful that is in practice. For most people taking spironolactone, this is not a reason to worry, but if you ever feel unusually tired, confused, or nauseated, those can be signs of low sodium worth mentioning to your doctor or pharmacist.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Spironolactone →

Theobromine

Insufficient Evidence
Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Theobromine? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to control fluid balance, nerve signals, and muscle function, so keeping levels in a healthy range matters. Theobromine has mild diuretic properties, meaning it can nudge the kidneys to release more water and, along with it, potentially some sodium. That said, the current evidence here is really thin, and there is no clear proof this is a meaningful concern for most people using theobromine. If you have questions about your sodium levels or any symptoms like unusual fatigue or muscle weakness, it is worth a quick conversation with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Theobromine →

Torsemide

Insufficient Evidence

Brand names include Demadex, Soaanz

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Torsemide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, nerve signals, and blood pressure working properly, so your body guards it carefully. Torsemide is a loop diuretic, meaning it works in the kidneys to push extra fluid out through urine, and sodium gets pulled along with it. The evidence here is rated insufficient, so we simply do not know how often this is a real concern, though rare cases of a significant drop in sodium levels have been reported with this class of drug. If you take torsemide long-term, it is worth asking your pharmacist or doctor whether your sodium level has been checked.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Torsemide →

Trichlormethiazide

Insufficient Evidence

Brand names include Metahydrin, Naqua, Marazide II

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Trichlormethiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so your body guards it carefully. Trichlormethiazide is a thiazide diuretic, meaning it works partly by telling your kidneys to release more sodium into the urine rather than keeping it. Because the evidence here is rated as insufficient, we do not have a clear picture of how often this actually becomes a problem, though low sodium has occasionally been reported with this class of medication. If you have been on this drug for a while and notice symptoms like unusual fatigue or confusion, that is worth a conversation with your pharmacist or doctor.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Trichlormethiazide →

Urea

Insufficient Evidence

Brand names include Ureaphil

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Urea? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium keeps your fluid balance, blood pressure, and nerve signals working properly, so keeping levels in a healthy range matters. Urea is itself an osmotic diuretic, meaning it pulls water out through the kidneys, and there is some thought that this process could also nudge sodium levels lower in certain people. That said, the evidence for this specific concern with urea is currently too limited to draw firm conclusions. If you are taking urea long-term, it is worth mentioning to your pharmacist or doctor so they can keep an eye on things if needed.

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.

Full nutrient report for Urea →

Important

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.
Understand the basics

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.

Common questions

SODIUM & medications: FAQs

Which medications can lower SODIUM?
In our licensed clinical database, 117 medications have been associated with SODIUM depletion, including Agomelatine, Amitriptyline, Amitriptyline, Chlordiazepoxide and Amitriptyline, Perphenazine. Each entry above shows the evidence rating and the published details. An association is not a guarantee — dose, duration, diet, and your own health all matter.
I take one of these medications — am I deficient in SODIUM?
Not necessarily. These entries describe reported associations, not certainties. Many people take these medications without developing a meaningful SODIUM problem. If you take one long-term, the reasonable step is to ask your healthcare provider whether checking your SODIUM status is appropriate for you.
Should I start a SODIUM supplement?
Not without checking first. Supplements are not risk-free — some interact with medications, and for certain nutrients (like potassium or magnesium) supplementation can be genuinely risky with kidney disease or particular drug combinations. Food-first strategies and clinician-guided testing usually come before a supplement.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English education is written and reviewed by licensed HelloPharmacist pharmacists.

Wondering about your SODIUM levels?

Ask a licensed pharmacist — free, no appointment needed.

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Sources

Sources & How We Checked

Medication associations with SODIUM are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.