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What medications can affect potassium levels?

Medically reviewed by Sally Chao, MD. Last updated on Feb 26, 2024.

Official answer

by Drugs.com

Hundreds of medications can affect your potassium level, either making it too high or too low.

Hyperkalemia

Some medications cause the blood level of potassium to increase, which is known as hyperkalemia. It occurs when your blood serum level exceeds 5.0 mmol/L.

Drugs used to treat high blood pressure, heart-related problems and kidney issues can cause high potassium. They include:

Angiotensin-converting enzyme (ACE) inhibitors, such as:

Angiotensin receptor blockers (ARBs), such as:

ACE inhibitors and ARBs are available in combination with other drugs. These combination drugs contain an ACE inhibitor or ARB along with another drug to lower blood pressure. They include several different brand and generic names. Typically, when hydrochlorothiazide (HCTZ) is added to an ACE inhibitor or an ARB, there is less risk for hyperkalemia. That’s because HCTZ can decrease potassium levels.

Potassium-sparing diuretics, such as:

Non-selective beta blocker:

Direct renin inhibitor:

A class of common drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs) may also increase potassium. They are used to treat pain and inflammation and include:

Calcineurin inhibitors may also cause hyperkalemia. These drugs suppress the immune system and are used after transplants to prevent rejection.

Anti-infectives that may increase potassium include:

  • Trimethoprim, which is usually combined with sulfamethoxazole
  • Pentamidine, which is used to treat a type of infection known as pneumocystis pneumonia

Other drugs that may increase potassium include:

  • Anectine (succinylcholine) may increase blood levels of potassium. It’s a skeletal muscle relaxant used during anesthesia.
  • Mannitol is an osmotic diuretic used to reduce intracranial pressure and intraocular pressure.

Hypokalemia

Some medications may cause your blood level of potassium to decrease, which is known as hypokalemia. The following drugs may cause low potassium:

Diuretics, such as:

Medications to treat chronic obstructive pulmonary disease (COPD) or other breathing problems:

Other drugs that may decrease potassium include:

Symptoms of hyperkalemia

If your potassium level is too high or too low, you may not know it. Your doctor may order a blood test to check the level.

Symptoms of mild hyperkalemia include muscle weakness, tingling and nausea.

Severe hyperkalemia is a medical emergency. Symptoms include:

  • Chest pain
  • Shortness of breath
  • Heart palpitations
  • Nausea and vomiting

Symptoms of hypokalemia

You likely won’t notice a mild decrease in your potassium level. However, symptoms may include:

  • Constipation
  • Heart fluttering or pounding
  • Low blood pressure
  • Tiredness
  • Muscle weakness or spasms
  • Numbness or tingling sensations
  • Increased urination and thirst
  • Loss of appetite, nausea or vomiting
  • Confusion

A severe drop in potassium levels can be life-threatening, causing heart irregularities. It may make you faint or feel lightheaded.

References
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