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Letters |1 November 1996

Hyperkalemia and Trimethoprim-Sulfamethoxazole

Igor Ougorets, MD; Deborah Asnis, S., MD; Alex Melchert, MS

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  • Flushing Hospital Medical Center Flushing, NY 11355.
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TO THE EDITOR:
Trimethoprim-sulfamethoxazole has been used since 1968 and has been associated with major adverse reactions, including skin lesions, thrombocytopenia and leukopenia, and gastrointestinal dysfunction. In the past decade, hyperkalemia has been increasingly recognized as a side effect of this drug combination.
Allapan and colleagues [1] described 80 patients treated with standard-dose therapy (trimethoprim, <320 mg/d; sulfamethoxazole, <1600 mg/d) for various infections other than Pneumocystis carinii pneumonia. They found that hyperkalemia developed and serum creatinine levels increased 4 to 5 days after the start of therapy in many patients. No other electrolyte abnormalities were noted. Trimethoprim-sulfamethoxazole was believed to inhibit distal tubule sodium reabsorption and potassium secretion.
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Ougorets I, Asnis D, Melchert A. Hyperkalemia and Trimethoprim-Sulfamethoxazole. Ann Intern Med. ;125:779. doi: 10.7326/0003-4819-125-9-199611010-00023

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Published: Ann Intern Med. 1996;125(9):779.

DOI: 10.7326/0003-4819-125-9-199611010-00023

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