Potassium-Sparing Diuretics

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Potassium-Sparing Diuretics - Interactions and Warnings

An increase in serum potassium levels may occur after coadministration of potassium-sparing diuretics and ACE inhibitors, resulting in hyperkalaemia especially in patients with renal insufficiency.
- Drug Saf 1995 May;12(5):334-47 -- ACE inhibitors. Drug interactions of clinical significance. -- Mignat C, Unger T.

Its occurrence is dose dependent and can be corrected by potassium supplements, but potassium-retaining diuretics, which also correct the often associated fall in serum magnesium, are preferable. Many reports link hypokalaemia with cardiac arrhythmias, but some dispute this association in the absence of the concomitant use of digoxin. Hyponatraemia rarely occurs, but can be life threatening. Calcium excretion is markedly reduced, but unlike other electrolyte disturbances from diuretics, this may be valuable: some suggest diuretics have an anti-osteoporotic action. Diuretics increase glucose and insulin resistance and should be used sparingly in diabetics.
- Eur Heart J 1992 Dec;13 Suppl G:96-103 -- Adverse reactions to diuretics. -- Prichard BN, Owens CW, Woolf AS.

Urinary zinc excretion was studied in a randomized trial in 9 patients during treatment with bendroflumethiazide, chlorthalidone and hydrochlorothiazide and in another 9 patients during treatment with bumetanide, furosemide and triamterene. During treatment with the thiazides, the zinc concentration rose by 30% and the total amount of zinc excretion increased by 60%. In contrast, during treatment with the loop-diuretics, urine zinc concentration diminished and the total amount of zinc excretion increased much less than during therapy with the thiazides.
- Acta Med Scand 1980;208(3):209-12 -- Urinary zinc excretion during treatment with different diuretics. -- Wester PO.

May cause magnesium deficiency and potassium deficiency.
- Acta Med Scand Suppl 1986;707:79-83 -- Potassium-sparing diuretics. -- Dyckner T, Wester PO.

One of the most common and serious side effects of diuretic therapy is in increased urinary loss of potassium. Another, although less well publicized, side effect of diuretic therapy is excessive urinary loss of magnesium.
- Magnesium 1986;5(5-6):282-92 -- Magnesium and potassium-sparing diuretics. -- Ryan MP.

last update: November 2008

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