Background Trimethoprim therapy can cause hyperkalemia and is often coprescribed with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). In circumstances where continued treatment with trimethoprim is required, induction of high urinary flow rates with intravenous fluids and a loop diuretic, as well as alkalinisation of the urine, have been shown to block the antikaliuretic effect of trimethoprim on distal nephron cells. No such risk was identified with ciprofloxacin, norfloxacin, or nitrofurantoin. Some patients may have several of these risk factors and take multiple interacting drugs. 2011 Sep 12;343:d5228. Epub 2018 Jun 29. 2018 Oct-Dec;40(4):410-417. doi: 10.1590/2175-8239-JBN-3821. Cases of hypoglycemia in non-diabetic patients treated with Bactrim are seen rarely, usually occurring after a few days of therapy. COVID-19 is an emerging, rapidly evolving situation. Hyperkalemia has been reported in 16 to 21 percent of patients hospitalized with the acquired immunodeficiency syndrome (AIDS)1–3. Name must be less than 100 characters Patients with renal dysfunction, liver disease, malnutrition or those receiving high doses of Bactrim are particularly at risk. Compared with amoxicillin, the use of TMP-SMX was associated with a substantially greater risk of hyperkalemia requiring hospital admission (adjusted odds ratio, 5.1; 95% confidence interval [CI], 2.8 to 9.4).

Prevention of this adverse reaction depends upon recognition of patients at risk of developing hyperkalaemia as well as proper dosage selection of trimethoprim for the patient's prevailing glomerular filtration rate. Cotrimoxazole (trimethoprim-sulfamethoxazole) is a combination antimicrobial that is frequently used to treat a wide variety of infections. It is probable that other disturbances in potassium homeostasis, such as hyopoaldosteronism and treatment with medications that impair renal potassium excretion, are also risk factors for hyperkalaemia with trimethoprim therapy. It is probable that other disturbances in potassium homeostasis, such as hyopoaldosteronism and treatment with medications that impair renal potassium excretion, are also risk factors for hyperkalaemia with trimethoprim therapy. /publications/issue/2011/February2011/DrugInteractions-02112 Clarke Drive Suite 100 Cranbury, NJ 08512 P:609-716-7777 F:609-716-9038 The objective of this study was to characterize the risk of hyperkalemia-associated hospitalization in elderly patients who were being treated with trimethoprim … 1997 Sep-Oct;4(9-10):343-8. doi: 10.1097/00045391-199709000-00010.Crellin E, Mansfield KE, Leyrat C, Nitsch D, Douglas IJ, Root A, Williamson E, Smeeth L, Tomlinson LA.Antoniou T, Gomes T, Mamdani MM, Yao Z, Hellings C, Garg AX, Weir MA, Juurlink DN.BMJ. Expert panelists review the causes, diagnostic work-up, management, and emerging therapies inherent in the evolving paradigm of irritable bowel syndrome.Trimethoprim and Potassium-Sparing Drugs: A Risk for HyperkalemiaJohn R. Horn, PharmD, FCCP, and Philip D. Hansten, PharmDTrimethoprim and Potassium-Sparing Drugs: A Risk for HyperkalemiaPharmacists should closely monitor patients who take trimethoprim and other drugs that increase serum potassium. 2020 Jun;42(3):965-971. doi: 10.1007/s11096-020-01052-x.Takubo M, Tanaka S, Kushimoto M, Ikeda J, Ogawa K, Suzuki Y, Abe M, Ishihara H, Fujishiro M.Antibiotics (Basel). Unable to load your delegates due to an error Epub 2018 Jul 23.BMJ Evid Based Med.

Other risk factors for the development of hyperkalemia include renal dysfunction, diabetes, advanced age, and the use of salt substitutes containing potassium chloride or nonsteroidal anti-inflammatory drugs. Increased risk for hyperkalaemia with trimethoprim treatment appears to be related to both higher dosages and underlying renal impairment.

This site needs JavaScript to work properly. 2020 Apr 23;9(4):201. doi: 10.3390/antibiotics9040201.Anstrom KJ, Noth I, Flaherty KR, Edwards RH, Albright J, Baucom A, Brooks M, Clark AB, Clausen ES, Durheim MT, Kim DY, Kirchner J, Oldham JM, Snyder LD, Wilson AM, Wisniewski SR, Yow E, Martinez FJ; CleanUP-IPF Study Team.Respir Res. Clipboard, Search History, and several other advanced features are temporarily unavailable. The recognition of this disorder of potassium homeostasis prompted the investigation and ultimate description of the mechanism by which trimethoprim causes hyperkalaemia. Hyperkalaemia has been demonstrated to occur with the administration of both high and standard dosages of trimethoprim.

2018 Dec;23(6):233-234. doi: 10.1136/bmjebm-2018-110991. doi: 10.2165/00002018-200022030-00006. Please enable it to take advantage of the complete set of features! Trimethoprim was found to reduce renal potassium excretion through the competitive inhibition of epithelial sodium channels in the distal nephron, in a manner identical to the potassium-sparing diuretic amiloride.

Only recently has hyperkalaemia been recognised as a relatively common complication of therapy with trimethoprim.

Springer Decreased Excretion of Potassium Because the maintenance of normal potassium levels is critical to life, our kidneys have efficient mechanisms for hanging on to potassium to prevent our levels from being too low, and also for excreting excess potassium in urine to prevent our levels from being …