The short answer:
The most common drugs that cause a low potassium level include diuretics, some antibiotics, insulin, bronchodilators, laxatives, and theophylline. Also, drugs that lower your magnesium blood level could also cause a low potassium blood level. In this article, we provide you with a list of the most commonly used drugs that cause lower potassium levels.
Key facts:
- The low potassium blood level is commonly known as hypokalemia.
- Hypokalemia means your potassium blood level decreases below 2.5 mmol/l.
- A low potassium level could result from low potassium intake, excessive potassium loss in urine, and drug-induced low potassium levels.
- The most commonly used medications that cause a low potassium blood level include diuretics such as thiazide and furosemide, antibiotics such as penicillin and aminoglycosides, glucocorticoids and mineralocorticoids, some bronchodilators, and laxatives and enemas.
Content:
What does a low potassium level mean?
Drugs that cause a low potassium level
Symptoms of the low potassium blood level
Recommended treatments for low potassium level
What does a low potassium level mean?
Potassium plays a critical role in many cell functions.
About 98% of potassium in your body is found in intracellular fluid compartments, leaving only 2% in extracellular fluid spaces.
The low potassium blood level is commonly known as hypokalemia.
When your potassium blood level decreases below 2.5 mmol/l symptoms of hypokalemia are observed (Ref).
Hypokalemia could result from form low potassium intake in your diet, an increase in the loss of potassium in urine or stool, low potassium levels secondary to other diseases, or drug-induced low potassium levels (Ref).
What are the main causes of low potassium blood levels (Hypokalemia)?
The main causes of low blood levels of potassium are the following (Ref):
- Low potassium intake in the diet.
- Increase potassium loss due to vomiting diarrhea, and laxative abuse.
- Increase potassium loss through the urine due to diuretics.
- A low potassium level is caused by diseases such as chronic kidney disease.
- A low potassium blood level is induced by hypomagnesemia (a low magnesium blood level).
- Medications induce low potassium blood levels.
What are the most commonly used drugs that can lower your potassium blood levels?
Several drugs can affect the absorption and elimination of potassium and as a result, could markedly alter your potassium blood level leading to hypokalemia. These include the following:
- Diuretics
- High doses of glucocorticoids and mineralocorticoids
- Substances with mineralocorticoid-like action
- Some antibiotics
- Drugs that cause low magnesium levels could also lower your potassium blood levels.
- Drugs increase potassium loss in stool
- Drugs decrease potassium levels by transcellular potassium shift
- Decongestants
- Bronchodilators
- B2 adrenergic agonist
- Laxatives and enemies
- Antipsychotic agent
Diuretics
Diuretics that cause hypokalemia include the following:
- Acetazolamide
- Chlorothiazide
- Chlorthalidone
- Indapamide
- Furosemide
- Torsemide
- Metolazone
- Ethacrynic acid
- Bumetanide
- Quinethazone
- Thiazides
Diuretics cause hypokalemia by inducing potassium loss in the kidney.
Diuretics are commonly used with patients having hypertension (high blood pressure), heart failure, swelling, and edema. Potassium is lost with excessive water loss by the action of these medications. Thus, diuretics, which increase urination, could increase your potassium loss in the urine leading to a low potassium blood level.
A study showed that hypokalemia is commonly reported in older patients with hypertension more than in those with normal blood pressure. Moreover, hypokalemia occurrence was higher in hypertensive patients treated with potassium-losing diuretics, and prevention of diuretic-induced hypokalemia with oral supplementation of potassium seems to be insufficient.
High doses of glucocorticoids and mineralocorticoids
Glucocorticoids and mineralocorticoids that lower your potassium blood levels include the following.
- Prednisone
- Hydrocortisone
- Fludrocortisone
Substances with mineralocorticoid-like action
- Licorice
- Carbenoxolone
A retrospective cohort study showed that the occurrence rate of hypokalemia was higher in patients treated with licorice-containing Japanese traditional Kampo-medicines.
Antibiotics:
Some antibiotics are reported to decrease your potassium blood level. This includes the following
- Penicillin
- Ampicillin
- Nafcillin
- Carbenicillin
- Aminoglycosides
- Amphotericin B
- Foscarnet
- Acyclovir
Drugs that cause low magnesium level
Hypomagnesemia is associated with hypokalemia. Therefore, drugs that lower tour magnesium blood level could also cause a low potassium blood level. This includes the following: medications:
- Cisplatin
- Aminoglycoside
- Amphotericin B
- Foscarnet
Studies showed that low magnesium blood level is present in more than 50% of cases of clinically significant hypokalemia, and contributes to the development of hypokalemia by reducing the intracellular potassium concentration and promoting renal potassium loss (Ref).
Drugs cause a low potassium level by increasing the loss of potassium in stool
- Phenolphthalein
- Sodium polystyrene sulfonate
- Sorbitol
Drugs decrease potassium levels by transcellular potassium sift.
This means that these medications lower your potassium blood level by pushing potassium out of your bloodstream and into your cells (Ref). This includes the following:
- Theophylline
- Caffeine
- Verapamil
- Insulin overdose
- Chloroquine
A study reported that the prevalence of hypokalemia in diabetic individuals over 55 years of age receiving insulin therapy is up to 1.2%.
Decongestants
- Pseudoephedrine
- Phenylpropanolamine
B2 adrenergic agonist
- Epinephrine
Bronchodilators
This group of medications is most commonly used for the treatment of bronchial asthma and chronic obstructive pulmonary disease (COPD). This includes the following:
- Terbutaline
- Albuterol
- Pirbuterol
- Fenoterol
- Formoterol
- Salmeterol
- Isoproterenol
- Metaproterenol
Laxatives and enemas.
- Laxatives and enemas at high doses can cause a loss of potassium in your stool.
- It’s worse if they cause diarrhea.
Antipsychotic agents
- Risperdal and Seroquel
What are the main symptoms of a low potassium blood level (hypokalemia)?
The most common symptoms of hypokalemia include
- Constipation
- Heart palpitations
- Low blood pressure
- Tiredness
- Muscle weakness or spasms
- Numbness or tingling sensations
- Increased urination and thirst
- Loss of appetite,
- Nausea
- Vomiting
- Confusion
What are the recommended treatments for a low potassium blood level?
- Change the drugs causing lower potassium blood levels.
- Increase potassium intake in the diet (Ref).
- Administration of potassium supplements.
