hypokalemia
7 interactions related to hypokalemia
prednisone + potassium
Prednisone has weak mineralocorticoid activity that promotes renal potassium excretion. Especially at higher doses or with prolonged use, this can cause hypokalemia, which presents as muscle weakness, fatigue, and potentially arrhythmias.
prednisone + licorice
Glycyrrhizin in licorice inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase type 2, prolonging the half-life of glucocorticoids and dramatically amplifying mineralocorticoid effects. The combination potentiates sodium retention, hypertension, and hypokalemia, and has been linked to severe hypokalemic crises.
hydrochlorothiazide + potassium
Hydrochlorothiazide promotes urinary potassium excretion at the distal convoluted tubule and is a leading cause of drug-induced hypokalemia. Many patients still develop low potassium despite supplementation, while some on combination antihypertensives risk the opposite problem if a potassium-sparing agent is added.
furosemide + potassium
Furosemide blocks the Na-K-2Cl cotransporter in the loop of Henle and is the most potent diuretic class for causing dose-dependent hypokalemia, affecting 25-36% of users. Supplementation or potassium-sparing co-therapy is frequently required, but uncontrolled dosing combined with ACE inhibitors or kidney disease can flip levels into hyperkalemia.
furosemide + licorice
Glycyrrhizin in licorice inhibits 11-beta-hydroxysteroid dehydrogenase type 2, allowing cortisol to act on mineralocorticoid receptors and stimulating renal potassium excretion. Combined with furosemide, this produces additive potassium wasting and a markedly higher risk of severe hypokalemia, edema, hypertension, and arrhythmia.
licorice tea + digoxin
Licorice (Glycyrrhiza glabra) contains glycyrrhizin, which inhibits renal 11-beta-hydroxysteroid dehydrogenase type 2 and causes potassium loss through mineralocorticoid-like activity. The resulting hypokalemia sharply increases digoxin's binding to cardiac Na/K-ATPase, raising the risk of life-threatening digoxin toxicity and arrhythmia.
digoxin + licorice
Glycyrrhizin in licorice inhibits 11-beta-hydroxysteroid dehydrogenase type 2, mimicking aldosterone excess and causing sodium retention and potassium wasting. The resulting hypokalemia sensitizes the myocardium to digoxin and can trigger toxicity (arrhythmias, heart block) even at therapeutic serum digoxin levels.