hypokalemia
7 interactions related to hypokalemia
prednisone + potassium
Prednisone has weak mineralocorticoid activity that promotes potassium loss through the kidneys. With higher doses or prolonged use this can lower blood potassium (hypokalemia), which may show up as muscle weakness, fatigue, cramps, or palpitations. The risk is greatest when other potassium-wasting drugs or licorice are also in the mix.
prednisone + licorice
Glycyrrhizin in real licorice inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase type 2, which normally inactivates cortisol and prednisolone at the kidney's mineralocorticoid receptor. Blocking it produces a pseudohyperaldosteronism state — sodium and water retention, rising blood pressure, and potassium loss. Layered onto prednisone, this can drive clinically significant hypokalemia, and severe cases of hypokalemic paralysis, arrhythmia, and refractory hypertension have been reported.
hydrochlorothiazide + potassium
Hydrochlorothiazide promotes urinary potassium excretion at the distal convoluted tubule and is a common cause of drug-induced low potassium (hypokalemia). Many patients stay low even with food or supplements, while others on combination blood-pressure regimens face the opposite risk of high potassium if a potassium-sparing drug is added. Either direction can affect heart rhythm, so potassium should be supplemented only under medical guidance with blood monitoring.
furosemide + potassium
Furosemide is a loop diuretic that blocks the sodium-potassium-chloride cotransporter in the kidney, making it one of the most reliable causes of drug-induced low potassium (hypokalemia). Supplementation or potassium-sparing co-therapy is often needed, but adding potassium on your own — especially alongside ACE inhibitors, ARBs, or kidney impairment — can swing levels too high. The combination should always be guided by blood monitoring rather than self-dosing.
furosemide + licorice
Glycyrrhizin in licorice inhibits 11-beta-hydroxysteroid dehydrogenase type 2, allowing cortisol to act on mineralocorticoid receptors and driving renal potassium loss. Combined with furosemide, which already wastes potassium, this can add up to a markedly higher risk of significant hypokalemia, worsening edema, raised blood pressure, and arrhythmia.
licorice tea + digoxin
Licorice (Glycyrrhiza glabra) contains glycyrrhizin, which inhibits the renal enzyme 11-beta-hydroxysteroid dehydrogenase type 2 and produces mineralocorticoid-like potassium loss. The resulting hypokalemia increases the heart's sensitivity to digoxin, raising the risk of digoxin toxicity and dangerous arrhythmias.
digoxin + licorice
Glycyrrhizin in licorice inhibits the kidney enzyme 11-beta-hydroxysteroid dehydrogenase type 2, producing a state of apparent mineralocorticoid excess that causes sodium retention and potassium loss. The resulting low potassium makes the heart more sensitive to digoxin and can trigger toxic arrhythmias even when serum digoxin levels look normal.