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Drug induced low sodium

Authoring team

Drug-induced hyponatraemia occurs in approximately 5% of outpatients and 15% of inpatients (1)

  • in an Australian study the commonest drugs causing hyponatraemia were:
    • indapamide
    • sertraline
    • amiloride/hydrochlorothiazide
    • carbamazepine
    • furosemide
    • fluoxetine

  • most patients with hyponatraemia are diagnosed incidentally on routine blood tests

Example causes of drug induced hyponatraemia:

Diuretics

  • thiazide diuretics
    • indapamide
    • chlorothiazide
  • combination diuretics
    • amiloride/hydrochlorothiazide
  • loop diuretics
    • furosemide

Anticonvulsants

  • carbamazepine

ACE inhibitor

  • enalapril
  • ramipril

COX2 inhibitor

  • celecoxib

Hypnotics

  • temazepam

Sulphonylureas

  • gliclazide
  • glimepiride
  • glibenclamide
  • glipizide

Proton pump inhibitor

  • omeprazole
  • pantoprazole

Hormonal analogue

  • desmopressin
  • oxytocin

Antidepressants

  • SSRIs
    • sertraline
    • fluoxetine
    • citalopram
    • paroxetine
    • venlafaxine
  • MAOI
    • moclobemide

Recreational drugs

  • ecstasy

 

Reference:

  • Fourlanos S, Greenberg . Managing drug-induced hyponatraemia in adults.Aust Prescr: 2003;26:114-7.

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