Indapamide-induced Severe Hyponatremia in a Middle-aged Male Patient within Two Weeks

Iqbal, Phool; Laswi, Bushra; Kazman, Rashid; Fatima, Haajra; Hssain, Ali Ait

doi:10.7759/cureus.6515

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…As electrolyte disturbance was mostly reported to be hyponatremia and hypokalemia, the predominance presentation was secondary to the severe hyponatremia rather than hypokalemia in the form of neurological symptoms, mainly delirium, unsteady gaits, recurrent falls, along with nausea and vomiting. Seizures have been reported as well, but they were self-limited and did not require sedation or antiepileptic drugs [8][9][10]. Mok et al reported a unique cardiac case of acquired Brugada syndrome and prolonged QT interval that developed polymorphic ventricular arrhythmia and cardiac arrest due to severe hyponatremia and severe hypokalemia secondary to indapamide [11].…”

Section: Discussionmentioning

confidence: 99%

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Alamin

Ahmed

Suliman

2020

Cureus

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Indapamide is one of the most effective and well-known anti-hypertensive medications. Electrolyte disturbances have been classically recognized as a typical side effect profile of indapamide. The most common electrolyte imbalance described with indapamide was hypokalemia; however, hyponatremia is being increasingly reported. In this case, we report a unique form of severe electrolytes derangement (hyponatremia, hypokalemia, hypophosphatemia, and hypocalcemia), which was complicated by seizures, rhabdomyolysis, and acute kidney injury that occurred within only 10 days of indapamide initiation. The patient was admitted to the medical intensive care unit for prompt electrolyte replacement and close monitoring. With the discontinuation of indapamide and the prompt replacement of the deficient electrolytes, the patient's condition has improved dramatically, and he was discharged in a good state of health. Electrolyte disturbances are expected to be seen with indapamide usage, and it might be associated with severe consequences like arrhythmias and seizures. This case report would raise awareness and add to the importance of closely following patients after prescribing indapamide.

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Section: Discussionmentioning

confidence: 99%

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Alamin

Ahmed

Suliman

2020

Cureus

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Concomitant Use of Antipsychotics and Diuretic Accelerates the Hyponatremia Effect

Ismail

Daud²

2022

MJoSHT

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We reported a case of severe symptomatic hyponatremia with a serum sodium level of 113 mmol/l after 2 weeks commencement of 2 types atypical antipsychotics; clozapine and amisulpiride with indapamide, a thiazide-like diuretic antihypertensive medication. Discontinuation of indapamide despite of continuation of his antipsychotics showed improvement in his serum sodium level. The aim of our case-report is to emphasize the life-threatening complication associated with the combination of agents that may cause hyponatremia. Both agents are known to cause electrolytes imbalance. Hence, close monitoring of the serum sodium is important during the treatment course.

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Indapamide-induced Severe Hyponatremia in a Middle-aged Male Patient within Two Weeks

Cited by 2 publications

References 13 publications

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Concomitant Use of Antipsychotics and Diuretic Accelerates the Hyponatremia Effect

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