Possible Interaction: Potassium and Angiotensin Ii Receptor Antagonist

“It has become more common in cardiovascular practice due to the growing … disease and the broad application of drugs that modulate renal elimination of potassium by reducing production of angiotensin II (angiotensin-converting …-adrenergic receptor antagonists), blocking angiotensin II receptors ( angiotensin receptor blockers ), or antagonizing the … (mineralocorticoid receptor antagonists).”

“Angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers (ACE/ARB), diuretics, and proton pump inhibitor (PPI) can interfere with potassium levels in these patients.”

“Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers , and insulin treatment may also affect the level of potassium and Mg.”

“… potassium concentrations were only … higher in the ARB vs CCB group (range: 4.2-4.3 vs 3.7-3.8 mEq/l, respectively, but clinically significant) and the number of patients with potassium values >6.0 mEq/l was higher in ARB (n = 7) vs CCB (n = 1).”

“Some medications such as cyclooxygenase (COX-1, COX-2) inhibitors, angiotensin converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) reduce the elimination of renal potassium resulting in hyperkalemia.”

“Thus, chronic administration of ARBs overlapped on possible preoperative dehydration can affect the elimination of potassium resulting in hyperkalemia.”