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- M A Perazella.
- Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT 06520-8029, USA.
- Am J Ther. 1997 Sep 1;4(9-10):343-8.
AbstractTrimethoprim-sulfamethoxazole is a commonly prescribed antimicrobial agent. Twenty-five years after its introduction into clinical practice, an unrecognized and potentially lethal adverse reaction associated with trimethoprim-sulfamethoxazole therapy, hyperkalemia, was described. Both "high-dose" and "standard-dose" trimethoprim-sulfamethoxazole have been associated with this electrolyte disorder. Recognition of this potassium disturbance led to the subsequent description of the mechanism by which trimethoprim-sulfamethoxazole induced hyperkalemia. Trimethoprim was found to act like the potassium-sparing diuretic amiloride and reduce renal potassium excretion. Hence, trimethoprim is in fact a potassium-sparing diuretic like amiloride and causes hyperkalemia in high-risk patients.
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