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Can Quinapril-Hydrochlorothiazide Cause Low Serum Potassium Levels?

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Posted on Tue, 8 Aug 2017
Question: I ran out of my medication, quinapril/hctz 20/25 mg for exactly one week recently, and I have now been back on that medication (which I have taken daily for the past 10 years). I have been back on it now for a week, and had lab work done today in preparation for surgery next Thursday. After leaving the preop appointment, I got a call from my doctor's office to let me know that my potassium level is at a critical 2.9, and I was asked to contact my PCP. I have a couple of days to bring my level up before my next lab test. If I can't bring my potassium up, I may need to reschedule my surgery, which is currently set for next Thursday. My questions are: Do you think that being off this medication for a week could have something to do with my low potassium levels, and do you feel that there would be anything I could eat this weekend, (bananas?) this weekend to help my numbers come back up? I wish I could attach the lab results, but I was not given those. I appreciate your advice.
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
you need potassium supplementation

Detailed Answer:
Hello,

The hctz component of your antihypertensive medication is probably causing the low potassium levels. 2.9 is too low to ignore, so you should raise it somehow. The best way to do that would be with a very slow intravenous infusion of normal saline with potassium chloride and appropriate monitoring of potassium levels until they get back to normal.

An alternative approach would be to take potassium by mouth (potassium gluconate for example). Bananas and tomatoes are fine but they can't raise the levels so much unless you eat many of them. They'll help of course.

Since potassium requires strict control to avoid serious problems like arrhythmias and even syncope, it's better to monitor the blood levels to make sure they won't go lower or too high (after correction). Make sure you get the tests on your hands as soon as possible. It has happened so many times in the past that test results reported over the phone were wrong...

I'm sure the potassium levels won't pose serious problems regarding your surgery as they can be corrected fairly quickly in the hospital setting.

I hope you find my comments helpful!
Kind regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (11 hours later)
Thank you very much, Dr. Zogra! This information, and your advice, is just what I needed. Best Regards!
doctor
Answered by Dr. Panagiotis Zografakis (12 minutes later)
Brief Answer:
You're welcome!

Detailed Answer:
Glad to help!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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Can Quinapril-Hydrochlorothiazide Cause Low Serum Potassium Levels?

Brief Answer: you need potassium supplementation Detailed Answer: Hello, The hctz component of your antihypertensive medication is probably causing the low potassium levels. 2.9 is too low to ignore, so you should raise it somehow. The best way to do that would be with a very slow intravenous infusion of normal saline with potassium chloride and appropriate monitoring of potassium levels until they get back to normal. An alternative approach would be to take potassium by mouth (potassium gluconate for example). Bananas and tomatoes are fine but they can't raise the levels so much unless you eat many of them. They'll help of course. Since potassium requires strict control to avoid serious problems like arrhythmias and even syncope, it's better to monitor the blood levels to make sure they won't go lower or too high (after correction). Make sure you get the tests on your hands as soon as possible. It has happened so many times in the past that test results reported over the phone were wrong... I'm sure the potassium levels won't pose serious problems regarding your surgery as they can be corrected fairly quickly in the hospital setting. I hope you find my comments helpful! Kind regards!