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What Are The Side Effects Of Metroprolol And Spironolactone?

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Posted on Sat, 14 Jun 2014
Question: My Husband is taking Metroprolol ER Succinate (25 mg. tablets) and Spironoloctone (25 mg. tablets). What are the possible serious side effects of these two drugs when used together?
doctor
Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer:
Serious adverse effect, hyperkalemia

Detailed Answer:
Thank you for asking!
These two drugs are not to be used together as metoprolol and spironolactone both increase serum potassium.And that could lead to hyperkalemia and serious adverse effects may show up. A close monitoring and better avoidance of this combination is advised.COnsult your cardiologist for a safer replacement.As Game of electrolytes is a serious game you don't wanna play.
I hope it helps.take care and seek your cardiologist for further management. Don't forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shafi Ullah Khan (16 hours later)
My husband had some sort of seizure yesterday during the lunch hour I shared with him. He suddenly grabbed his head and then fell back in his chair, became stiff for several seconds as I shook him...thankfully he came out of it! Please fully explain just what is hyperkalemia? Later, he had a hard time breathing and took some prescription allergy medicine later at night, same day (5/28/14).
doctor
Answered by Dr. Shafi Ullah Khan (46 minutes later)
Brief Answer:
Increased potassium likely cause

Detailed Answer:
Thank you for asking!
That strange phase in your husband's life of sudden stiffness needs a little more clinical correlation. The condition hyperkalemia does that too called XXXXXXX muscle paralysis and that could explain the symptoms your husband had. it needs a little digging. If there is no previous history of seizures then it makes it more worth sorting out.Rest assured these two medicines we talked about has nothing to do with it.Get to a neurologist and see it to him and let him decide what it was/It would be unwise to comment on it for me as it needs a little work up for surety.
Now the hyperkalemia.Let me explain.Hyperkalemia is defined as a serum potassium concentration greater than approximately 3.5-5.5 mEq/L in adults;. Levels higher than 7 mEq/L can lead to significant hemodynamic and neurologic consequences, whereas levels exceeding 8.5 mEq/L can cause respiratory paralysis or cardiac arrest and can quickly be fatal.
Following are the classic hallmark presentation signs of this condition XXXXXXX muscle paralysis ( most likely explanation of that afternoon episode)
Dyspnea (shortness of breath)
Palpitations
Chest pain
Nausea or vomiting
Paresthesias (tingling sensations)
So it makes it more likely due to increased potassium in the blood due the combined use of these two medicines we talked about. A simple visit to ER and cardiologist if possible and having serum electrolytes assessment would clear the mind here. Let them reschedule the meds and replace with something safer and non interacting.
I hope it helps.Don't forget to close the discussion please.
Regards
S Khan


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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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What Are The Side Effects Of Metroprolol And Spironolactone?

Brief Answer: Serious adverse effect, hyperkalemia Detailed Answer: Thank you for asking! These two drugs are not to be used together as metoprolol and spironolactone both increase serum potassium.And that could lead to hyperkalemia and serious adverse effects may show up. A close monitoring and better avoidance of this combination is advised.COnsult your cardiologist for a safer replacement.As Game of electrolytes is a serious game you don't wanna play. I hope it helps.take care and seek your cardiologist for further management. Don't forget to close the discussion please. May the odds be ever in your favour. Regards S Khan