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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes low potassium and magnesium levels while on Keppra, Mirtazapine and Metoprolol?

Why do I keep ending e.r with low potassium and magnesium,when I go in with i we think are the signs of a heart issues? I have chf and epilepsy plus very severe anxiety since I lost all my memories in 9-2014. I am not sure exactly what I am try to ask because I I had learn everything again. I am on troknendi Xr 200 one a day, generic prontix 40mgs twice a day, keppra 500 twice a day, Mirtazapine 15mg one a day, norco 325mgs 3 a day ,flector patches every twelve hours, atorvastinn 10mg one a day, metoprolol tartrate 25mgs 1/4 to 1/2 twice a day as needed, 81 msg aspirin one a day, generic skelaxin 3 times a day, for severe muscle spasms, alprazolam1 mg 3 times for severe anxiety. Albuterol tabs 4 mags 3 times a day, Adair discus 2 times aday . As you can see I have quite things wrong me. To me the biggest one is my low potassium, magnesium and high blood pressure. I have bulging discs, arthritis, mild scoliosis, spinal stenosis ,asthma, I had a heart in 3-3-2015. Fibromyalgia, tendinitis, migraines, nerve pain . I just want to if any of this medicines could be lowering my potassium and magnesium and making me feel much worse than I should. I feel very stupid going to e r and finding out it is only my potassium and magnesium, please me if can. I sure would appreciate it. At 830 I had taken my pressure and it was 148/105 my pulse was 63. Sincerely bummi47
Fri, 7 Sep 2018
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General & Family Physician 's  Response

Low potassium and magnesium can certainly make you feel not good, so I can understand why you would want to get checked out at the ER. While there are many causes for low potassium and magnesium, one medication that I see that might not be helping is the Protonix (I'm assuming you meant to put Protonix?). This medication can cause low magnesium, and once you have low magnesium, you can easily get low potassium as well. I would ask your doctor if he/she agrees and whether you can stop it or switch to something else.

As for your blood pressure, it is higher than it should be, but not so high that it is an emergency. I would check with your doctor and maybe another blood pressure medicine could be added. The metoprolol you take is for blood pressure too, and maybe the dose could be increased, but that medication also lowers your heart rate, and yours is already a little low, so your doctor might not want to increase it.

Hope I have answered your query. Let me know if I can assist you further.
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