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Hyponatraemia associated with trimethoprim use

Kareeann Sok Fun Khow, Tuck Yean Yong1

  • 1Department of General Medicine, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia. tyyong@hotmail.com.

Current Drug Safety
|December 31, 2013
PubMed

Insights

Trimethoprim (TMP) antibiotic use can rarely cause serious electrolyte imbalances like hyponatraemia and hyperkalaemia. Discontinuation of TMP corrected these adverse effects in patients, highlighting the need for monitoring.

Area of Science:

  • Nephrology
  • Clinical Pharmacology

Background:

  • Trimethoprim (TMP) is a widely used antibiotic.
  • While generally safe, TMP can rarely cause electrolyte disturbances.

Observation:

  • Three patients presented with symptomatic hyponatraemia requiring hospitalization during TMP treatment.
  • One patient also experienced hyperkalaemia and type 4 renal tubular acidosis.

Findings:

  • TMP-induced electrolyte and acid-base disorders resolved after drug discontinuation.
  • TMP may inhibit sodium influx via the epithelial sodium channel in the cortical collecting duct, affecting sodium and potassium balance.

Implications:

  • This study highlights a rare but significant adverse effect of TMP.
  • Clinicians should consider evaluating electrolytes in patients experiencing clinical changes after starting TMP.

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