Nebivolol Induced Hyperkalemia: Case Report

Area of Science:

• Cardiology
• Clinical Pharmacology
• Pharmacovigilance

Background:

• Nebivolol is a beta-blocker used for hypertension.
• Hyperkalemia is a serious condition linked to cardiac arrhythmias and sudden death.
• Nebivolol is not currently listed as a cause of hyperkalemia in its product information.

Observation:

• A 47-year-old woman developed persistent hyperkalemia (serum potassium up to 6.4 mmol/L) while taking nebivolol for hypertension.
• Other causes of hyperkalemia were excluded through extensive diagnostic evaluation.
• The hyperkalemia resolved after nebivolol dosage reduction and discontinuation.

Findings:

• This case provides the first documented evidence of nebivolol-induced hyperkalemia.
• The adverse event occurred despite the patient having normal drug metabolism based on pharmacogenetic testing.
• The findings suggest a direct link between nebivolol and hyperkalemia, independent of common genetic factors affecting drug degradation.

Implications:

• Hyperkalemia is a potentially lethal adverse event that may be caused by nebivolol.
• Healthcare professionals should be aware of this newly identified side effect.
• The Summary of Product Characteristics for nebivolol should be updated to include hyperkalemia as a potential adverse event.