Octreotide-induced hyperkalemia

A 68-year-old woman was admitted with numerous injuries after being hit by an automobile. On day 16 of hospitalization octreotide was started for treatment of a pancreatic fistula, and within 2 days the patient's serum potassium increased. By the third and fourth days of octreotide therapy the level had increased to the point at which it required treatment. The patient was asymptomatic, however, and had normal renal function. Octreotide was discontinued on the fifth day of the course, with a subsequent decrease in serum potassium. Two days later, one dose of the drug was given; serial serum potassium levels were measured before and after the dose, and increased after the rechallenge. Octreotide was not administered for the remainder of the patient's hospitalization, and hyperkalemia did not recur.