{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:45:02Z","timestamp":1787013902892,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T00:00:00Z","timestamp":1489968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PB\u2010PG\u20100906\u201011116"],"award-info":[{"award-number":["PB\u2010PG\u20100906\u201011116"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      Co\u2010trimoxazole maintains a well\u2010established role in the treatment of\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      and\n                      <jats:italic>Toxoplasma gondii<\/jats:italic>\n                      , as well as urinary tract infections. Observational studies report hyperkalaemia to be associated with co\u2010trimoxazole, which may stem from an amiloride\u2010like potassium\u2010sparing effect. The current study investigated changes in serum potassium in patients without acute infections, and the influence of concomitant antikaliuretic drugs on this effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A\n                      <jats:italic>post hoc<\/jats:italic>\n                      analysis was carried out of a randomized controlled trial in patients with interstitial lung disease who were assigned to placebo or 960\u00a0mg co\u2010trimoxazole twice daily. Serum potassium and creatinine were measured at baseline, 6\u00a0weeks, and 6, 9 and 12\u00a0months. The primary outcome was the difference in mean serum potassium concentrations between co\u2010trimoxazole and placebo at 6\u00a0weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean serum potassium levels were similar at baseline: 4.24 (\u00b1 0.44) mmol l\n                      <jats:sup>\u20131<\/jats:sup>\n                      in the 87 co\u2010trimoxazole group participants and 4.25 (\u00b1 0.39) mmol l\n                      <jats:sup>\u20131<\/jats:sup>\n                      in the 83 control participants. Co\u2010trimoxazole significantly increased mean serum potassium levels at 6\u00a0weeks, with a difference between means compared with placebo of 0.21\u00a0mmol l\n                      <jats:sup>\u20131<\/jats:sup>\n                      [95% confidence interval (CI) 0.09, 0.34;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001). This significant increase in serum potassium was detectable even after exclusion of patients on antikaliuretic drugs, with a difference between means for co\u2010trimoxazole compared with placebo of 0.23\u00a0mmol l\n                      <jats:sup>\u20131<\/jats:sup>\n                      (95% CI 0.09, 0.38;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.002). There were 5\/87 (5.7%) patients on co\u2010trimoxazole whose serum potassium concentrations reached \u22655.5\u00a0mmol l\n                      <jats:sup>\u20131<\/jats:sup>\n                      during the study period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Co\u2010trimoxazole significantly increases serum potassium concentration, even in participants not using antikaliuretic drugs. While the magnitude of increase was often minor, a small proportion in our outpatient cohort developed hyperkalaemia of clinical importance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bcp.13263","type":"journal-article","created":{"date-parts":[[2017,2,13]],"date-time":"2017-02-13T12:46:42Z","timestamp":1486990002000},"page":"1808-1814","source":"Crossref","is-referenced-by-count":15,"title":["The effect of co\u2010trimoxazole on serum potassium concentration: safety evaluation of a randomized controlled trial"],"prefix":"10.1111","volume":"83","author":[{"given":"Wei Yee","family":"Chan","sequence":"first","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan B.","family":"Clark","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew 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