{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T04:21:06Z","timestamp":1773375666496,"version":"3.50.1"},"reference-count":13,"publisher":"American Society of Consultant Pharmacists","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:p>The objective of this analysis is to investigate the risk of hyperkalemia in hospitalized patients using sulfamethoxazole-trimethoprim (Co-trimoxazole) and a potassium-sparing drug (potassium-sparing diuretic or renin-angiotensin system [RAS]-inhibitor). Researchers conducted a nested\n case control study within a cohort of hospitalized patients using a potassium-sparing diuretic and\/or a RAS-inhibitor from the PHARMO Database Network. Researchers estimated the odds ratios (ORs) and 95% confidence intervals (CI) for the risk of hyperkalemia in patients receiving both Co-trimoxazole\n and a potassium-sparing drug compared with patients only receiving a potassium-sparing drug. Among a cohort of 25,849 patients, researchers identified 2054 cases of hyperkalemia during hospitalization in patients also using a potassium-sparing drug. Using Co-trimoxazole in addition to a potassium-sparing\n drug was associated with an increased risk of hyperkalemia in hospitalized patients (OR<jats:sub>adj<\/jats:sub> = 1.65, 95% CI 1.26-2.16) compared with using only a potassium-sparing drug. There was a trend of a more pronounced association between hyperkalemia and the co-use of Co-trimoxazole and potassium-sparing\n drugs in patients with an estimated GFR of 15-29 mL\/min (OR<jats:sub>adj<\/jats:sub> = 3.15, 95% CI 1.29-7.70). The number needed to harm for hyperkalemia induced by adding Co-trimoxazole to patients receiving a potassium-sparing drug is 19.5. Using the combination of Co-trimoxazole with a potassium-sparing\n drug in hospitalized patients increases the risk of hyperkalemia compared with using only a potassium-sparing drug. Physicians and other prescribers should be aware of hyperkalemia and routinely monitor serum potassium levels in hospitalized patients using this combination of drugs.<\/jats:p>","DOI":"10.4140\/tcp.n.2024.259","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T04:30:28Z","timestamp":1719549028000},"page":"259-266","source":"Crossref","is-referenced-by-count":3,"title":["Sulfamethoxazole-Trimethoprim-Induced Hyperkalemia in Hospitalized Patients Using Potassium-Sparing Drugs: An Observational Study"],"prefix":"10.4140","volume":"39","author":[{"given":"Madelon H.","family":"Butterhoff","sequence":"first","affiliation":[{"name":"1Tergooi Medical Center, Department of Pharmacy, Hilversum, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hieronymus J.","family":"Derijks","sequence":"additional","affiliation":[{"name":"1Tergooi Medical Center, Department of Pharmacy, Hilversum, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Hermens","sequence":"additional","affiliation":[{"name":"1Tergooi Medical Center, Department of Pharmacy, Hilversum, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"van der Linden","sequence":"additional","affiliation":[{"name":"1Tergooi Medical Center, Department of Pharmacy, Hilversum, Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"316","DOI":"10.7326\/0003-4819-124-3-199602010-00006","article-title":"Hyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole","volume":"124","year":"1996","journal-title":"Ann Intern Med"},{"issue":"5","key":"ref2","first-page":"ofaa112","article-title":"Low-dose TMP-SMX in the treatment o","volume":"7","year":"2020","journal-title":"Pneumocystis jirovecii"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1111\/bcp.13263","article-title":"TIPAC investigators. The effect of co-trimoxazole on serum potassium concentration: safety evaluation of a randomized controlled trial","volume":"83","year":"2017","journal-title":"Br J Clin Pharmacol."},{"issue":"3","key":"ref4","first-page":"e156","article-title":"Hyperkalemia associated with use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers","volume":"30","year":"2012","journal-title":"Cardiovasc Ther."},{"key":"ref5","doi-asserted-by":"crossref","first-page":"d5228","DOI":"10.1136\/bmj.d5228","article-title":"Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study","volume":"343","year":"2011","journal-title":"BMJ"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1001\/archinternmed.2010.142","article-title":"Trimethoprim-sulfamethoxazole-induced hyperkalemia in patients receiving inhibitors of the renin-angiotensin system","volume":"170","year":"2010","journal-title":"Arch Intern Med"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"g6196","DOI":"10.1136\/bmj.g6196","article-title":"Co-trimoxazole and sudden death in patients receiving inhibitors of renin-angiotensin system: population based study","volume":"349","year":"2014","journal-title":"BMJ"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"E138","DOI":"10.1503\/cmaj.140816","article-title":"Trimethoprim-sulfamethoxazole and risk of sudden death among patients taking spironolactone","volume":"187","year":"2015","journal-title":"CMAJ"},{"issue":"5","key":"ref9","doi-asserted-by":"crossref","first-page":"467","DOI":"10.2169\/internalmedicine.55.5697","article-title":"Renal insufficiency in concert with renin-angiotensin aldosterone inhibition is a major risk factor for hyperkalemia associated with low-dose trimethoprim-sulfamethoxazole in adults","volume":"55","year":"2016","journal-title":"Intern Med."},{"issue":"2","key":"ref10","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/0895-4356(92)90016-G","article-title":"A chronic disease score from automated pharmacy data","volume":"45","year":"1992","journal-title":"J Clin Epidemiol."},{"key":"ref11","first-page":"k341","article-title":"Trimethoprim use for urinary tract infection and risk of adverse outcomes in older patients: cohort study","volume":"360","year":"2018","journal-title":"BMJ"},{"issue":"4","key":"ref12","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1159\/000013599","article-title":"Predictors of the development of hyperkalemia in patients using angiotensin converting enzyme inhibitors","volume":"20","year":"2000","journal-title":"Am J Nephrol"},{"issue":"6","key":"ref13","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1056\/NEJMra035279","article-title":"Managing hyperkalemia caused by inhibitors of the renin-angiotensin aldosterone system","volume":"351","year":"2004","journal-title":"N Engl J Med"}],"container-title":["The Senior Care Pharmacist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ascp\/tscp\/2024\/00000039\/00000007\/art00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T04:47:33Z","timestamp":1719982053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.4140\/TCP.n.2024.259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7,1]]}},"alternative-id":["2639-9636(20240701)39:7L.259;1-"],"URL":"https:\/\/doi.org\/10.4140\/tcp.n.2024.259","relation":{},"ISSN":["2639-9636"],"issn-type":[{"value":"2639-9636","type":"print"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}