Therapeutic amounts of intravenous salbutamol (albuterol) in four healthy people were associated with decreased plasma levels of calcium, magnesium, phosphate, and potassium.¹⁹ Decreased potassium levels have been reported with oral,²⁰ intramuscular, and subcutaneous albuterol administration.²¹ How frequently this effect occurs is not known; whether these changes are preventable through diet or supplementation is also unknown.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,²² although this deficiency may not be reflected by a low blood level of magnesium.²³ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.²⁴

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.²⁵ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.²⁶ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.²⁷ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.²⁸

Prolonged and frequent use of stimulant laxatives, including bisacodyl, may cause excessive and unwanted loss of water, potassium, and other nutrients from the body.^{29 , 30} Bisacodyl should be used for a maximum of one week, or as directed on the package label. Excessive use of any laxative can cause depletion of many nutrients. In order to protect against multiple nutrient deficiencies, it is important to not overuse laxatives.³¹ People with constipation should consult with their doctor or pharmacist before using bisacodyl.

Potassium-depleting diuretics, including loop diuretics, cause the body to lose potassium. Loop diuretics may also cause cellular magnesium depletion,³² although this deficiency may not be reflected by a low blood level of magnesium.³³ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including loop diuretics, should supplement both potassium and magnesium.³⁴

People taking loop diuretics should be monitored by their doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.³⁵ Fruit is high in potassium, and increasing fruit intake is another way of supplementing potassium. Magnesium supplementation is typically 300–400 mg per day.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{36 , 37} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{38 , 39} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁴⁰ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{41 , 42} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{43 , 44} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁴⁵ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{46 , 47} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{48 , 49} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁵⁰ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{51 , 52} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{53 , 54} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁵⁵ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{56 , 57} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{58 , 59} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁶⁰ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,⁶¹ although this deficiency may not be reflected by a low blood level of magnesium.⁶² Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.⁶³

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.⁶⁴ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.⁶⁵ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.⁶⁶ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.⁶⁷

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,⁶⁸ although this deficiency may not be reflected by a low blood level of magnesium.⁶⁹ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.⁷⁰

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.⁷¹ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.⁷² Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.⁷³ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.⁷⁴

Cisplatin may cause excessive loss of magnesium and potassium in the urine.^{75 , 76} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{77 , 78} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁷⁹ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{80 , 81} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{82 , 83} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁸⁴ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Colchicine has been associated with impaired absorption of beta-carotene, fat, lactose (milk sugar), potassium, and sodium.⁸⁵

Oral corticosteroids increase the urinary loss of potassium.⁸⁶ This may not cause a significant problem for most people. Individuals who wish to increase potassium intake should eat more fruits, vegetables, and juices rather than taking over-the-counter potassium supplements, which do not contain significant amounts of potassium.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{87 , 88} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{89 , 90} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁹¹ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Oral corticosteroids increase the urinary loss of potassium.⁹² This may not cause a significant problem for most people. Individuals who wish to increase potassium intake should eat more fruits, vegetables, and juices rather than taking over-the-counter potassium supplements, which do not contain significant amounts of potassium.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{93 , 94} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{95 , 96} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.⁹⁷ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Glutathione , the main antioxidant found within cells, is frequently depleted in individuals on chemotherapy and/or radiation. Preliminary studies have found that intravenously injected glutathione may decrease some of the adverse effects of chemotherapy and radiation, such as diarrhea.⁹⁸

Taking docusate increases the amount of potassium excreted from the body in the stool.⁹⁹ Whether people taking docusate for long periods of time need to increase their intake of potassium is unknown.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{100 , 101} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{102 , 103} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁰⁴ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{105 , 106} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{107 , 108} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁰⁹ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Felodipine can lead to increased excretion of potassium.¹¹⁰ A potassium deficiency may result if potassium intake is not sufficient. People taking felodipine should eat a high-potassium diet and be checked regularly for low blood potassium by a doctor.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{111 , 112} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{113 , 114} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹¹⁵ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{116 , 117} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{118 , 119} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹²⁰ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Potassium-depleting diuretics, including loop diuretics, cause the body to lose potassium. Loop diuretics may also cause cellular magnesium depletion,¹²¹ although this deficiency may not be reflected by a low blood level of magnesium.¹²² Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including loop diuretics, should supplement both potassium and magnesium.¹²³

People taking loop diuretics should be monitored by their doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.¹²⁴ Fruit is high in potassium, and increasing fruit intake is another way of supplementing potassium. Magnesium supplementation is typically 300–400 mg per day.

Gentamicin has been associated with hypokalemia (low potassium levels) in humans.¹²⁵

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,¹²⁶ although this deficiency may not be reflected by a low blood level of magnesium.¹²⁷ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.¹²⁸

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.¹²⁹ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.¹³⁰ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.¹³¹ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.¹³²

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,¹³³ although this deficiency may not be reflected by a low blood level of magnesium.¹³⁴ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.¹³⁵

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.¹³⁶ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.¹³⁷ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.¹³⁸ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.¹³⁹

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{140 , 141} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{142 , 143} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁴⁴ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{145 , 146} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{147 , 148} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁴⁹ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,¹⁵⁰ although this deficiency may not be reflected by a low blood level of magnesium.¹⁵¹ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.¹⁵²

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.¹⁵³ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.¹⁵⁴ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.¹⁵⁵ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.¹⁵⁶

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{158 , 159} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{160 , 161} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁶² Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{163 , 164} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{165 , 166} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁶⁷ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{168 , 169} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{170 , 171} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁷² Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{173 , 174} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{175 , 176} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁷⁷ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{178 , 179} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{180 , 181} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.¹⁸² Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Many chemotherapy drugs can cause diarrhea, lack of appetite, vomiting, and damage to the gastrointestinal tract. Recent anti-nausea prescription medications are often effective. Nonetheless, nutritional deficiencies still occur.¹⁸³ People undergoing chemotherapy should talk to their doctor about whether supplementing with a multivitamin-mineral will protect them against deficiencies.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,¹⁸⁴ although this deficiency may not be reflected by a low blood level of magnesium.¹⁸⁵ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.¹⁸⁶

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.¹⁸⁷ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.¹⁸⁸ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.¹⁸⁹ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.¹⁹⁰

Oral corticosteroids increase the urinary loss of potassium.¹⁹¹ This may not cause a significant problem for most people. Individuals who wish to increase potassium intake should eat more fruits, vegetables, and juices rather than taking over-the-counter potassium supplements, which do not contain significant amounts of potassium.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,³ although this deficiency may not be reflected by a low blood level of magnesium.⁴ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.⁵

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.⁶ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.⁷ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.⁸ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.⁹

Mineral oil has interfered with the absorption of many nutrients, including beta-carotene, calcium, phosphorus, potassium, and vitamins A, D, K, and E in some,¹⁹² but not all,¹⁹³ research. Taking mineral oil on an empty stomach may reduce this interference. It makes sense to take a daily multivitamin-mineral supplement two hours before or after mineral oil. It is important to read labels, because many multivitamins do not contain vitamin K or contain inadequate (less than 100 mcg per day) amounts.

Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K.^{194 , 195} Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{196 , 197} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{198 , 199} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.²⁰⁰ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,²⁰¹ although this deficiency may not be reflected by a low blood level of magnesium.²⁰² Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.²⁰³

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.²⁰⁴ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.²⁰⁵ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.²⁰⁶ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.²⁰⁷

Oral corticosteroids increase the urinary loss of potassium.²⁰⁸ This may not cause a significant problem for most people. Individuals who wish to increase potassium intake should eat more fruits, vegetables, and juices rather than taking over-the-counter potassium supplements, which do not contain significant amounts of potassium.

Oral corticosteroids increase the urinary loss of potassium.²⁰⁹ This may not cause a significant problem for most people. Individuals who wish to increase potassium intake should eat more fruits, vegetables, and juices rather than taking over-the-counter potassium supplements, which do not contain significant amounts of potassium.

Salsalate and aspirin are rapidly converted in the body to salicylic acid. Taking large amounts of aspirin can result in lower than normal blood levels of potassium,²¹¹ though it is not known whether this change is significant. Controlled studies are needed to determine whether people taking salsalate are at risk for potassium deficiency.

Four people who took sulindac developed high blood levels of potassium, which returned to normal within a few days after the drug was stopped.²¹² Controlled research is needed to determine whether potassium supplements or a high potassium diet might aggravate this problem. Until more information is available, people taking sulindac and potassium supplements, potassium containing salt substitutes, or large amounts of fruits and vegetables should have potassium blood levels checked regularly by their doctor.

Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, vitamin B6, vitamin B12, vitamin C, and vitamin K.²¹³ This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study.²¹⁴ The importance of this interaction is unknown.

Taking large amounts of niacinamide, a form of vitamin B3, can suppress inflammation in the body. According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin.^{215 , 216 , 217 , 218 , 219 , 220 , 221} Preliminary evidence also suggests a similar beneficial interaction may exist between tetracycline and niacinamide in the treatment of dermatitis herpetiformis.^{222 , 223}

Preliminary evidence indicates that theophylline can promote potassium and magnesium deficiency.^{224 , 225} Some doctors have noted a tendency for persons on theophylline to become deficient in these minerals. Therefore, supplementing with these minerals may be necessary during theophylline therapy. Consult with a doctor to make this determination.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{226 , 227} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{228 , 229} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.²³⁰ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Cisplatin may cause excessive loss of magnesium and potassium in the urine.^{232 , 233} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{234 , 235} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.²³⁶ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Calcium , magnesium, and potassium depletion requiring prolonged replacement were reported in a child with tetany who had just completed a three-week course of i.v. tobramycin.²³⁷ The authors suggest this may have been due to kidney damage related to the drug. Seventeen patients with cancer developed calcium, magnesium, and potassium depletion after treatment with aminoglycoside antibiotics, including tobramycin.²³⁸ The authors suggested a possible potentiating action of tobramycin-induced mineral depletion by chemotherapy drugs, especially doxorubicin (Adriamycin®).

Until more is known, people receiving i.v. tobramycin should ask their doctor about monitoring calcium, magnesium, and potassium levels and the possibility of mineral replacement.

Potassium-depleting diuretics, including loop diuretics, cause the body to lose potassium. Loop diuretics may also cause cellular magnesium depletion,²³⁹ although this deficiency may not be reflected by a low blood level of magnesium.²⁴⁰ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including loop diuretics, should supplement both potassium and magnesium.²⁴¹

People taking loop diuretics should be monitored by their doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.²⁴² Fruit is high in potassium, and increasing fruit intake is another way of supplementing potassium. Magnesium supplementation is typically 300–400 mg per day.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion,²⁴³ although this deficiency may not be reflected by a low blood level of magnesium.²⁴⁴ Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.²⁴⁵

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels.²⁴⁶ A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death.²⁴⁷ Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides.²⁴⁸ Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.²⁴⁹

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{250 , 251} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{252 , 253} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.²⁵⁴ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause kidney damage, resulting in depletion of calcium and phosphate.²⁵⁵

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{256 , 257} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{258 , 259} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.²⁶⁰ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine.^{261 , 262} Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels.^{263 , 264} Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures.²⁶⁵ Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

Many chemotherapy drugs can cause diarrhea, lack of appetite, vomiting, and damage to the gastrointestinal tract. Recent anti-nausea prescription medications are often effective. Nonetheless, nutritional deficiencies still occur.²⁶⁶ People undergoing chemotherapy should talk to their doctor about whether supplementing with a multivitamin-mineral will protect them against deficiencies.

In order to lose weight, some individuals who are overly zealous, as well as those with eating disorders, occasionally induce vomiting with ipecac. However, chronic abuse of ipecac can result in low blood levels of potassium,¹⁵⁷ which might result in an irregular heart rhythm. Though avoidance of this behavior is the best form of prevention, individuals who abuse ipecac should supplement with potassium or high-potassium foods to prevent potassium deficiency.

People taking potassium-depleting diuretics may develop low potassium and magnesium blood levels. Prolonged diarrhea and vomiting might also result in low blood potassium levels. People with low potassium or magnesium blood levels who take quinidine might develop serious drug side effects.²¹⁰ Therefore, people taking quinidine should have their blood potassium and magnesium levels checked regularly and might need to supplement with both minerals, especially when taking potassium-depleting diuretics.

Some people taking thioridazine experience changes in the electrical activity of the heart, which sometimes improve with potassium supplementation.²³¹ More research is needed to determine if people taking thioridazine might prevent heart problems by supplementing with potassium.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,²⁶⁷ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.²⁶⁸ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (for example, bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{269 , 270 , 271} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,²⁷² potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others),^{273 , 274 , 275} or large amounts of high-potassium foods (including noni juice) at the same time as ACE inhibitors could cause life-threatening problems.²⁷⁶ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,²⁷⁷ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.²⁷⁸ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (for example, bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{279 , 280 , 281} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,²⁸² potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),^{283 , 284 , 285} or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems.²⁸⁶ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,²⁸⁷ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.²⁸⁸ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,²⁸⁹ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.²⁹⁰ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{291 , 292 , 293} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,²⁹⁴ potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),^{295 , 296 , 297} or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems.²⁹⁸ Therefore, individuals should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,²⁹⁹ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³⁰⁰ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Cyclosporine can cause excess retention of potassium, potentially leading to dangerous levels of the mineral in the blood (hyperkalemia).³⁰¹ Potassium supplements, potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others), and even high-potassium foods (primarily fruit) should be avoided by people taking cyclosporine, unless directed otherwise by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{302 , 303 , 304} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,³⁰⁵ potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others),^{306 , 307 , 308} or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems.³⁰⁹ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³¹⁰ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³¹¹ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{312 , 313 , 314} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,³¹⁵ potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),^{316 , 317 , 318} or large amounts of high-potassium foods at the same time as taking ACE inhibitors could cause life-threatening problems.³¹⁹ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Indomethacin may cause elevated blood potassium levels in people with normal and abnormal kidney function.^{320 , 321 , 322 , 323} Until more is known, people taking indomethacin should not supplement potassium without medical supervision.

A 50-year-old male developed high blood levels of potassium following eight days of ketorolac treatment.³²⁴ Additional research is needed to determine whether taking ketorolac together with supplemental potassium might enhance this side effect. individuals taking oral ketorolac should probably avoid potassium supplements and salt substitutes until more information is available.

Three kidney transplant patients developed hyperkalemia (high blood potassium levels), a potentially dangerous condition, following intravenous administration of labetalol.³²⁵ Additional research is needed to determine whether taking oral labetalol together with potassium supplements might also lead to elevated blood levels of potassium. However, some other beta-blockers (called “nonselective” beta-blockers) are known to decrease the uptake of potassium from the blood into the cells,³²⁶ leading to hyperkalemia.³²⁷ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³²⁸ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³²⁹ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

People taking nadolol may experience significant increases in blood levels of potassium,³³⁰ though it is unknown whether supplementation with potassium might enhance this effect. People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of high-potassium foods, such as fruit (e.g., bananas), unless directed to do so by their doctor.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³³¹ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³³² People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³³³ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³³⁴ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{335 , 336 , 337} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,³³⁸ potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others),^{339 , 340 , 341} or large amounts of high-potassium foods (such as bananas and other fruit) at the same time as taking ACE inhibitors could cause life-threatening problems.³⁴² Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³⁴³ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³⁴⁴ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

An 85-year-old man developed higher than normal blood levels of potassium following several months of treatment with piroxicam.³⁴⁵ Until more is known, people taking piroxicam for long periods should have their blood checked regularly for high potassium levels and may need to avoid high potassium intake with the guidance of a health practitioner.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³⁴⁶ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³⁴⁷ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{348 , 349 , 350} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,³⁵¹ potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),^{352 , 353 , 354} or large amounts of high-potassium foods (including noni juice) at the same time as taking ACE inhibitors could cause life-threatening problems.³⁵⁵ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{356 , 357 , 358} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,³⁵⁹ potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),^{360 , 361 , 362} or large amounts of high-potassium foods (including noni juice) at the same time as ACE inhibitors could cause life-threatening problems.³⁶³ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

TMP/SMX has been reported to elevate potassium and other constituents of blood (creatinine and BUN).³⁶⁴ In particular, people with impaired kidney function should be closely monitored by their prescribing doctor for these changes. People taking sulfamethoxazole or TMP/SMX should talk with their prescribing doctor before taking any potassium supplements or potassium-containing products, such as No Salt, Salt Substitute, Lite Salt, and even high-potassium foods (primarily fruit).

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³⁶⁵ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³⁶⁶ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{367 , 368 , 369} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,³⁷⁰ potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others),^{371 , 372 , 373} or large amounts of high-potassium foods (such as bananas and other fruit) at the same time as taking ACE inhibitors could cause life-threatening problems.³⁷⁴ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

The combination drug trimethoprim/sulfamethoxazole (TMP/SMX) has been reported to elevate blood potassium and other constituents of blood (creatine and BUN).^{375 , 376} In particular, people with impaired kidney function should be closely monitored by their prescribing doctor for these changes. People taking trimethoprim or TMP/SMX should talk with the prescribing doctor before taking any potassium supplements or potassium-containing products, such as No Salt, Salt Substitute, Lite Salt, and even high-potassium foods (primarily fruit).

TMP/SMX has been reported to increase blood potassium to levels above the normal range in some patients, particularly those with impaired kidney function.³⁷⁷ People who have been prescribed TMP/SMX should ask their doctor whether they should avoid potassium supplements, potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others), and high-potassium foods (primarily fruit).

As a potassium-sparing drug, amiloride reduces urinary loss of potassium.³⁷⁸ This can cause potassium levels to build up in the body. People taking this drug should avoid use of potassium chloride–containing products, such as Morton Salt Substitute, No Salt, Lite Salt, and others. Even eating several pieces of fruit per day can sometimes cause problems for people taking potassium-sparing diuretics, due to the high potassium content of fruit.

However, one medication (Moduretic) contains the combination of the potassium-sparing drug amiloride and the potassium-depleting drug hydrochlorothiazide. With the use of Moduretic, potassium excess and potassium depletion are both possible. People taking this combination drug should have their potassium levels monitored by a doctor to determine whether their potassium intake should be increased, reduced, or kept the same.

Controlled studies indicate that individuals on low-salt diets who take celecoxib retain sodium and potassium, which might result in higher than normal blood levels of these minerals.³⁷⁹ More research is needed to determine whether potassium supplements might produce unwanted side effects in people taking celecoxib. Until more information is available, people taking celecoxib should have their sodium and potassium blood levels monitored by their healthcare practitioner.

Medical doctors prescribing digoxin also check for potassium depletion and prescribe potassium supplements if needed. Potassium transport from the blood into cells is impaired by digoxin.³⁸⁰ Although digoxin therapy does not usually lead to excess potassium in the blood (hyperkalemia), an overdose of digoxin could cause a potentially fatal hyperkalemia.³⁸¹ People taking digoxin should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor. On the other hand, many people taking digoxin are also taking a diuretic; in these individuals, increased intake of potassium may be needed. These issues should be discussed with a doctor.

Intravenous administration of epinephrine to human volunteers reduced plasma concentrations of vitamin C.³⁸² Epinephrine and other “stress hormones” may reduce intracellular concentrations of potassium and magnesium.³⁸³ Although there are no clinical studies in humans, it seems reasonable that individuals using epinephrine should consume a diet high in vitamin C, potassium, and magnesium, or should consider supplementing with these nutrients.

NSAIDs have caused kidney dysfunction and increased blood potassium levels, especially in older people.³⁸⁴ People taking NSAIDs, including etodolac, should not supplement potassium without consulting with their doctor.

Haloperidol may cause hyperkalemia (high blood levels of potassium) or hypokalemia (low blood levels of potassium).³⁸⁵ The incidence and severity of these changes remains unclear. Serum potassium can be measured by any doctor.

Heparin therapy may cause hyperkalemia (abnormally high potassium levels).^{386 , 387} Potassium supplements, potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others), and even high-potassium foods (primarily fruit) should be avoided by persons on heparin therapy, unless directed otherwise by their doctor.

Ibuprofen has caused kidney dysfunction and increased blood potassium levels, especially in older people.³⁸⁸ People taking ibuprofen should not supplement potassium without consulting with their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{389 , 390 , 391} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,³⁹² potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),^{393 , 394 , 395} or large amounts of high-potassium foods (including noni juice) at the same time as ACE inhibitors could cause life-threatening problems.³⁹⁶ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Individuals taking potassium-depleting diuretics and those who are otherwise at risk of developing potassium deficiency (such as people with chronic diarrhea or vomiting) may experience a fall in serum potassium levels if they take magnesium without taking additional potassium.³⁹⁸ This could lead to muscle cramps or, in individuals taking digoxin or digitalis, more serious problems such as cardiac arrhythmias. Individuals who have a history of potassium deficiency and those who are at risk of developing potassium deficiency, as well as people taking digoxin or digitalis, should consult a physician before taking magnesium-containing products.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,³⁹⁹ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.⁴⁰⁰ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.^{401 , 402 , 403} This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,⁴⁰⁴ potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others),^{405 , 406 , 407} or large amounts of high-potassium foods (such as bananas and other fruit) at the same time as taking ACE inhibitors could cause life-threatening problems.⁴⁰⁸ Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

NSAIDs have caused kidney dysfunction and increased blood potassium levels, especially in older people.⁴⁰⁹ People taking NSAIDs, including nabumetone, should not supplement potassium without consulting with their doctor.

Naproxen has caused kidney problems and increased blood potassium levels, especially in older people.^{410 , 411} People taking naproxen should not supplement potassium without consulting with their doctor.

NSAIDs have caused kidney dysfunction and increased blood potassium levels, especially in older people.⁴¹² People taking NSAIDs, including oxaprozin, should not supplement potassium without consulting with their doctor.

Overuse or misuse of laxatives, including senna, can cause water, sodium, and potassium depletion.⁴¹³ To avoid depletion problems, people should limit laxative use, including senna, to one week or less.⁴¹⁴

People with prolonged diarrhea and vomiting, as well as those taking potassium-depleting diuretics, might develop low blood potassium levels. Individuals with low blood potassium levels who take sotalol have an increased risk of developing a serious heart arrhythmia and fainting. Therefore, people taking sotalol should have their blood potassium levels checked regularly and may need to supplement with potassium, especially when taking potassium-depleting diuretics.

Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,⁴¹⁵ leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.⁴¹⁶ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

As a potassium-sparing diuretic, spironolactone reduces urinary loss of potassium, which can lead to elevated potassium levels.⁴¹⁷ People taking spironolactone should avoid potassium supplements, potassium-containing salt substitutes (Morton Salt Substitute, No Salt, Lite Salt, and others), and even high-potassium foods (primarily fruit). Doctors should monitor potassium blood levels in patients taking spironolactone to prevent problems associated with elevated potassium levels.

However, one medication (Aldactazide) contains the combination of the potassium-sparing drug spironolactone and the potassium-depleting drug hydrochlorothiazide. With the use of Aldactazide, potassium excess and potassium depletion are both possible. People taking this combination drug should have their potassium levels monitored by a doctor to determine whether their potassium intake should be increased, reduced, or kept the same.

As a potassium-sparing drug, triamterene reduces urinary loss of potassium, which can lead to elevated potassium levels.⁴¹⁸ People taking triamterene should avoid potassium supplements, potassium-containing salt substitutes (Morton Salt Substitute, No Salt, Lite Salt, and others) and even high-potassium foods (primarily fruit). Doctors should monitor potassium blood levels in patients taking triamterene to prevent problems associated with elevated potassium levels.

However, some medications (for example, Dyazide, Maxzide) contain the combination of the potassium-sparing drug triamterene and the potassium-depleting drug hydrochlorothiazide. With the use of these combination medications, potassium excess and potassium depletion are both possible. People taking these drugs should have their potassium levels monitored by a doctor to determine whether their potassium intake should be increased, reduced, or kept the same.