Drug-induced hypokalemia: an analytical study based on real-world drug monitoring data.

Background: Drug-induced hypokalemia is often associated with adverse clinical outcomes, and unfortunately, the inability to fully understand the drugs that cause hypokalemia puts us in a passive position. This study applies pharmacovigilance data to present a panorama of suspected medications associated with hyperkalemia.

Research design and methods: This study used disproportionality analysis to mine adverse events in OpenFDA, identified all suspected drugs that caused hypokalemia, and coded and classified the suspected drugs according to the Anatomical Therapeutic Chemical (ATC) classification system.

Results: There are 19755 reports related to drug-induced hypokalemia. The majority of individuals with hypokalemia are females, with a concentrated age range of 65 to 84 years old. After the occurrence of hypokalemia, 8.02% died due to hypokalemia. This study identified 1141 suspected drugs, and among the top 50 drugs, 32 drugs did not include hypokalemia in their instructions. All suspected drugs can be categorized into 73 subgroups according to the ATC classification system.

Conclusions: By mining the OpenFDA database, we have identified all suspected drugs that cause hypokalemia and conducted a comprehensive evaluation. The instructions for most of the suspected drugs do not focus on hypokalemia. When the treatment regimen includes other drugs that can directly/indirectly cause a decrease in blood potassium, we recommend actively monitoring blood potassium when using suspected drugs.