Q. My pharmacist said I could have killed myself if I kept taking potassium with my blood pressure medicine. My new doctor switched me to enalapril and didn’t mention any precautions.
Before this I was on hydrochlorothiazide and potassium supplements. It’s lucky my pharmacist noticed I had changed blood pressure prescriptions when I went to have the potassium refilled. I have also used Lite Salt or NoSalt for years to reduce my sodium intake. Do I need to stop using the salt substitute as well?
A. Potassium-based salt substitutes can be a good way of cutting back on sodium and getting extra potassium. But in combination with medicines such as Vasotec (enalapril), Capoten (captopril), Lotensin (benazepril), Aceon (perindopril), Accupril (quinapril), Altace (ramipril), Mavic (trandolapril), or Zestril (lisinopril), salt substitutes and potassium supplements could be disastrous. Too much potassium can cause fatal heart rhythms.
This was an example of a serious medical mistake. The new physician clearly did not take time to review all the prior medications that had been prescribed. Potassium supplements are often recommended to compensate for the depletion of potassium brought on by diuretics like hydrochlorothiazide (HCTZ) or furosemide (Lasix). But when the prescription was changed to an ACE inhibitor like enalapril, the doctor should have been far more careful to check the medical records and ask about salt substitutes. Fortunately, the pharmacist saved the day (and potentially your life).
Such mistakes are far more common than most people realize. That’s why we wrote, Top Screwups Doctors Make and How to Avoid Them. You can get an autographed copy by visiting our People’s Pharmacy store. The book offers hundreds of questions to ask and tips to prevent this kind of potentially lethal error. In particular, there is information on common mistakes made with ACE inhibitors, diabetes drugs, hypothyroidism and heartburn. Here’s a link to the People’s Pharmacy Store if you would like a copy.
Vitamin and mineral interactions with some medicines can be life threatening. We are sending you our Guide to Drug and Nutrient Interactions. It tells which prescription drugs can provoke nutritional deficits, and alerts you to problems that may occur if you take supplements with your medications.