Drug Induced Hyponatraemia

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Listed below are some drugs that may cause hyponatraemia (serum sodium concentration below 135 mmol/L)

  • Angiotensin-converting enzyme inhibitors (ACE inhibitors) e.g. ramipril, enalapril
  • Angiotensin II receptor blockers e.g. losartan, olmesartan
  • Diuretics
    • Thiazide and related diuretics e.g. bendroflumethiazide, hydrochlorothiazide, chlortalidone, metolazone, indapamide
    • Loop diuretics e.g. bumetanide, furosemide, torasemide
    • Potassium-sparing diuretics e.g. amiloride
    • Mineralocorticoid receptor antagonists e.g. spironolactone, eplerenone, finerenone
  • Heparin
  • Antidepressants
    • Tricyclic antidepressants e.g. amitriptyline, imipramine, dosulepin
    • Selective serotonin reuptake inhibitors (SSRIs) e.g. sertraline, fluoxetine, paroxetine, citalopram
    • Monoamine-oxidase inhibitors (MAOIs) e.g. phenelzine, moclobemide
  • Antipsychotics
    • Phenothiazine e.g. chlorpromazine, thioridazine
    • Butyrophenones e.g. haloperidol
    • Atypical antipsychotics such as quetiapine, lurasidone, aripiprazole
  • Antiepileptics e.g. carbamazepine, sodium valproate, lamotrigine, oxcarbazepine, eslicarbazepine
  • Sulphonylureas e.g. chlorpropamide, tolbutamide
  • Opioids e.g. morphine
  • Atovaquone
  • Amphotericin
  • Linezolid
  • Desmopressin
  • Cyclophosphamide
  • Acetazolamide
  • MDMA (ecstasy)
  • Avelumab

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