From the FDA Drug Label
Serum electrolytes (particularly potassium), CO2, creatinine and BUN should be determined frequently during the first few months of Furosemide tablets therapy and periodically thereafter. Abnormalities should be corrected or the drug temporarily withdrawn. Reversible elevations of BUN may occur and are associated with dehydration, which should be avoided, particularly in patients with renal insufficiency
- Hypernatremia is not directly mentioned in the provided drug label as a potential side effect of furosemide.
- However, dehydration is mentioned as a cause of reversible elevations of BUN, and dehydration can lead to hypernatremia.
- The label does recommend monitoring serum electrolytes, which includes sodium, but does not explicitly state that furosemide can cause hypernatremia.
- There is no information in the label about the other listed medications (donepezil, atorvastatin, montelukast, metoprolol, venlafaxine, mometasone, clopidogrel) causing hypernatremia.
- Based on the information provided, it is unclear if these medications can cause hypernatremia, but furosemide may indirectly contribute to hypernatremia through dehydration 1.
From the Research
Lasix (furosemide) is the most likely medication to cause hypernatremia due to its loop diuretic effect, which can lead to dehydration and elevated sodium levels if fluid intake is inadequate. The other medications listed, including donepezil, atorvastatin, montelukast, mometasone, clopidogrel, metoprolol, and venlafaxine, are not typically associated with hypernatremia as a common side effect 2, 3, 4, 5, 6.
Key Points to Consider:
- Venlafaxine has been associated with syndrome of inappropriate antidiuretic hormone secretion (SIADH), which typically causes hyponatremia rather than hypernatremia 6.
- Metoprolol, a beta-blocker, generally doesn't affect sodium levels significantly 6.
- Donepezil, atorvastatin, montelukast, mometasone, and clopidogrel are not typically associated with hypernatremia 2, 3, 4, 5.
- Patients taking Lasix should maintain adequate fluid intake and have electrolytes monitored regularly, especially elderly patients who are more susceptible to dehydration 6.
- Any patient experiencing symptoms like excessive thirst, dry mouth, confusion, or lethargy while taking these medications should seek medical attention as these could indicate electrolyte disturbances including hypernatremia 6.
Recommendations for Patients:
- Patients on Lasix should be closely monitored for signs of dehydration and electrolyte imbalances.
- Regular monitoring of electrolyte levels, especially sodium, is crucial for patients on Lasix.
- Patients should be educated on the importance of maintaining adequate fluid intake while on Lasix.
- Healthcare providers should be vigilant for symptoms of hypernatremia in patients on Lasix and take prompt action if such symptoms arise.