sulindac and Hyperkalemia

The incidence and severity of hyperkalemia and azotemia was investigated in a prospective randomized study involving 74 patients receiving either sulindac 200 mg p.o. b.i.d. or indomethacin 25 mg p.o. t.i.d. and 100 mg p.r. The mean +/- SE posttreatment increment in serum potassium was 0.8 +/- 0.1 mmol/l in patients treated by indomethacin compared to 0.5 +/- 0.1 in those receiving sulindac (p less than 0.025). The mean +/- SE posttreatment increment in blood urea nitrogen (BUN) was 3.1 +/- 0.4 mmol/l in patients on indomethacin compared to only 0.9 +/- 0.3 in patients on sulindac (p less than 0.001). In 5 patients who developed hyperkalemia while on indomethacin, changing to sulindac resulted in a sharp reduction of serum potassium in 3, and normalization of BUN in all patients. These data support the claim of a reduced risk of impaired renal function associated with the use of sulindac.

Topics: Aged; Aged, 80 and over; Blood Urea Nitrogen; Female; Humans; Hyperkalemia; Indenes; Indomethacin; Male; Middle Aged; Potassium; Prospective Studies; Random Allocation; Sulindac; Uremia

Topics: Acute Kidney Injury; Aged; Arthritis; Female; Gout; Humans; Hyperkalemia; Indenes; Recurrence; Sulindac

Topics: Aged; Aged, 80 and over; Deglutition Disorders; Esophageal Stenosis; Humans; Hyperkalemia; Infant Food; Male; Potassium; Sulindac

Hyperkalemia has recently been recognized as a complication of nonsteroidal antiinflammatory agents (NSAID) such as indomethacin. Several recent studies have stressed the renal sparing features of sulindac, owing to its lack of interference with renal prostacyclin synthesis. We describe 4 patients in whom hyperkalemia ranging from 6.1 to 6.9 mEq/l developed within 3 to 8 days of sulindac administration. In all of them normal serum potassium levels reached within 2 to 4 days of stopping sulindac. As no other medications known to effect serum potassium had been given concomitantly, this course of events is suggestive of a cause-and-effect relationship between sulindac and hyperkalemia. These observations indicate that initial hopes that sulindac may not be associated with the adverse renal effects of other NSAID are probably not justified.

Topics: Adult; Aged; Female; Humans; Hyperkalemia; Indenes; Kidney Diseases; Male; Middle Aged; Sulindac