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Exposure to trimethoprim–sulfamethoxazole is associated with hospitalisation for hyperkalaemia in older people treated with spironolactone
  1. Rebecca L Dunn
  1. Department of Pharmacy, Clinical and Administrative Sciences, University of Oklahoma Health Sciences Center College of Pharmacy, Oklahoma City, Oklahoma, USA
  1. Correspondence to Rebecca L Dunn
    Department of Pharmacy, Clinical and Administrative Sciences, University of Oklahoma Health Sciences Center College of Pharmacy, 1122 NE 13th Street, Suite 4413, Oklahoma City, OK 73117, USA; rebecca-dunn{at}ouhsc.edu

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Context

Trimethoprim–sulfamethoxazole (TMP–SMX) is a combination antibiotic used for a number of infectious diseases and organisms.1 It is generally well tolerated; however, electrolyte disturbances, primarily hyperkalaemia, have been reported with both standard and high-dose therapy.1 2 Spironolactone, an aldosterone receptor antagonist, predominantly used in the management of heart failure and cirrhosis, is also known to cause hyperkalaemia.3 The risk of developing hyperkalaemia during co-administration of these two commonly prescribed medications is unknown. Antoniou et al describe the association between hospitalisation for hyperkalaemia and prior use of TMP–SMX in an older population receiving spironolactone.

Methods

The authors completed a population-based, nested case-control study with the objective of characterising the association between hospitalisation for hyperkalaemia and TMP–SMX use in an older population treated with spironolactone. Older subjects aged 66 years or greater, treated with …

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