Pseudohyperaldosteroism during itraconazole treatment: a hitherto neglected clinically significant side effect. Issue 6 (18th June 2021)

• Record Type: Journal Article
• Authors: Brandi, Sandra L; Feltoft, Claus L; Serup, Jørgen; Eldrup, Ebbe
• Is Part Of: BMJ case reports. Volume 14:Issue 6(2021)
• Publication Date: 2021-06-18
• Subjects: hypertension -- unwanted effects / adverse reactions -- endocrinology -- drugs: infectious diseases -- dermatology; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2021-243191
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We describe a married couple who both presented with hypertension and hypokalaemia. Both patients were diagnosed with pseudohyperaldosteronism triggered by the widely used antifungal drug itraconazole. This effect appears to be dose-dependent, where a daily intake of 100 mg itraconazole is enough to induce pseudohyperaldosteronism. Clinicians should be aware of pseudohyperaldosteronism as a possible adverse effect of itraconazole, and we recommend monitoring potassium levels and blood pressure in all patients receiving this drug over a longer period of time. Voriconazole is probably an alternative antifungal treatment to itraconazole but also with this drug potassium levels should be monitored.