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Clinician’s Corner: Potassium

Potassium is lost through the kidneys when patients take diuretic therapy (fluid pills) for high blood pressure, heart failure, kidney failure to help remove excess fluid. Diarrhea, vomiting and corticosteroid use can also deplete potassium. Thiazide diuretics “lightweight diuretics” – HCTZ, chlorthalidone can cause potassium depletion, but the more potent “loop diuretics” -Lasix (furosemide); Demadex (Torsemide), Bumex (Bumetanide) can cause significant potassium loss. These potent diuretics are used for heart failure and kidney failure.

Hey doc, do I have to swallow those horse pills? Can’t I just eat a banana?

Your Thompson Pharmacist never recommends potassium rich foods to replace potassium chloride supplements when they are prescribed. Consider the following:

  • Bananas: contain 1mEq of potassium per inch, and a 10 inch banana contains about 140 calories. Bananas cost about 59-79 cents per pound. Could you imagine eating 4 large bananas a day, at almost 600 calories!
  • Orange juice to get 10mEq of potassium you need to drink 7 ounces which is 90 calories. To replace 40mEq would be nearly 400 calories.
  • Potassium rich foods contain potassium phosphate, not potassium chloride, which is important with diuretic loss as well as vomiting and diarrhea.
  • Over the counter potassium is potassium gluconate, and it would take about 4 tablets to equal 10mEq. There is no chloride in these tablets, which needs replaced, along with the potassium.

Patient Information from your Thompson Pharmacist

  • To reduce esophagitis with oral potassium, drink at least ½ cup (4oz) of water and stay upright for five to ten minutes after administration.
  • All potassium tablets should be taken with food to minimize GI upset.
  • Watch salt substitutes. Contain 15-20 mEq per ¼ teaspoon serving
  • You might be seeing “ghost tablets: in your stool, the left over wax remnants from your potassium tablets. Don’t be alarmed, as the potassium is already pulled out of the tablets and you are seeing the leftover wax–(especially the bright yellow ones!)

Your Thompson Pharmacist can work along with your doctor to choose the best potassium for you.  Your grocer is not the best source for potassium supplements!  At Thompson Pharmacy it’s all for YOU!