芍薬甘草湯誘因性低カリウム血症発現に及ぼす種々の併用薬の影響

概要

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One of the major adverse effects of Shakuyaku-kanzo-To (SKT), a herbal medicine containing licorice, is licorice-induced pseudoaldosteronism with hypokalemia and hypertension. Owing to the risk of hypokalemia, caution should be therefore exercised when SKT is co-administered with potassium lowering drugs. In order to clarify this risk, we examined the occurrence of hypokalemia in 103 patients receiving SKT. Thirty (29.1%) of the 103 patients developed hypokalemia and SKT dosing periods tended to be longer in these patients than in those who did not develop hypokalemia (54.5 vs. 23.0 days, respectively). The co-administration of potassium lowering drugs was more frequent in the patients with hypokalemia (90.0% vs. 64.4% for no hypokalemia p<0.01). The occurrence rates of hypokalemia varied with drugs co-administered with SKT; with 75.0% for glycyrrhizin preparations, 47.2% for diuretics, 41.9% for glucocorticoids, 20.0% for sennoside preparations and 25.0% for others. The above results confirmed that the co-administration of potassium lowering drugs enhanced SKT-induced hypokalemia. Frequent serum potassium monitoring is therefore required when potassium lowering drugs, especially glycyrrhizin preparations, diuretics and glucocorticoids, are co-administered to patients receiving SKT.
日本医療薬学会の論文
2007-08-10