engleski

Nebivolol induced hyperkalemia: case report

Aim: In this article we document a conclusive case of nebivolol--induced hyperkalemia for the first time in known medical literature. Hyperkalemia is related to serious conditions like cardiac arrhythmias and sudden cardiac death. Nebivolol was not known to cause hyperkalemia, and this event is not listed in its summary of product characteristics (SmPC). For older beta blockers, hyperkalemia is recognized as a rare occurring adverse event linked to CYP2D6 (Cytochrome P450 2D6) polymorphism and poor drug degradation. Major findings: A 47--year-old woman taking nebivolol for hypertension developed persistent hyperkalemia, with serum potassium levels up to 6, 4 mmol/L. After extensive diagnostic evaluation, and exclusion of other known conditions leading to hyperkalemia, its cause remained occult. Since hyperkalemia coincided with increased doses of nebivolol, dose reduction and discontinuation were attempted, resulting in normalised serum potassium. Poor drug metabolism could not explain this adverse effect, since pharmacogenetic testing showed no relevant aberations. Principal conclusion: Hyperkalemia is a harmful adverse event with possible lethal outcome, and it may be caused by nebivolol. Therefore, medical professionals have to be aware of this side effect and, hyperkalemia must be listed as an adverse event in nebivolol’s SmPC.

nebivolol ; adverse event ; hyperkalemia

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