Risk of hyperkalemia associated with selective COX-2 inhibitors

Hisham Aljadhey, Wanzhu Tu, Richard A. Hansen, Susan Blalock, D. Craig Brater, Michael D. Murray

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Background: Selective cyclooxygenase-2 (COX-2) inhibitors have been linked to cardiac death. The mechanism for this adverse effect appears to be by ischemic insult; however another mechanism could involve hyperkalemia. The objective of this study was to determine the effects of selective COX-2 inhibitors and non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) on serum potassium concentration and the electrocardiogram. Methods: A retrospective cohort study was conducted using propensity score matching of patients from an inner-city academic medical center at Indianapolis, Indiana. Two hundred and two patients prescribed selective COX-2 inhibitors were matched to 202 patients prescribed non-selective NSAIDs using propensity scores methods. Outcomes included change in serum potassium concentration from baseline and the risk of an abnormal electrocardiogram. Results: Compared to patients prescribed non-selective NSAIDs, those prescribed a selective COX-2 inhibitor had a higher risk of serum potassium increase greater than 5 mEq/L (OR, 2.56; 95%CI, 1.03-6.36). However, patients prescribed selective COX-2 inhibitors had no greater risk of electrocardiogram abnormality (OR, 1.16; 95%CI, 0.74-1.82). Conclusions: Selective COX-2 inhibitors may have a greater risk of hyperkalemia than non-selective NSAIDs. This study was exploratory with small numbers of patients. Further studies are needed to confirm these results and any association with cardiovascular events.

Original languageEnglish (US)
Pages (from-to)1194-1198
Number of pages5
JournalPharmacoepidemiology and Drug Safety
Volume19
Issue number11
DOIs
StatePublished - Nov 1 2010

Keywords

  • Hyperkalemia
  • NSAIDs
  • Retrospective cohort study, propensity score
  • Selective COX-2 inhibitors

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Epidemiology

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