Polypharmacy Induced Hyponatremia: An Additive Effect

Abstract

Polypharmacy is a leading cause of adverse events in the elderly population. A 63- year old male was admitted in the hospital diagnosed with Syndrome of Inappropriate Diuresis (SIAD) and subsequent severe hyponatremia due to additive effect of escitalopram, carvedilol and pantoprazole. Step-wise withdrawal of offending agents and clinical management helped in resolving hyponatremia within 3 weeks. Escitalopram is known to cause hyponatremia; however pantoprazole and carvedilol induced hyponatremia is a rare occurrence. Assessment of drug-drug interactions and monitoring of potential adverse effects may improve the quality of patient care and reduce the negative outcomes of polypharmacy.