Hyponatremia in patients treated with lorcainide, a new antiarrhythmic drug.

Abstract:

:The effects of lorcainide, a new antiarrhythmic drug, on serum electrolytes and osmolality are described in a series of 33 patients with organic heart disease and complex ventricular arrhythmias treated with lorcainide. In eight patients, a mean decrease in serum Na+ of 8.25 +/- 3.2 mEq/L was observed after a single 200 mg intravenous dose of lorcainide. Sixteen of 33 patients developed significant hyponatremia and hypoosmolality during oral treatment with lorcainide. In all except two patients, serum Na+ returned to normal values within 3 to 12 months of continued lorcainide therapy. Low serum Na+ and hypoosmolality in the absence of volume depletion, clinically manifest edema, and unaltered renal, adrenal, cardiac, or thyroid function suggest that this antiarrhythmic drug produced the syndrome of inappropriate antidiuretic hormone secretion (SIADH). SIADH appeared to be transient and asymptomatic in our patients. One patient developed severe hyponatremia with serum Na+ of 108 mEq/L when hydrochlorothiazide was given to control hypertension. It is concluded that SIADH is an important side effect of lorcainide therapy. We recommend that serum Na+ be carefully monitored in patients started on lorcainide therapy, and extreme caution should be exercised in prescribing diuretics to patients with persistent hyponatremia.

journal_name

Am Heart J

journal_title

American heart journal

authors

Somani P,Temesy-Armos PN,Leighton RF,Goodenday LS,Fraker TD Jr

doi

10.1016/0002-8703(84)90690-2

subject

Has Abstract

pub_date

1984-12-01 00:00:00

pages

1443-8

issue

6

eissn

0002-8703

issn

1097-6744

pii

0002-8703(84)90690-2

journal_volume

108

pub_type

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