Hyponatraemia (Guidelines)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Audience

  • Highland HSCP only
  • Primary and Secondary care
  • Adults only

Drug-induced hyponatraemia: potential causes 

 

Amiodarone

Anti-psychotics

  • Phenothiazine (chlorpromazine, prochlorperazine)
  • Butyrophenones (haloperidol) 

Anti-hypertensives

  • ACE inhibitors
  • ARBs
  • Amlodipine 

Antidiabetics

  • Sulphonylureas
  • Insulin

Anti-epileptics

  • Carbamazepine
  • Oxycarbamazepine
  • Sodium valproate
  • Lamotrigine
  • Levtiracetam

Anti-cancer agents

  • Vincristine
  • Vinblastine
  • Cisplatin
  • Carboplastin
  • Cyclophosphamide
  • Melphalan
  • Ifosfamide

Anti-depressants

  • Tricyclics
  • SSRIs
  • Monoamine oxidase inhibitors

Analgesics

  • Nonsteroidal anti-inflammatory drugs (particularly in combination with thiazide diuretics or heart failure).
  • Opioids

Diuretics

  • Thiazides
  • Amiloride
  • Spironolactone/Eplerenone
    Loop diuretics

Dopamine antagonists

  • Metoclopramide
  • Domperidone

NMDA (Ecstasy)

Proton pump inhibitors

  • Class effect

Theophylline

Vasopressin receptor agonists

  • Desmopressin
  • Oxytocin

References

  • Grant P et al. “The diagnosis and management of inpatient hyponatraemia and SIADH,” Eur J Clin Invest 2015; 45(8) 888-894
  • Hyponatraemia. BMJ best practice guidance. February 2024.
  • Hyponatraemia. NICE Clinical Knowledge Summaries. November 2020
  • Overview of the treatment of hyponatremia in adults. UpToDate. July 2024
  • Spasovski G et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. European Journal of Endocrinology (2014) 170, G1–G47

Abbreviations

Abbreviation  Meaning 
BD  twice daily 
BP  blood pressure 
CNS  central nervous system 
IV  intravenous 
JVP  jugular venous pressure 
K  potassium 
LVF  left ventricular failure 
Na  sodium 
OD  once daily 
SIADH  syndrome of inappropriate antidiuretic hormone secretion

Editorial Information

Last reviewed: 29/08/2024

Next review date: 25/08/2027

Author(s): Endocrinology department, Medicines information service.

Version: 3

Approved By: TAM Subgroup of the ADTC

Reviewer name(s): Dr D MacFarlane, Consultant Physician , Medicines information service.

Document Id: TAM293