Managing drug-induced hyponatraemia in adults

Abstract

Drug-induced hyponatraemia is commonly associated with diuretics, selective serotonin reuptake inhibitors and antiepileptics. With increasing polypharmacy and an ageing population, the prevalence of drug-induced hyponatraemia is likely to increase. Most patients with drug-induced hyponatraemia are asymptomatic and the diagnosis is made incidentally following routine blood tests. Mild cases may be managed either by stopping the drug or by careful observation if the drug is considered essential. More severe hyponatraemia may require fluid restriction in the short term as well as withdrawal of the causal drug. Referral may be required for patients with acute illness and for those with severe and/or refractory hyponatraemia.