Severe ventricular arrhythmia secondary to indapamide-induced hypopotassemia

We report on two patients, treated with indapamide for mild hypertension, who developed life-threatening ventricular arrhythmias. The former showed severe hypokalemia, QT interval prolongation and "torsade de pointes": the latter, who suffered from ischemic heart disease, had slightly decreased serum potassium and ventricular fibrillation. In both cases no other cause accounting for hypokalemia and ventricular arrhythmia was found. Therefore we stress that serum potassium and ECG must be carefully monitored during indapamide therapy, mainly in patients with cardiac disease.