Dr. Louise Achey
Q: On my medicine bottle, there's a sticker saying, “It may be advisable to drink a full glass of orange juice or eat a banana daily while taking this medication.” Why would I need bananas and orange juice with this medicine?
Pharmacists add this sticker to medicines containing "water pills." Water pills are also called diuretics, and work to remove fluid from your lungs, hands, and feet. Your body gets rid of that excess fluid by triggering the urge to urinate, often for hours after taking each pill.
Water is not all that you lose when taking a diuretic. Along with the water, a diuretic removes essential minerals like sodium, magnesium, and potassium from your body.
Potassium is vital in balancing your heart’s electrical activity. Bananas and orange juice are good sources of potassium. The sticker on your pill bottle reminds you to get plenty of potassium every day, to help replace what you could be losing from that medicine.
Potassium supplements are described either by weight in milligrams (mg) or chemically by milliequivalents (mEq). Most prescription forms of potassium are labeled as mEq and are available as either 10mEq or 20mEq tablets.
Unfortunately, most prescription potassium pills are large. They can be awkward or hard to swallow, leading some folks to try non-prescription versions instead. One common non-prescription form is 595mg of potassium gluconate. This sounds like a lot, but actually contains only 99 mg of elemental potassium in each tablet, the other 496mg being the gluconate part.
How does 99mg of non-prescription potassium compare to the prescription strength of 10mEq of potassium? In each mEq, there is 40mg of potassium, whether it comes as potassium chloride or potassium gluconate.
A potassium gluconate tablet with 99mg of potassium has 2.5mEq. You’ll need to take 4 tablets of non-prescription potassium gluconate to match the potassium in one prescription-only tablet of 10mEq potassium chloride.
How much potassium can you get in drinking an 8-ounce glass of orange juice or eating a banana every day?
The average American gets 2640mg of potassium in their diet. However, to prevent high blood pressure and bone loss, the Institute of Medicine recommends 4700mg of potassium every day, nearly twice that amount.
Eating a medium-sized banana gives you 422mg of potassium, and an 8-ounce glass of orange juice contains 473mg of potassium. One potato with the skin has 610mg of potassium, and a sweet potato has 694mg.
Leafy green vegetables and foods that grow on vines are particularly useful as potassium sources. So are milk and yogurt. Tomatoes are another great source of potassium. More information on the potassium content of foods is available in the online resource Dietary Guidelines for Americans 2015-2020, at www.dietaryguidelines.gov.
Eating bananas and drinking orange and tomato juice regularly may not be enough to keep your potassium level balanced. People taking "water pills" every day may need more potassium than they can get by eating bananas and oranges every day.
One easy and inexpensive way to get more potassium chloride in your diet is to use a salt substitute. Salt substitutes such as Nu Salt® or Morton Salt Substitute® are sodium-free. They contain potassium chloride salt crystals instead of sodium chloride salt crystals. There are also low-sodium salt substitutes like Morton’s Lite Salt, with a 50-50 ratio of sodium to potassium chloride.
Both sodium-free or low sodium salt substitutes are concentrated sources of potassium. Switching from using table salt (sodium chloride) to a salt substitute with potassium chloride can dramatically increase your potassium intake.
People with kidney disease or getting dialysis cannot easily remove potassium from their bodies. They should avoid using a salt substitute containing potassium. But for others, switching to a salt substitute is one of the least expensive ways to get more potassium.
Here Are 4 Tips to Getting Enough Potassium:
1. Switch your salt.
Nu-Salt® has 795mg potassium in each ¼ teaspoon. That's 20mEq of potassium, more than many prescription-strength potassium tablets. Morton Salt Substitute® has 610 mg of potassium per ¼ teaspoonful (15mEq) of potassium.
2. Check with your doctor.
Certain heart medicines like lisinopril, losartan, and spironolactone encourage potassium to stay in your body. Ask your doctor before switching to a salt substitute containing potassium.
3. Try other potassium-rich foods.
Sweet potatoes, white potatoes, and 8 ounces of either low-fat or non-fat yogurt have more potassium than bananas. Low-sodium V-8 has nearly twice the potassium that orange juice has.
4. Avoid potassium if you have kidney problems.
Check with your doctor before eating potassium-rich foods.
Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Check out her NEW website TheMedicationInsider.com for daily tips on how to take your medicine safely ®2020 Louise Achey
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