International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 4, Issue 6 | Review Article | Open Access DOI

A Rare Case of Severe Hyponatremia Associated with Acyclovir Use and Exacerbated by Furosemide

Chet Raj Awasthi*

Rizwanullah1, Fardin Akbar Hyderi2, Sneha Kanduri Hanumantharayudu3, Pavan Kumar Makam Surendraiah4, Chet Raj Awasthi5*, Shivani Shah6

1Resident Physician at Hayatabad Medical Complex Peshawar, Pakistan

2Clinical Supervisor, The Partners Care, NY, USA

3House physician, Partners care,NY, USA

4Patient advocate,Westchester Medical Center, NY, USA

5Department of Care of Elderly, General Medicine, Watford General Hospital, Vicarage Road Watford, Hertfordshire, WD18 0HB,United Kingdom

6Carribean Medical University School of Medicine, Willemstad, Curacao

*Correspondence to: Chet Raj Awasthi 

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Abstract

Hyponatremia, a common electrolyte disorder, is rarely associated with acyclovir therapy. We report a 64-year-old woman with a history of hypertension and type 2 diabetes mellitus who presented with altered mental status and severe hyponatremia (serum sodium: 112 mmol/L) after receiving acyclovir for herpes zoster and a single dose of intravenous furosemide. Initial management with hypertonic saline and fluid restriction failed to improve her condition. Acyclovir was subsequently discontinued, leading to a gradual resolution of hyponatremia and normalization of sodium levels. This case underscores the potential role of acyclovir in inducing hyponatremia, possibly through syndrome of inappropriate antidiuretic hormone secretion (SIADH), and highlights the importance of recognizing and managing this rare but serious adverse effect.

Keywords:

Hyponatremia; Acyclovir; SIADH; Furosemide; Herpes Zoster; Electrolyte Imbalance

Citation:

Rizwanullah, Fardin Akbar Hyderi, Sneha Kanduri Hanumantharayudu, Pavan Kumar Makam Surendraiah, Shivani Shah. A Rare Case of Severe Hyponatremia Associated with Acyclovir Use and Exacerbated by Furosemide. Int Clinc Med Case Rep Jour. 2025;4(6):1-4.