The primary goals of treating hypoPP are to alleviate acute attack symptoms, prevent and manage immediate complications, and reduce the risk of both future attacks and late complications. Treatment involves a multi-layered approach, combining medications, dietary adjustments, and trigger management. These strategies have proven highly beneficial for most patients. However, individual responses to treatment vary, making it essential to work closely with your medical provider to develop a personalized plan that best suits your needs.
Potassium Supplementation
Potassium supplementation can be used in patients who have episodes that involve a drop in potassium
levels. These supplements come in multiple forms. Different forms of potassium may be easier for
people to take due to size and texture. Some people find that a certain manufacturer/brand of
potassium is easier to swallow due to the coating on a tablet, size, shape, etc. If this is the case let your
pharmacy know so they can order that brand.
Most potassium supplements require a prescription from your doctor. Over the counter formulations
contain less potassium and are not as strictly regulated for quality and safe manufacturing practices.
Consult with your doctor before adding over the counter medications to your regimen.
Prescription options include:
Tablets– 8MEQ, 10MEQ, 15MEQ, 20MEQ
Capsules-8MEQ, 10MEQ
Effervescent– This is a tablet that is dissolved in liquid and then consumed. It comes in 10MEQ, 20MEQ,
and 25MEQ
Liquid– Ready to drink formulation. Comes in 20MEQ/15ML and 40MEQ/15ML
Carbonic Anhydrase Inhibitors
Dichlorphenamide is an FDA approved carbonic anhydrase inhibitor used for primary hypo and hyper
forms of periodic paralysis. The exact mechanism of action for these conditions is unknown. It is
available as the brand name Keveyis from Xeris pharmaceutical. It has also recently been made available
in a generic form. For the brand name Keveyis, Xeris Pharmaceutical offers patient support and savings
on their website at www.Keveyis.com.
Acetazolamide is another carbonic anhydrase inhibitor. More information is available on
dichlorphenamide because acetazolamide lacks clinical trials for periodic paralysis.
Potassium Sparing Diuretics
These medications were developed to treat other conditions such as high blood pressure, fluid
retention, and heart failure. They are diuretics and work by helping the body to eliminate excess fluid. In
doing this they cause the body to retain potassium. Although these were not indicated for the treatment
of periodic paralysis some patients with hypo variants do see a benefit when adding them to their
regimen. Available options are eplerenone, spironolactone, amiloride, and triamterene. Triamterene is
available alone but is commonly used in combination with hydrochlorothiazide (name brand Dyazide).
Hydrochlorothiazide is another diuretic but may cause a decrease in potassium instead of retention.