Which medication is known to potentially cause hypovolemic hyponatremia?

Furosemide, a loop diuretic, has a well-documented effect on fluid and electrolyte balance, particularly influencing sodium levels in the body. It works in the loop of Henle in the kidneys to inhibit the reabsorption of sodium and chloride, leading to increased urine output. This mechanism can result in the loss of significant amounts of sodium and water, particularly in patients who are already at risk for volume depletion or dehydration.

When furosemide causes the kidneys to excrete more sodium alongside water, it can lead to a scenario known as hypovolemic hyponatremia. This condition occurs when there is both a loss of blood volume (hypovolemia) and a relatively lower sodium concentration in the blood (hyponatremia) due to the diuretic effect of furosemide. Patients taking this medication require careful monitoring for electrolyte imbalances, hydration status, and symptoms of hyponatremia.

Other medications such as insulin, aspirin, and metformin do not have the same direct effects on sodium balance and are less likely to cause hypovolemic hyponatremia as a consequence of their pharmacological actions.