Cola-induced hypokalaemia: pathophysiological mechanisms and clinical implications

Int J Clin Pract. 2009 Jun;63(6):900-2. doi: 10.1111/j.1742-1241.2009.02051.x.


Background/aims: The consumption of soft drinks has increased considerably during the last decades. Among them, the cola-based preparations are possibly the refreshments with the largest sales worldwide. In addition to the possible detrimental effects of moderate, chronic cola consumption, it has been proposed that the consumption of large amounts of cola-based soft drinks may result in severe hypokalaemia.

Methods: In this review, we discuss the clinical significance of these disturbances and summarise the pathophysiological mechanism that may underlie the development of this rare, but potentially severe, side effect.

Results/conclusion: Several lines of evidence suggest that the chronic consumption of large amounts of cola soft drinks may adversely affect potassium homeostasis and result in potentially severe conditions such as hypokalaemic myopathy.

Publication types

  • Review

MeSH terms

  • Caffeine / adverse effects
  • Carbonated Beverages / adverse effects*
  • Carbonated Beverages / statistics & numerical data
  • Fructose / adverse effects
  • Glucose / adverse effects
  • Homeostasis / drug effects
  • Humans
  • Hypokalemia / etiology*
  • Hypokalemia / metabolism
  • Phosphodiesterase Inhibitors / adverse effects
  • Potassium / metabolism


  • Phosphodiesterase Inhibitors
  • Fructose
  • Caffeine
  • Glucose
  • Potassium