Karen Schroeder Kassel, MS, RD, MEd
There are different types of diuretics (water pills) that are used to treat many health conditions. These include:
Diuretics may be prescribed to treat:
Diuretics act on the kidneys to increase the production of urine. Unlike other types, potassium-sparing diuretics do not cause your body to lose potassium.
It is important that your doctor checks your progress at regular visits to allow for dosage adjustments and to manage any side effects. Before you have any type of surgery, including dental surgery, emergency treatment, or medical tests, make sure the doctor or dentist knows that you are taking a diuretic.
Thiazide diuretics, and especially loop diuretics, may cause an excessive loss of potassium from your body. To help prevent this, your doctor may recommend that you:
To prevent the loss of too much water and potassium, tell your doctor if you become sick, especially with severe or continuing vomiting or diarrhea.
Do not make any dietary changes, even if you are on a special diet, without talking to your doctor first. Some diuretics do not cause potassium loss and may not require any dietary adjustment.
Diuretics are generally not useful for treating the normal swelling of hands and feet that can occur with pregnancy. Diuretics should not be taken during pregnancy unless recommended by your doctor. You also need to be cautious about taking medication when you are breastfeeding. Diuretics are not recommended for nursing mothers.
Tell your doctor about all of the medications that you take. Some should not be taken with diuretics, while others may require a different dosage level. If you are taking any type of diuretic to control high blood pressure, check with your doctor before taking any over-the-counter medications, including those to treat colds, cough, and allergies.
The presence of other conditions may affect the use of diuretics. Tell your doctor if you have any other conditions, especially diabetes, kidney, liver, heart, and autoimmune disorders.
Medications are only part of the treatment for high blood pressure. Research has shown that you can help control your blood pressure by eating a low-sodium diet that is rich in fruits, vegetables, and low-fat dairy. Exercising regularly and maintaining a healthy weight are also essential lifestyle factors to manage high blood pressure.
When you are taking a diuretic, you may have dizziness, or lightheadedness that can lead to fainting. This may happen when you get up from a lying or sitting position. Getting up slowly may help. These symptoms are also more likely to occur if you drink alcohol, stand for long periods of time, exercise vigorously, or if the weather is hot. If the problem continues or worsens, tell your doctor.
Some diuretics may cause your skin to be more sensitive to sunlight. Exposure to sunlight, even for brief periods of time, may cause a rash, itching, redness, or sunburn. If you have skin problems because of the sun, follow these precautions:
It is essential to take your medication even if you feel fine and do not have any symptoms, which is often the case with high blood pressure. You must continue to take the medication as directed in order to keep your blood pressure under control. It may be possible to taper off the medication, particularly if you make lifestyle changes, such as diet and exercise, recommended by your doctor. If high blood pressure persists without treatment, it can lead to heart attacks, heart failure, blood vessel diseases, stroke, kidney failure, and/or blindness.
Take each dose at the same time each day. Since diuretics work by increasing the amount of urine you produce, try to take your medication early in the day so that your need to urinate will not disrupt your sleep.
If the diuretic upsets your stomach, it may be taken with food or drink. If stomach upset continues or gets worse, or if you suddenly get severe diarrhea, tell your doctor.
If you miss a dose, take it as soon as possible. But if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
The side effects listed here are most commonly encountered with at least one type of diuretic drug, not necessarily all of them. Many of the effects of diuretics are similar, these side affects may occur with any one of these medications, although they may be more common with some more than with others. Side effects may be more prevalent in the elderly.
Side effects may include:
Diuretics are generally well tolerated by most people. If you are having problems with side effects talk to your doctor. You may be able to get your dose adjusted or try a different medication.
Family Doctor.org—American Academy of Family Physicians
USP Drug Information
Canadian Pharmacists Association
Amiloride. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 18, 2013. Accessed March 7, 2014.
Bumetanide. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 18, 2013. Accessed March 7, 2014.
Chlorothiazide. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 18, 2013. Accessed March 7, 2014.
Chronic kidney disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 3, 2014. Accessed March 7, 2014.
Diuretics. US National Library of Medicine website. Available at: http://livertox.nlm.nih.gov/Diuretics.htm. Updated July 23, 2013. Accessed March 7, 2014.
Hydrochlorothiazide. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 18, 2013. Accessed March 7, 2014.
Hyperkalemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 13, 2013. Accessed March 7, 2014.
Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 21, 2014. Accessed March 7, 2014.
Hypokalemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 15, 2013. Accessed March 7, 2014.
Last reviewed March 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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