Hypertension/High Blood Pressure Health Center

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High Blood Pressure and Diuretics (Water Pills)

For high blood pressure, diuretics, commonly known as "water pills," help your body get rid of unneeded water and salt through the urine. Getting rid of excess salt and fluid helps lower blood pressure and can make it easier for your heart to pump. Diuretics may be used to treat a number of heart-related conditions, including high blood pressure, heart failure, kidney and liver problems, and glaucoma.�

While diuretics are used to remove fluid, only thiazide diuretics, such as Esidrix or Zaroxolyn, are used to lower blood pressure.�

Loop diuretics (Lasix, Bumex) are more powerful and are often used when people have congestive heart failure symptoms and are especially useful in emergencies but do not significantly lower blood pressure.

Potassium-sparing diuretics (like Aldactone) help your body retain potassium and are used more often in congestive heart failure patients. They are often prescribed in conjunction with the other two types of diuretics, but also do not significantly lower blood pressure.

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What Are the Side Effects of Diuretics?

Like any drug, diuretics come with potential side effects. They include:

Frequent urination. This may last for several hours after a dose.
Arrhythmia (abnormal heart rhythm)
Electrolyte abnormalities -- Blood test monitoring of electrolytes is important before and during drug use.
Extreme tiredness or weakness. These effects should decrease as your body adjusts to the medication. Call your doctor if these symptoms persist.
Muscle cramps or weakness. Be sure that you are taking your potassium supplement correctly, if prescribed. Contact your doctor if these symptoms persist.
Dizziness, lightheadedness. Try rising more slowly when getting up from a lying or sitting position.
Blurred vision, confusion, headache, increased perspiration (sweating), and restlessness. If these effects are persistent or severe, contact your doctor.
Dehydration. Signs include dizziness, extreme thirst, excessive dryness of the mouth, decreased urine output, dark-colored urine, or constipation. If these symptoms occur, don't assume you need more fluids, call your doctor.
Fever, sore throat, cough, ringing in the ears, unusual bleeding or bruising, rapid and excessive weight loss. Contact your doctor right away.
Skin rash. Stop taking the medication and contact your doctor right away.
Loss of appetite, nausea, vomiting, or muscle cramps. Be sure that you are taking your potassium supplement correctly, if prescribed.

Rarely, potassium-sparing diuretics like Aldactone can cause breast enlargement in men and women, deepening of the voice, increased hair growth and irregular menstrual cycles.

In addition, most diuretics are sulfa drugs.�If you are allergic to sulfa drugs, tell your doctor.

Contact your doctor if you have any other symptoms that cause concern.

Guidelines for Taking Diuretics

Here are some general guidelines if you're taking a diuretic:

Before a diuretic is prescribed, tell your doctor if you are taking any other medications that may have been prescribed by another physician or any over-the-counter or herbal remedies. Also, tell your doctor if you have any other medical problems.
Follow your doctor�s instructions on how often you should take the diuretic. If you are taking a single dose a day, it might be better to take it in the morning instead of at night, so that you will not have your sleep interrupted by frequent trips to the bathroom. (This is more pertinent for patients with congestive heart failure or patients with cirrhosis and portal hypertension.)
While taking a diuretic, have your blood pressure and kidney function tested regularly, as advised by your doctor.
Keep all appointments with your doctor and the laboratory so that your response to this drug can be monitored.