Hypertension: Diuretic Treatment

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. Examples of diuretics include:

• Esidrix (hydrochlorothiazide also commonly known as HCTZ)
• Lasix (furosemide)
• Bumex (bumetanide)
• Demadex (torsemide)
• Zaroxolyn (metolazone)
• Aldactone (spironolactone)

Diuretics are categorized as thiazide-like (Zaroxolyn and Esidrix), loop (Lasix, Bumex) or potassium-sparing (Aldactone). Thiazide diuretics provide the most effect on lowering blood pressure, cause moderate increases in sodium excretion, and are appropriate for long-term use. Loop diuretics are more powerful and are often used when people have congestive heart failure symptoms and are especially useful in emergencies. Potassium-sparing diuretics help your body retain potassium are used more often in congestive heart failure patients and are often prescribed in conjunction with the other two types of diuretics.

What Are the Side Effects?

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 the taking of these medications.
• 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.

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