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.

Thiazide diuretics, such as Esidrix or Zaroxolyn, can be used to lower blood pressure, or to treat edema in heart failure.

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

Potassium-sparing diuretics (like Aldactone, Dyrenium) 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.

What Are the Side Effects of Diuretics?

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

  • Frequent urination. This may last for several hours after a dose.
  • Arrhythmia (abnormal heart rhythm)
  • Electrolyte abnormalities -- Blood test monitoring of blood chemistries or electrolytes, such as potassium, sodium, or kidney function, 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. If you take potassium supplements, 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 or tenderness in men and in women it can cause deepening of the voice, decreased 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). Talk to your doctor before changing the timing of your medications.
  • 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.

Food or Drug Interactions of Diuretics

Diuretics are often prescribed in combination with other blood pressure and heart medications as a single pill. This could increase the effects of these other medications or contribute to abnormalities in your electrolyte levels, such as potassium.

If you experience an increase in side effects after taking your medications together, contact your doctor. You may need to change the times you are taking each medication.

Follow your doctor's dietary advice, which may include:

  • Following a low-sodium [or salt] diet.
  • Taking a potassium supplement or including high-potassium foods (such as bananas and orange juice). Note: some types of diuretics cause your body to lose potassium.
  • If you are taking a "potassium-sparing" diuretic, such as Aldactone, your doctor may want you to avoid potassium-rich foods, salt substitutes, low-sodium milk, and other dietary sources of potassium.

Alcohol and sleep aids may increase the side effects of this medication and should be avoided.

Can Pregnant Women Take Diuretics?

Diuretic use during pregnancy is not recommended. The effects of the drug on the unborn baby are unknown.


Can Breastfeeding Women Take Diuretics?

No. Many diuretics pass into breast milk and can cause dehydration in the baby.

Can Children Take Diuretics?

Children can safely take diuretics. The side effects are similar to those in adults. Children require smaller doses of the drug. Potassium-sparing diuretics like Aldactone can cause calcium deficiencies.

Can an Elderly Person Take Diuretics?

As with most medications, older people should take diuretics with caution. These medications can be very helpful and effective in older patients, but they need to carefully supervised by a physician. Older people tend to experience more side effects such as fainting and dizziness due to dehydration.

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on October 12, 2015


SOURCES: Medicinenet.com: "Water Pills Help All With Hypertension." American Heart Association.

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