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Drugs & Supplements

Diuretics

Medication Names
  • furosemide (Lasix®)
  • metolazone (Zaroxolyn®)
  • bumetanide (Bumex®)
  • hydrochlorothiazide (Esidrix®)
  • torsemide (Demadex®)
  • chlorthalidone (Thalitone®)
  • Other:____________________________
Categories of diuretics

Diuretics are categorized as thiazide-like (hydrochlorothiazide, chlorthalidone, and metolazone) and loop diuretics (furosemide, bumetanide, torsemide).

Why this medication is prescribed?

Diuretics, also commonly known as "water pills," cause the kidneys to get rid of unneeded water and salt from the tissues and bloodstream into the urine. Getting rid of excess fluid makes it easier for your heart to pump. It is used to treat high blood pressure and reduce the swelling and water build-up caused by various medical problems, including both systolic and diastolic heart failure. It also helps make breathing easier by removing water that has backed up in the lungs.

When to take

Follow the label directions on how often to take this medication. If you are taking a single dose a day, take it in the morning with your breakfast or right away after eating your breakfast.

If you are taking more than one dose a day, take the last dose no later than 4 p.m. The number of doses you take each day, the time allowed between doses, and how long you need to take the medication will depend on the type of diuretic prescribed, as well as your condition.

Special directions
  • Weigh yourself at the same time every day (on the same scale) before eating and after urinating and record your weight. Call your doctor or nurse if you gain 3 pounds in one day or 5 pounds in one week.
  • While taking this medication, have your blood pressure and kidney function tested regularly, as advised by your doctor or nurse, since diuretics can alter your blood potassium and magnesium levels.
Food and drug interactions
  • Diuretics are generally prescribed in combination with other heart failure medications. If you experience an increase in side effects after taking your medications together, contact your doctor or nurse. You may need to change the times you are taking each medication.
  • Before a diuretic is prescribed, tell your doctor or nurse if you are taking any of the following: other medications for high blood pressure, digoxin, indomethecin, probenecid, or corticosteroids (prednisone).
  • Before this medication is prescribed, tell your doctor or nurse if you have diabetes, kidney disease, liver disease, or gout.

Follow your doctor’s or nurse’s dietary advice, which may include:

  • Following a low-sodium diet.
  • Taking a potassium supplement or including high-potassium foods (such as bananas and orange juice) if you are losing potassium. Talk with your doctor or nurse about your level of potassium intake. Diuretics may cause a decrease in the level of potassium in your blood.
Side effects and how to manage them
  • Frequent urination - This may last for up to four hours after each dose.
  • Extreme tiredness or weakness - These effects should decrease as your body adjusts to the medication. Call your doctor or nurse if these symptoms persist, since it could mean your medication dose needs to be adjusted.
  • Muscle cramps or weakness - Be sure that you are taking your potassium supplement correctly, if prescribed. Contact your doctor or nurse if these symptoms persist.
  • Thirst - For thirst, try sucking on sugarless hard candy or a towel soaked in ice water. Contact your doctor or nurse if you have extreme thirst, which could be a sign of dehydration.
  • Dizziness, lightheadedness - Try rising more slowly when getting up from a lying or sitting position.
  • Blurred vision, confusion, headache, increased perspiration (sweating), restlessness - If these effects persist or are severe, contact your doctor or nurse.
  • 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 or nurse.
  • Fever, sore throat, cough, ringing in the ears, unusual bleeding or bruising, rapid and excessive weight loss - Contact your doctor or nurse right away.
  • Skin rash - Stop taking the medication and contact your doctor or nurse right away.
  • Loss of appetite, nausea, or vomiting - Be sure that you are taking your potassium supplement correctly and on a full stomach, if prescribed.

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

Sources

www.americanheart.org/downloadable/heart/5360_HFGuidelineFinal.pdf

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/1/2010...#12881