What conditions can be treated with diuretics?

• High blood pressure – this medication can reduce the fluid amount in the blood vessels, which leads to lowering the body’s blood pressure.
• Congestive heart failure – through the help of diuretics, your heart can pump blood effectively throughout the body.

Different Types of Diuretics

There are three types of diuretics – the thiazide, loop, and potassium-sparing diuretics. Though they have different names, every type will help the body with increasing fluid excretion through urine.

Thiazide Diuretics

This type of diuretics is commonly prescribed by doctors, especially to those patients who need to relieve high blood pressure. Aside from this effect, this medication also helps in relaxing your blood vessels.

Thiazides can be taken with other medications such as:

• chlorthalidone
• hydrochlorothiazide (Microzide)
• metolazone
• indapamide

Loop Diuretics

This type of diuretics will help patients in treating heart failure. Some of the examples are:

• torsemide (Demadex)
• furosemide (Lasix)
• bumetanide

Potassium-sparing diuretics

While other types of diuretics can help the body in reducing the fluid levels, they also trigger the loss of potassium. But with potassium-sparing, the patient doesn’t need to worry about losing potassium inside the body. 

Potassium-sparing diuretic was given to those patients who are at risk of low potassium levels. This medication does not help in lowering blood pressure, so a doctor may prescribe other medications for lowering blood pressure while taking potassium-sparing. 

Some of the examples of potassium-sparing diuretics are:

• amiloride
• triamterene (Dyrenium)
• spironolactone (Aldactone)
• eplerenone (Inspra)

Side Effects

As long as you are taking diuretics as prescribed and instructed by your doctor, this medication can be well tolerated. But despite that, there are noted side-effects while using diuretics. The most common of them are:

• too much or too little potassium in the blood
• low sodium levels
• acute dizziness
• thirst
• headache
• increased blood sugar
• increased cholesterol
• skin rashes
• muscle cramps
• gout
• diarrhea

In some cases, serious side effects may also happen, such as:

• Kidney failure – a person who is taking diuretics may increase his chance of developing kidney failure or worsen his symptoms. If you find or experience symptoms of this medical condition while using diuretics, you need to inform your doctor immediately.
• Allergic reaction – this medication has active and inactive ingredients, and it can cause an allergic reaction to the patient. As soon as you feel that your body shows an allergic reaction to this medication, you need to stop using it immediately.
• Irregular heartbeat – this is a rare case for patients who are using diuretics. So if you experience irregular heartbeat after taking your first dose, call your doctor right away and discuss your situation. He will give you instructions on the right way to deal with your condition.
• What you can do – when you observe that diuretics limit the things that you can do, you need to talk to your doctor that this side effect is happening to you. You don’t have to panic as long as you can contact your healthcare provider.

When you start experiencing one or more of these side effects, you need to talk to your doctor and discuss your condition. Your doctor may change your medication or give you additional medicine that can reduce or manage your side effects. But you should never stop taking diuretics without consulting your doctor.

Indication and Dosage

Every medication from your doctor must have the right dosage and proper administration, and the same goes for diuretics. Here are some of the important things that you know when you are taking diuretics:

• Take this medication by mouth every morning, and you will feel the effect after 1-2 hours.
• After taking this medication, expect to excrete more urine for the first fourteen days.
• The most recommended time to take this medication is every morning because this schedule is easier to remember.
• A diuretics type that is powerful and short-acting can be used once or twice a day.
• The Furosemide (frusemide) and bumetanide can empty your stomach 30 minutes after you take these medicines.

Drug Interaction

Thiazide diuretics are administered with other antidiabetic drugs such as:

• oral agents and insulin Apidra
• Exubera
• Humalog Mix 50-50
• Humulin 70-30
• Humulin R
• Humulin 50-50
• Humulin N
• Humalog
• Velosulin
• Levemir
• Lantus
• Novolog
• Novolog Mix 50/50
• Novolog Mix 70/30

With those patients who are taking digoxin or Lanoxin, the concurrent digoxin and diuretics may lead to low levels of potassium and will cause cramps, weakness, and irregular heartbeats.

Lithium (Lithobid, Eskalith, Lithotabs, Lithonate) given simultaneously with diuretics (thiazides and loop diuretics) can cause lithium toxicity because of the decreased renal elimination of lithium. To maintain the safety of the patient, the lithium levels must be closely monitored.

Diuretics are commonly prescribed along with other medications for heart disease and high blood pressure. 

Warnings and Precautions of Diuretics

If a patient has trouble urinating, doctors will never recommend diuretics. If you have an allergic reaction to the active or inactive ingredients of diuretics, this is another reason why you need to avoid this medication. 

If you have the following conditions, you need to consult your doctor and discuss your case before you start taking diuretics:

• you have severe kidney and/or liver disease
• you are dehydrated
• you experience irregular heartbeat
• your pregnancy is in the third trimester, or you developed high blood pressure while being pregnant
• your age is 65 years or older
• you have gout
• you have an allergy to sulfa drugs such as Bactrim and Septra
• you are taking drugs that can damage your hearing such as Platinol (cisplatin) and carboplatin

You have to be honest with your doctor during your first consultation so he can give you the right treatment for your condition.

Overdose and Contraindication of Diuretics

The contraindications of this medication are the following:

• patients with drug hypersensitivity and electrolyte imbalance
• must be used carefully with someone who has renal dysfunction
• not suitable for patients who has diabetes mellitus
• caution must be given to patients who have liver disease 
• older patients have a high risk of side effects; thus they must be given with lower dosage
• thiazides and loop diuretics may cross the placenta and can cause fetal abnormalities

Clinical Pharmacology of Diuretics

This medication belongs to the group of drugs that are commonly used. The different types of diuretics (thiazide diuretics, loop diuretics, and potassium-sparing diuretics) are drugs that have a practical significance. There have been a lot of studies and data that show the pharmacokinetics of these drugs, but the metabolism of this medication has not yet been explained. Diuretics have several pharmacodynamic drug interactions, which can be generally predicted from the spectrum of pharmacodynamic actions of the medicines involved.

Diuretics may be administered through mouth or an IV infusion or slow intravenous injection. After 1 to 3 hours, this medication will be absorbed from the gastrointestinal tract. The metabolism happens in the liver and can be released through urine. The effect of diuretics may extend up to 6 hours. 

Medication Guide

Every medicine must be taken with proper direction. If you are using diuretics under your doctor’s guidance, you need to follow every instruction he provided so you can guarantee the effectiveness of the medication. But if you are taking diuretics as self-medication, always ask your pharmacist regarding the instructions and check the medicine’s packaging before using it. Other important medication guides that you need to keep in mind are:

• If you are taking other medication aside from diuretics, you need to inform your doctor right away. The list of supplements and herbal products must also be presented to your doctor for a better assessment of your condition.
• Your doctor should know your medical history or other medical problems that you have.
• Your doctor may check your blood pressure regularly and conduct a blood test and urine test to check the levels of specific minerals.
• Various tests may also be done to check the condition of your kidney and determine if it’s working well or not.
• You may be advised to change or modify your diet and limit your salt intake. A diet that is low with sodium is recommended while taking this medication.
• Some types of diuretics may cause the loss of potassium in your body, that’s why you will need to increase your intake with foods that are rich in potassium such as bananas, spinach, sweet potatoes, and lentils. You may also consider taking potassium supplements together with diuretics.
• If you are taking potassium-sparing diuretic like spironolactone (Aldactone), triamterene (Dyrenium), or amiloride (Midamar), your doctor will advise that you avoid foods that are rich with potassium, low-sodium milk, salt substitutes, and other sources of potassium.

Since diuretics are one of the common medications that may be prescribed to anyone, proper medication guide must be strictly followed.