Cochin Cardiac Club

Health Blog by Dr.Uday Nair




Heart Disease and Diuretics

Sometimes diuretics are used as heart disease treatment. Diuretics, commonly known as "water pills," help your body get rid of unneeded water and salt through the urine. Getting rid of excess fluid makes it easier for your heart to pump and controls blood pressure. Examples of diuretics include:
  • Lasix (furosemide)
  • Bumex (bumetanide)
  • Demadex (torsemide)
  • Esidrix (hydrochlorothiazide)
  • Zaroxolyn (metolazone)
  • Aldactone (spironolactone)

Diuretics are categorized as thiazide-like (Zaroxolyn and Esidrix), loop (Lasix, Bumex, Demadex) or potassium sparing (Aldactone). Thiazide diuretics cause moderate increases in water excretion and are appropriate for long-term use. Loop diuretics are more powerful and are especially useful in emergencies. Potassium-sparing diuretics help your body retain the mineral potassium and are often prescribed in conjunction with the other two types of diuretics. Some diuretics are a combination of potassium-sparing and thiazide diuretics.

Who Should Take Diuretics?

If you have any of the following conditions, your doctor may recommend you take a diuretic.
  • Edema. Diuretics decrease swelling (edema) that usually occurs in the legs.
  • High blood pressure . Thiazide diuretics lower blood pressure, which substantially reduces the risk of stroke and heart attack.
  • Heart failure . Diuretics reduce the swelling (edema) and water build up in the lungs (congestion) caused by heart failure. Normally, loop diuretics are used for heart failure.
  • Kidney problems. Diuretics reduce water retention.
  • Liver problems. Diuretics reduce the amount of fluid build up associated with cirrhosis (disease of the liver).
  • Glaucoma . Diuretics reduce the pressure in the eye associated with this disease.

How Should I Take Diuretics?

Before a diuretic is prescribed, tell your doctor if you have diabetes, kidney disease, liver disease, or gout.
Follow the label directions on how often you should take the diuretic. If you are taking a single dose a day, take it in the morning with your breakfast or right 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 a diuretic will depend on the type prescribed, as well as your condition.
Weigh yourself at the same time every day (on the same scale) and record your weight. Call your doctor if you gain three pounds in one day or five pounds in one week.
While taking a diuretic, have your blood pressure and kidney function tested regularly, as advised by your doctor. These tests are important because diuretics can change your blood potassium and magnesium levels.
Keep all appointments with your doctor and the laboratory so that your response to this medication can be monitored.

What Are the Side Effects of Diuretics?

Diuretics can cause the following side effects:
  • Frequent urination. This may last for up to four hours after each dose. If you are taking two diuretic doses each day, take the second dose no later than late afternoon so you can sleep through the night.

  • 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 these symptoms 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. Try sucking on sugarless hard candy. 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 are persistent or 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, vomiting, or muscle cramps. Be sure that you are taking your potassium supplement correctly, if prescribed. Contact your doctor or nurse if these symptoms persist.
Contact your doctor or nurse if you have any other symptoms that cause concern

What Foods or Drugs Interact With Diuretics?

To avoid harmful drug interactions, tell your doctor and pharmacist all the medications you are taking, including herbal preparations, over-the-counter drugs, vitamins, and nutrition supplements.
Diuretics are often prescribed in combination with other drugs. 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.
Before a diuretic is prescribed, tell your doctor if you are taking other medications for high blood pressure, digoxin, indomethacin, probenecid, or corticosteroids (prednisone).
Some diuretics may require you to avoid or include certain foods in your diet. Follow your doctor's advice, which may include:
  • Following a low-salt diet.
  • Taking a potassium supplement or including high-potassium foods such as bananas and orange juice if you are losing potassium. Talk to your doctor about your level of potassium intake.

Can Pregnant Women Take Diuretics?

Check with your doctor if you are pregnant or planning to become pregnant while taking a diuretic.

Can Breastfeeding Women Take Diuretics?

Most diuretics are compatible with breastfeeding, with some precautions; talk to your doctor.

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

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