General Health

Diuretics (Water Pills): Uses, Side-Effects, Risks

Fluids are important for the human body and play several functions. In some cases, however, there may be an excessive accumulation of floods in the body.

These fluids may accumulate in blood vessels, which can cause some medical issues to develop.

In patients with existing conditions, such as high blood pressure, these diseases might become aggravated in the presence of fluid accumulation.

There are treatments available for these scenarios. Diuretics make up one of the most commonly used treatments.

Patients with high blood pressure may be prescribed diuretics. There are other conditions treated with these drugs as well.

Individuals who use diuretics should understand what these drugs do in their bodies. It is also important to understand the different types of diuretics and what they can help for.

We look at the benefits of using diuretics in this post. We will also consider potential side-effects and the conditions that can be effectively treated with these drugs.

What are Diuretics?

Diuretics are pharmaceutical drugs that are often referred to as water pills as well. The reference is due to the actions that these drugs have in the body.

They work by helping to eliminate excess fluids that have accumulated in a patient’s body. The fluids are usually in the form of water. Additionally, diuretics are also effective at reducing the collection of salt.

These pills will help the body get rid of the excess salt and water through urine.

Chemicals in the pills help to push the excess fluids from blood vessels toward the kidneys. At this point, the fluids will be sent to the bladder – and finally expelled from the body via the urinary tract.

In most cases, diuretics will only be available to patients through a prescription. A doctor will need to determine if the patient may benefit from diuretics. Both the benefits and drawbacks are considered.

Alternatives may be offered if the patient may be at risk of side-effects when using diuretics.

Types of Diuretics

The goal of any diuretic is to assist in reducing the accumulation of fluids in the patient’s body. There are three different types of these drugs on the market.

Patients need to understand the difference between these drugs. Some types of diuretics have additional functions. This makes them more appropriate for treating specific conditions.

We will provide an overview of each diuretic drug that may be used to remove excess fluids in the body1:

  • Thiazide diuretics: Among all three types of diuretics, those classified as Thiazide diuretics are most commonly prescribed. These diuretics are especially crucial for patients with high blood pressure. They can effectively reduce fluid accumulation in the body. Additionally, Thiazide diuretics also helps with the dilation of blood vessels. This means blood vessels can relax more effectively. Common medications of the Thiazide diuretics class include hydrochlorothiazide, indapamide, metolazone, and chlorthalidone.

  • Loop diuretics: Loop diuretics are most commonly prescribed to patients with heart failure. These drugs effectively remove the fluids that accumulate with heart failure. It also helps to reduce the presence of edema. The most common examples of loop diuretics are furosemide, torsemide, and bumetanide.

  • Potassium-sparing diuretics: The third type of diuretic is not as commonly used as the other two. The primary concern here is that these diuretics do not reduce the fluids in the body as effectively. This is a problem in patients with higher amounts of fluids in their bodies. The benefit, however, is a reduced effect on potassium in the body. Thiazide and loop diuretics cause a decline in potassium levels. This electrolyte is critical to a person’s well-being. If the person takes drugs that already reduces potassium levels, then this diuretic is usually preferred.

What conditions are Diuretics used for?

The most common use of diuretics is generally to treat patients with high blood pressure. This is a prevalent condition that refers to blood pressure levels that are too high. The estimated prevalence of hypertension in the US alone is about 29%2. The risk increases with age.

When a patient has high blood pressure, fluids may accumulate in their blood vessels. In addition to fluids, there may also be the salt that collects in the circulatory system.

Salt contains sodium. In turn, sodium is known to have an adverse effect on blood pressure regulation. The presence of both salt and water in blood vessels makes it harder for the heart to pump blood through the body. As the heart needs to work harder, high blood pressure develops.

The use of diuretics may reduce these effects. The drug will help to expel the water and salt from blood vessels. This makes it easier for the heart to pump blood through the patient’s body. It also means that blood pressure will not increase – but might rather remain stable.

While diuretics are most commonly given to patients with hypertension, there are other uses for these drugs too. Patients with congestive heart failure may benefit from diuretics.

Heart failure makes it difficult for the heart to pump blood to all areas of the body. When this happens, fluids will start to build up in the patient’s body. In this case, the fluid accumulation is generally referred to as edema.

A patient with congestive heart failure may find that the edema is reduced when they take diuretic medications. Other possible use cases for diuretics may include:

  • Loop diuretics may assist in the management of acute pulmonary edema, anion disease, and acute renal failure

  • Thiazide diuretics may be helpful for nephrogenic diabetes insipidus

  • Potassium-sparing diuretics may help with both kidney and liver disease
  • Apart from the use of Flomax for kidney stones, sometimes diuretics may also be used as a treatment option for this condition.

Diuretics side effects

Diuretics are effective at reducing fluid in the body. At the same time, there are some side-effects that people need to take note of. By realizing these adverse effects, the patient knows what to expect.
The specific side-effects may depend on the type of diuretic a patient takes3. There are a few general side-effects that we will note below:

  • Increased thirst

  • Headaches

  • Dizziness

  • Increase in cholesterol levels

  • Similar to steroids and diabetes, diuretics can also cause higher levels of blood glucose

  • Muscle cramps

  • Symptoms linked to tinnitus

  • A low level of sodium in the blood

  • A deficiency of potassium or magnesium

  • An increase in breast size among male patients

  • Rashes

  • Itching

  • Changes in menstrual period

  • Changes in sexual functions and abilities

What medical condition can Diuretics affect?

Some medical conditions may also cause concern if a patient needs to use a diuretic drug. Patients do need to be aware of these conditions.

If affected by any, the patient should consider the use of an alternative product to manage high blood pressure, edema, heart failure, or a related disease.

Patients with these medical conditions are generally advised not to take a diuretic:

  • Severe kidney disease

  • Severe liver disease

  • Gout

  • Irregular heartbeat

  • Pregnancy

Patients who are suffering from dehydration also need to avoid the use of diuretics.

These drugs should also not be used by women who are in their third trimester. If a woman develops hypertension during pregnancy, then it is generally not advised to take diuretics as well.

Drug interactions

Diuretics may interfere with certain drugs. This is why a patient needs to tell their doctor what drugs they are currently taking. Both over-the-counter and prescription medications should be mentioned.

Drug interactions may cause some medication to work ineffectively. It can also sometimes cause an increase in the effects of some drugs. These effects may be dangerous for the patient using the diuretics.

Patients need to be wary of diuretics if they are already taking any of these drugs:

  • Salicylates (Pepto-Bismol or aspirin)

  • Aminoglycosides (gentamycin or amikacin)

  • Drugs used to treat cancer, such as Platinol, cisplatin, and carboplatin

  • Dofetilide (sold under the brand name Tikosyn)

  • Lithium (sold under the brand name Lithobid)

Natural Diuretics

The concerns with diuretic drugs make a lot of people fear them. The good news is, there are several alternative options. This includes a range of different natural diuretics.

These natural products can help increase the amount of fluid expelled from the body through urination. They can also help to reduce the accumulation of salt in blood vessels effectively.

Natural diuretics are generally considered safer options compared to some of the available prescription options. These are a few options that patients may consider to treat high blood pressure:

  • Nigella sativa (black cumin)

  • Dandelion

  • Ginger

  • Hibiscus

  • Caffeine

  • Parsley

Conclusion

Diuretics form an important part of a treatment plan for high blood pressure. Other conditions can also benefit from the use of diuretics. These drugs help to expel excess salts and fluids from the body.

While beneficial, there are side-effects to be noted. Patients should realize what they need to expect. This includes potential drug interactions that could occur.

Sources

  1. Cedars Sinai. Heart Disease Drug Therapy. [online] Available at: https://www.cedars-sinai.org/programs/heart/conditions/treatments/drug-therapy.html
  2.  Centers for Disease Control and Prevention. (2017) Hypertension Prevalence and Control Among Adults: the United States, 2015-2016. [online] Available at: https://www.cdc.gov/nchs/products/databriefs/db289.html
  3. Prichard BN1, Owens CW, Woolf AS.. (1992). Adverse reactions to diuretics.. European Heart Journal . 13 (1), p96-103.
  4. Mishra S. Diuretics in primary hypertension – Reloaded. Indian Heart J. 2016;68(5):720–723. doi:10.1016/j.ihj.2016.08.013

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