Hydrochlorothiazide Diet: Foods To Avoid And Eat

Hydrochlorothiazide is a thiazide diuretic (water pill) drug that helps prevent your body from absorbing too much salt, which can cause fluid retention. 

It works by forcing the kidneys to excrete excess water and salt from the body through the urine.

The medicine is used alone or in combination with other medications to treat high blood pressure. 

In addition, hydrochlorothiazide is used to treat edema (fluid retention; excess fluid trapped in bodily tissues).

Along with its needed effects, hydrochlorothiazide may cause some unwanted side effects. 

Hydrochlorothiazide can cause frequent urination, diarrhea, hair loss, loss of appetite, and headache. 

The drug can also cause a fast heart heartbeat, which is a sign of dehydration and electrolyte imbalance, along with weakness, tiredness, confusion, weak legs, and restlessness.

There are special dietary instructions to follow while you are taking hydrochlorothiazide. 

If your doctor recommends a low-salt diet or low-sodium diet or eating or drinking more potassium-rich foods (e.g., prunes, bananas, orange juice, and raisins), carefully follow these instructions.

Below we review the food to avoid and consume while on the drug and hydrochlorothiazide warnings.

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Foods To Avoid While Taking Hydrochlorothiazide

It is common practice to ask your doctor if a new prescription drug may interact with your other prescriptions. But have you asked about potentially problematic foods? 

Certain fruits, vegetables, snacks, and drinks can be problematic when combined with hydrochlorothiazide.

If you are concerned about what should you avoid when taking hydrochlorothiazide, this comprehensive list will guide you on your food choices.  

Here is a list of foods to avoid while on hydrochlorothiazide.

1) Foods high in calcium

Thiazide diuretics like Hydrochlorothiazide cause increased loss of sodium in the urine. By removing sodium from the body, diuretics also cause calcium to stay in the body. This increase in the reabsorption of urine calcium increases blood calcium levels.

Taking a lot of calcium with thiazide diuretics will raise your chances of getting milk-alkali syndrome, which is dangerous. 

If you’re using a thiazide diuretic, you should avoid consuming too much calcium daily.

Some examples of calcium-rich foods include:

  • Dairy products
  • Canned fish
  • Dark green leafy vegetables
  • Orange juice fortified with calcium

If you use calcium supplements while using a thiazide diuretic, consult your doctor about the correct dose. In addition, request that your blood pressure and calcium levels be examined.

dairy and insulin

2) Fatty food

Thiazide diuretics have been shown to increase serum triglyceride and cholesterol levels, particularly LDL and VLDL. 

It is unknown whether these effects are dose-related and sustained during chronic therapy.  

As a result, it is critical to follow a low-fat diet and avoid processed and fried meals.

People with preexisting hyperlipidemia (high fat levels in the blood) may need stricter monitoring during thiazide therapy, and their lipid-lowering regimen and diet may need to be adjusted accordingly.

3) Alcohol

Alcohol and hydrochlorothiazide do not mix. Ethanol and hydrochlorothiazide may work together to reduce your blood pressure.  

When taking a thiazide diuretic, consuming alcohol can raise the risk of orthostatic hypotension (a condition in which your blood pressure suddenly drops when you stand up from lying down or seated).

Headache, lightheadedness, fainting, dizziness, and pulse or heart rate changes are all possible symptoms. 

These side effects are most likely to occur at the start of treatment, after a dose increase, or when treatment is resumed after a break. 

Inform your doctor if you experience these symptoms and they do not go away after a few days or become bothersome.

metformin and alcohol

4) Herbal supplements

People on hydrochlorothiazide should avoid adding herbal supplements to their medication regimen without consulting their doctor. 

When taking diuretic pharmaceuticals, diuretic herbs should be avoided since they may intensify the impact of the drugs and lead to possible cardiovascular side effects. 

These herbs include Uva ursi, dandelion, buchu, juniper, horsetail, cleavers, and gravel root.

Likewise, using buckthorn (Rhamnus frangula, Rhamnus catartica, Frangula alnus) or alder buckthorn for more than 10 days may result in electrolyte loss (particularly the mineral potassium).

It is in the patient’s best interest to consult with their healthcare provider before using supplements when taking a prescription medication like Hydrochlorothiazide.

organic garlic supplement

Foods To Eat While On Hydrochlorothiazide

Eating particular food is beneficial while on hydrochlorothiazide.  Foods to stock up on include fruits, vegetables, moderate amounts of whole grain, low-fat dairy products, nuts, poultry, and fish.

1) Potassium-rich food

You may need to eat potassium-rich meals to reduce potassium loss while taking hydrochlorothiazide. 

Foods high in potassium include:

  • Bananas
  • Sweet potatoes
  • Avocados
  • Broccoli
  • Coconut water
  • Spinach

These foods, however, should be consumed in moderation. When consumed in excess, the high potassium content of these foods can interact with hydrochlorothiazide.

bananas prostate cancer

2) Magnesium-rich food

While potassium-depleting diuretics, such as thiazide diuretics, cause the body to lose potassium; they may also cause depletion of magnesium from the cell. 

However, this may not be represented by a low blood magnesium level.

Magnesium loss caused by potassium-depleting diuretics can result in further potassium loss. 

People on potassium-depleting diuretics, notably thiazide diuretics, should supplement potassium and magnesium until more is known.

Foods rich in magnesium include:

  • Pumpkin seeds
  • Cashews
  • Spinach
  • Almonds
  • Peanuts
  • Soy milk
  • Edamame

In addition, the following foods contain ample amounts of magnesium:

  • Avocados
  • Rice
  • Potato
  • Cereals
  • Dark chocolate
  • Black beans 

Magnesium supplementation is commonly given at 300-600 mg daily for people using thiazide diuretics. 

In comparison, greater levels (over 800 mg per day) have been observed in controlled research to minimize thiazide’s adverse effects. 

Combining potassium and magnesium supplements has been shown to treat excessively low potassium blood levels while protecting against excessive magnesium loss.

3) Grapefruit and grapefruit juice

Grapefruit does not appear to interact with hydrochlorothiazide, so you can consume it while taking this drug. 

metformin and grapefruit

4) Water

Like other diuretics or water pills, hydrochlorothiazide works by boosting urination to help eliminate water and salt from the body. 

The increased frequency and amount of urination can put you in danger of dehydration, leaving you thinking, “How much water should I drink while taking hydrochlorothiazide?” The average adult should drink eight to ten cups (8 ounces) of water daily.

It’s critical to drink the right amount every day, especially if you’re taking hydrochlorothiazide. 

Stay hydrated during exercise or in hot weather because the combination of hydrochlorothiazide and sweating can increase your risk of fluid loss and low blood pressure.

If you experience diarrhea or vomiting, drink plenty of fluids to avoid dehydration

Foods to avoidFoods to eat
High-calcium foodsPotassium-foods
Fatty foodsMagnesium-foods
Herbs and supplementsGrapefruit and grapefruit juice

Are There Any Other Things You Need To Avoid?

Hydrochlorothiazide may make you dizzy. Be careful while getting up from a sitting or sleeping position, and avoid driving or operating dangerous machinery until you know how the medications affect you.

You must inform your doctor about any additional medications you are taking, including vitamins and herbs. Do not discontinue any medications without first consulting your doctor.

The FDA warns that routine use of diuretics such as hydrochlorothiazide during a normal pregnancy is inappropriate and can endanger both the fetus and the parent. 

Furthermore, hydrochlorothiazide can pass from parent to kid via breast milk. As a result, the medication should not be used while breastfeeding.

People taking hydrochlorothiazide should be encouraged to restrict their exposure to sunlight, avoid tanning equipment, and use proper protection (e.g., sunscreen with SPF 30 or higher, hats and clothing) when exposed to sunlight to reduce the risk of non-melanoma skin cancer.

Should You Take Hydrochlorothiazide With Food?

You can take hydrochlorothiazide with or without food, but it is best to take this medicine on an empty stomach. But remember to take this drug in the morning, not the evening, as it will make you urinate more.


If you are on hydrochlorothiazide, avoid consuming alcohol, herbs and supplements, foods high in calcium, and fatty food. Instead, opt for potassium and magnesium-rich food in moderation. 

Don’t hesitate to ask your healthcare provider about hydrochlorothiazide precautions and interactions with food.

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  1. Herman LL, Bashir K. Hydrochlorothiazide. [Updated 2022 Jul 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
  2. Roy S. Hydrochlorothiazide. AMA J Ethics. 2017.

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