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Jai Ganesh

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Diuretic

Diuretic

Gist

Diuretics, sometimes called water pills, help rid your body of salt (sodium) and water. Most of these medicines help your kidneys release more sodium into your urine. The sodium helps remove water from your blood, decreasing the amount of fluid flowing through your veins and arteries. This reduces blood pressure.

Summary

A diuretic is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. A diuretic tablet is sometimes colloquially called a water tablet. There are several categories of diuretics. All diuretics increase the excretion of water from the body, through the kidneys. There exist several classes of diuretic, and each works in a distinct way. Alternatively, an antidiuretic, such as vasopressin (antidiuretic hormone), is an agent or drug which reduces the excretion of water in urine.

Medical uses

In medicine, diuretics are used to treat heart failure, liver cirrhosis, hypertension, influenza, water poisoning, and certain kidney diseases. Some diuretics, such as acetazolamide, help to make the urine more alkaline, and are helpful in increasing excretion of substances such as aspirin in cases of overdose or poisoning. Diuretics are sometimes abused by people with an eating disorder, especially people with bulimia nervosa, with the goal of losing weight.

The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. That is, the reduction in blood pressure is not due to decreased blood volume resulting from increased urine production, but occurs through other mechanisms and at lower doses than that required to produce diuresis. Indapamide was specifically designed with this in mind, and has a larger therapeutic window for hypertension (without pronounced diuresis) than most other diuretics.

Details

Overview

Diuretics, also called water pills, are medications designed to increase the amount of water and salt expelled from the body as urine. There are three types of prescription diuretics. They’re often prescribed to help treat high blood pressure, but they’re used for other conditions as well.

What diuretics help treat

The most common condition treated with diuretics is high blood pressure. The drugs reduce the amount of fluid in your blood vessels, and this helps lower your blood pressure.

Other conditions are also treated with diuretics. Congestive heart failure, for instance, keeps your heart from pumping blood effectively throughout your body. This leads to a buildup of fluids in your body, which is called edema. Diuretics can help reduce this fluid buildup.

Types of diuretics

The three types of diuretic medications are called thiazide, loop, and potassium-sparing diuretics. All of them make your body excrete more fluids as urine.

1. Thiazide diuretics
Thiazides are the most commonly prescribed diuretics. They’re most often used to treat high blood pressure. These drugs not only decrease fluids, they also cause your blood vessels to relax.

Thiazides are sometimes taken with other medications used to lower blood pressure. Examples of thiazides include:

chlorthalidone
hydrochlorothiazide (Microzide)
metolazone
indapamide

2. Loop diuretics
Loop diuretics are often used to treat heart failure. Examples of these drugs include:

torsemide (Demadex)
furosemide (Lasix)
bumetanide
Potassium-sparing diuretics

Potassium-sparing diuretics reduce fluid levels in your body without causing you to lose potassium, an important nutrient.

The other types of diuretics cause you to lose potassium, which can lead to health problems such as arrhythmia. Potassium-sparing diuretics may be prescribed for people at risk of low potassium levels, such as those who take other medications that deplete potassium.

Potassium-sparing diuretics don’t reduce blood pressure as well as the other types of diuretics do. Therefore, your doctor may prescribe a potassium-sparing diuretic with another medication that also lowers blood pressure.

Examples of potassium-sparing diuretics include:

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

Side effects of diuretics

When taken as prescribed, diuretics are generally well tolerated. However, they can still cause some side effects.

More common side effects

The more common side effects of diuretics include:

* too little potassium in the blood
* too much potassium in the blood (for potassium-sparing diuretics)
* low sodium levels
* headache
* dizziness
* thirst
* increased blood sugar
* muscle cramps
* increased cholesterol
* skin rash
* gout
* diarrhea

Serious side effects

In rare cases, diuretics may cause serious side effects. These can include:

* allergic reaction
* kidney failure
* irregular heartbeat

What you can do

If you have side effects that bother you while taking diuretics, talk to your doctor. They may prescribe a different medication or combination of medications to help reduce your side effects.

Whether or not you have side effects, don’t stop taking your diuretic without first talking to your doctor.

Risks of diuretics

Diuretics are generally safe, but there are some risks if you have other medical conditions or take certain medications.

Conditions of concern

Before you take a prescribed diuretic, be sure to tell your doctor if you have any of the following conditions or issues:

* diabetes
* pancreatitis
* lupus
* gout
* menstrual problems
* kidney problems
* frequent dehydration

Drug interactions

When you begin a new medication, make sure to tell your doctor about any other medications, supplements, or herbs you’re taking. Some medications that might interact with a diuretic include:

* cyclosporine (Restasis)
* antidepressants such as fluoxetine (Prozac) and venlafaxine (Effexor XR)
* lithium
* digoxin (Digox)
* other drugs for high blood pressure

Herb and plant diuretics

Some herbs and plants are considered “natural diuretics,” including:

* hawthorn
* green and black tea
* parsley

These substances aren’t meant to be used to replace a prescription diuretic. If you have questions about diuretics and other treatment options, talk to your doctor.

Talk with your doctor

Prescription diuretics can be helpful in treating serious conditions, such as heart failure, to less-pressing conditions, such as mild high blood pressure.

If your doctor prescribes a diuretic, feel free to ask them any questions you may have. Consider discussing these questions:

* How will I know my diuretic is working the way it’s supposed to work?
* Am I taking any medications that might interact with a diuretic?
* Should I follow a low-salt diet while taking a diuretic?
* Should I have my blood pressure and kidney function tested while taking this drug?
* Should I take a potassium supplement or avoid foods that contain potassium?

Additional Information

A diuretic is any drug that increases the flow of urine. Diuretics promote the removal from the body of excess water, salts, poisons, and accumulated metabolic products, such as urea. They serve to rid the body of excess fluid (edema) that accumulates in the tissues owing to various disease states.

There are many types of diuretics, but most act by decreasing the amount of fluid that is reabsorbed by the tubules of the kidneys, whence the fluid passes back into the blood. The most widely used diuretics, the benzothiadiazides (e.g., chlorothiazide), interfere with the reabsorption of salt and water by the kidney tubules. Instead of being reabsorbed, the salt and water are ultimately excreted, thus increasing the flow of urine. After they were synthesized in the late 1950s, the benzothiadiazides replaced most other existing diuretics. They are more convenient than some other diuretics in that they can be taken orally in the form of pills. These drugs are also used to reduce high blood pressure (hypertension).

Mercurial diuretics (e.g., calomel) work as do benzothiadiazides but are less easy to use. Another class of diuretics are substances that cannot be reabsorbed by the kidney tubules and thus limit the reabsorption of water by the tubules. These include mannitol, sucrose, and urea. Other diuretics (e.g., acetazolamide) work by blocking the reabsorption of sodium bicarbonate by the tubules, thus increasing urine formation. These and still other types are used infrequently in conjunction with the mercurial diuretics.

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