What are the side effects of taking water pills

Also known as “water pills,” these drugs rid the body of extra water and lower blood pressure.

Diuretics are a class of medications commonly known as "water pills."

They're prescribed to treat high blood pressure; swelling of the feet, ankles, and lower legs and fluid in the lungs caused by heart failure; fluid buildup in the abdomen caused by liver damage or certain cancers; and eye conditions such as glaucoma.

Other conditions that may be treated with diuretics include diabetes insipidus, polycystic ovarian syndrome (PCOS), kidney stones, male-pattern baldness in women, and osteoporosis.

There are several different classes of diuretics, each of which works differently in the kidneys to help rid the body of extra water and salt.

Examples of diuretics include:

• Loop diuretics, such as Lasix (furosemide), bumetanide, Demadex (torsemide), and Edecrin (ethacrynic acid)
• Thiazide diuretics, like Microzide (hydrochlorothiazide), chlorthalidone, and Zaroxolyn (metolazone)
• Potassium-sparing diuretics, including Aldactone (spironolactone), Inspra (eplerenone), Dyrenium (triamterene), and Midamor (amiloride)
• Carbonic anhydrase inhibitors such as Diamox (acetazolamide) — mainly used for glaucoma and altitude sickness

Don't take diuretics if you have trouble urinating, or if you're allergic to the active or inactive ingredients found in the medication.

Ask your doctor if you should avoid or be cautious using diuretics if you:

• Have severe liver or kidney disease
• Are dehydrated
• Have an irregular heartbeat
• Are in the third trimester of pregnancy and/or have developed high blood pressure during your pregnancy
• Are age 65 or older
• Have gout
• Are allergic to sulfa drugs, like Septra and Bactrim (sulfamethoxazole with trimethoprim)
• Are already taking drugs that can damage hearing, like the cancer drugs Platinol (cisplatin) and carboplatin; salicylates like aspirin and Pepto-Bismol (bismuth subsalicylate); or aminoglycosides like amikacin and gentamin

Common Side Effects

It's not uncommon to experience any of the following while taking a diuretic:

• Dizziness or headache
• Thirstiness
• Rash or itching
• Higher blood glucose or cholesterol level
• Changes in your sexual function or menstrual period
• Muscle cramps (loop diuretics)
• Ringing in the ears (loop diuretics)
• Low sodium, potassium, and/or magnesium levels in the blood (loop diuretics)
• High potassium levels in the blood (potassium-sparing diuretics)
• Enlarged breasts in men (Aldactone and Inspra)

Drug Interactions

Many drugs can interact with diuretics, but double-check with your doctor or pharmacist to make sure you're not taking more than one diuretic at a time (unless your doctor has told you otherwise).

Don't take loop diuretics if you're taking Tikosyn (dofetilide).

Make sure your potassium is carefully monitored if you're using digoxin and a loop or thiazide diuretic.

Dosages of insulin and oral diabetes medications may need to be adjusted while using diuretics.

Ask your doctor about diuretics if you're taking the mood stabilizer Lithobid (lithium), or if you're taking any medication that may lead you to feel dehydrated.

Review

Adverse reactions to diuretics

B N Prichard et al. Eur Heart J. 1992 Dec.

Abstract

Diuretics can result in various undesired biochemical changes, such as impotence, skin rashes, nausea, dizziness and lethargy as well as subjective side effects. The side effects are mostly predictable, their effects depending on both the circulatory blood volume and on the transport of water and solute in the renal tubules. Two of the commonest side effects are mild hypovolaemia, when any diuretic is used, and mild hypokalaemia when the non-potassium-sparing diuretics, such as thiazides and frusemide are used. Its occurrence is dose dependent and can be corrected by potassium supplements, but potassium-retaining diuretics, which also correct the often associated fall in serum magnesium, are preferable. Many reports link hypokalaemia with cardiac arrhythmias, but some dispute this association in the absence of the concomitant use of digoxin. Hyponatraemia rarely occurs, but can be life threatening. Calcium excretion is markedly reduced, but unlike other electrolyte disturbances from diuretics, this may be valuable: some suggest diuretics have an anti-osteoporotic action. Diuretics increase glucose and insulin resistance and should be used sparingly in diabetics. They rarely cause a non-ketotic hyperosmolar coma. Urate is raised, but clinical gout is not common. Cholesterol elevation has been reported in some studies, but long-term studies indicate that lipid changes are minor. Other rare side effects are not predictable from their pharmacological actions and these include the occurrence of skin rashes, thrombocytopenia, pancreatitis and interstitial nephritis; and ototoxicity from frusemide.

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