Medications in this class include:
- Furosemide (Lasix®)
- Metolazone (Zaroxolyn®)
- Hydrochlorothiazide (HydroDiuril®)
- Bumetanide (Burinex®)
- Ethacrynic acid (Edecrin®)
Why it’s important to take this medication
Diuretics (commonly called ‘water pills’) are very useful for reducing excess water in the body. People with heart failure have a tendency to retain fluid. Fluid can accumulate in the ankles, legs, belly, and lungs (making it difficult to breathe). With less water retention, it becomes easier to breath, and there is less swelling and abdominal bloating. Occasionally, when patients are admitted to the hospital because of “decompensated heart failure” from increased fluid accumulation, an intravenous (injectable) form of this medication may be required.
How do diuretics work?
- Diuretics stimulate the kidneys to produce more urine – getting rid of excess water and salt from the body.
How this medication should be taken:
- Take this medication at the same time(s) each day. Do not take a diuretic close to bedtime, as it will likely keep you up at night to pee.
- If you have an upset stomach with this medication, you may take it with food.
The most common side effects include:
- Passing more urine.
- A loss of potassium and magnesium, which may cause an irregular heartbeat, muscle cramping, and unusual tiredness. This will be monitored with periodic blood tests. Supplemental potassium and magnesium may be required if these levels are too low.
- Increased uric acid level (gout).
- Thirst and dry mouth (see section on Fluid Restriction).
- Skin rash. Contact your doctor if a skin rash develops.
- Skin is more sensitive to sunlight.
- Feeling dizzy.
- Upset stomach.
- Loss of appetite.
- Dehydration. This will be monitored by blood tests. Weighing yourself every day can also help to tell if you are losing too much fluid.
- A loss of hearing or ringing in the ears, particularly if you are on high doses of diuretics.
What should I remember while taking this medication?
- This medication may be taken with or without food, but should be taken at the same time(s) each day. If this medication upsets your stomach, try taking it with food or milk.
- Weigh yourself daily to see if you are retaining (gaining) or losing fluid.
- Your health care provider may sometimes advise you to adjust your diuretic dose depending on your weight.
- If you experience a lot of vomiting or diarrhea, contact your health care provider or pharmacist. Extra blood tests may be needed to check your potassium level and kidney function. In some cases, the medication may need to be held for a few days until you are feeling better. Do not stop any of your medications without speaking to your health care provider.
- This medication may make your skin more sensitive to sunlight. Try to stay out of direct sunlight. Use sunscreen and wear protective clothing, a hat and sunglasses when you are outside. Do not use a tanning bed.
- This medication may make you feel dizzy. Stand up slower if you have been sitting or lying down.
- Certain diuretics can raise blood sugar levels. If you have diabetes, talk to your health care provider on how this will affect the management of your diabetes.
- If you are pregnant or planning to become pregnant, talk to your health care provider.
- Tell your health care provider or pharmacist of any prescription and non-prescription medications, including vitamins or herbal remedies, you are taking.
What should I do if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed. Take the next dose at the regular time. Do not take two doses at the same time. If you are unsure of what to do, speak to your health care provider or pharmacist.