Diuretics are considered a cornerstone of standard heart failure treatment, but these medications may carry some potentially serious side effects and complications.
One of the many complications of heart failure is that blood and other fluids begin to pool, especially in the legs and feet.
To help remove excess fluid that causes swelling, known as edema, your doctor may prescribe diuretics. These medications help the body excrete more sodium and fluids. Too much sodium causes the body to retain more fluid in order to dilute circulating sodium and protect the heart and kidneys.
While many people use diuretics without issues, including people with coronary artery disease and heart failure, they can bring some side effects and other health risks.
This article explains how diuretics work for heart failure and what to discuss with your healthcare team, including which types of diuretics may be best to help ease symptoms and improve your heart health.
Diuretics are sometimes known as “water pills” because they help you excrete excess liquid in your body via urination. Doctors often prescribe diuretics for heart failure and high blood pressure. They are considered “cornerstones” of heart failure treatment.
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However, people can have different responses to diuretics. These effects can
When to consult your healthcare team
Diuretics are a cornerstone of heart failure treatment around the world, but their successful use requires following your healthcare team’s advice.
Expect to get regular monitoring of your condition, specifically your sodium and potassium levels, as well as your heart and kidney health.
There are three main types of diuretic medications. Each one works a little differently, but they all ultimately have the same purpose: to get excess fluids out of the body.
Loop diuretics
Loop diuretics work on a part of the kidneys called the loop of Henle to increase the amount of sodium and fluids the body excretes. Examples of loop diuretics include:
- bumetanide (Bumex)
- furosemide (Lasix)
- torsemide (Demadex)
- ethacrynic acid (Edecrin)
Thiazide diuretics
Thiazide diuretics help the kidneys extract more salt and fluid into your urine.
Examples of thiazide diuretics include:
- chlorothiazide (Diuril)
- chlorthalidone (Hygroton)
- indapamide (Lozol)
- hydrochlorothiazide (Esidrix)
- metolazone (Mykrox)
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Some people with heart failure are prescribed both loop and thiazide diuretics to be taken as separate pills or in combination medications.
Potassium-sparing diuretics
Potassium-sparing diuretics also help the kidneys remove more sodium and fluids, but without also excreting too much potassium. A proper balance of sodium and potassium is important for healthy blood pressure, among other bodily functions.
Examples of potassium-sparing diuretics include:
- amiloride (Midamor)
- spironolactone (Aldactone)
- triamterene (Dyrenium)
Since diuretics can be especially effective in lowering blood pressure and reducing the body’s sodium and fluid levels, it’s important to be aware of some safety considerations.
For example, plan to have regular blood pressure and kidney function checks, as well as blood tests measuring your sodium and potassium levels.
The goal of diuretic use is to keep sodium and fluid levels down. So, you will need to limit sodium in your diet and avoid consuming too many fluids each day.
Work with your doctor to create plans to ensure you stay hydrated and keep minimum levels of sodium circulating in your bloodstream. If you don’t take a potassium-sparing diuretic, you may want to take potassium supplements.
Diuretics can also cause side effects in some people. Some common side effects include:
- dehydration
- dizziness
- diarrhea
- headaches
- loss of appetite
- nausea
Diuretics also make you pee more often, so plan to take your last pill of the day several hours before bedtime to avoid or at least limit nighttime visits to the bathroom.
If you have heart failure, you may need prescription diuretics to effectively reduce fluid levels in your body and take pressure off of your blood vessels, heart, and kidneys. However, a number of natural and herbal products also have diuretic properties.
These products may be helpful if you have trouble taking diuretic medications. However, it’s important to consult with your healthcare team before taking any additional supplements.
You don’t want to risk any interactions with your medications, and you want to be sure your body is getting the treatment it needs as you manage heart failure.
Some common herbal supplements that may help lower the body’s fluid levels are:
- dandelion
- hawthorn
- hibiscus
- parsley
Green and black tea also have diuretic properties. The following foods have similar properties:
- berries
- grapes
- celery
- onions
- watermelon
Taking diuretics is part of standard heart failure treatment, but these drugs carry some potentially serious side effects and can cause complications affecting heart and kidney health.
For these reasons, if your doctor prescribes one or more diuretics, it’s important to keep your doctor’s recommendations in mind and promptly report any side effects to them.
