What is it and how does it work?
Diuretics are commonly known as “water pills”. Long acting diuretics are very helpful in the treatment of hypertension. It is inexpensive and effective for up to 24 hours.
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These drugs work on the kidneys and cause salt and water to be eliminated. They also relax the arteries. The end result is a reduction in blood pressure.
A few diuretics
Long-acting thiazide diuretics: (most commonly used for hypertension)
Hydrochlorothiazide in Dichlotride and often in combination with amiloride, like in Hexa-retic.
Short-acting loop diuretics:
Furosemide in Lasix, Puresis.
Potassium-sparing diuretics:
Amiloride, often in combination with hydrochlorothiazide like Amiloretic.
Spironolactone in Aldactone, Spiractin.
Combining thiazide and potassium diuretics:
Amiloretic, Moduretic, Hexa-retic.
Who benefits from diuretics?
Patients with Stage I hypertension are often introduced to long-acting thiazide diuretics as first-line therapy. Africans, the elderly and obese patients tend to be salt sensitive, and may respond very well to diuretic drugs.
Compelling indications for use as anti-hypertensive drug:
African patients.
The elderly.
Patients with Isolated Systolic Hypertension.
Heart failure.
Salt sensitive and obese patients.
How to take diuretics:
Your doctor will choose the appropriate diuretic and dosage for you. It should be taken in the morning since it causes increased urination, especially initially.
An example could be: Hydrochlorothiazide 12,5 to 25 mg, taken in the morning.
By limiting dietary salt, the pressure lowering effect of diuretics will be enhanced, and the dosage required may be reduced.
Increase your intake of potassium rich foods as diuretics may reduce potassium in the body. Eat plenty of fruit and vegetables.
Who should not take diuretics?
Compelling contraindications:
Gout - attacks may be precipitated.
Possible contraindications/take with caution:
Dyslipidaemia (abnormal blood cholesterol).
Erection problems or enlarged prostate.
Safety in pregnancy and lactation not established.
Diabetes – use low dosages.
Patients with impaired kidney or liver function.
Inform your doctor if:
You have ever had gout.
You have any sexual dysfunction.
You have diabetes.
You have any kidney or liver problems.
You are taking any other drugs, including self-medication.
Possible side effects
The level of potassium in the blood may decrease. This may alter the rhythm of the heart. This occurs especially with the use of loop diuretics, and to a lesser degree, the thiazide diuretics. This is quite rare and prevented by using low dosages. Potassium-sparing diuretics can be used if necessary.
Leg cramps can be a common side effect. Some patients may feel thirsty, dizzy or lethargic.
A small percentage of males may experience erection problems on diuretics.
Can it be taken with other drugs? Possible drug interactions
Non-steroidal anti-inflammatory drugs: some may affect the diuretic effect of hydrochlorothiazide.
The adverse effects of digitalis and lithium may be increased.
If taken with corticosteroids it may increase the loss of potassium from the body.
Alcohol and narcotics may aggravate postural hypotension. Diuretics may increase dehydration and hangovers after taking alcohol.
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