Diuretics

Diuretics are a large family of medications that act on the kidneys. They are divided into several categories, three of which are discussed here.

Although they share a common effect — helping eliminate excess fluid that may accumulate in areas such as the legs or lungs (edema) — each type has distinct characteristics. Some agents also help lower bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure or improve heart function in people with heart failure.

A) Loop diuretics

Furosemide [Lasix™], bumetanide [Burinex™], ethacrynic acid [Edecrin™]

In cardiology, these medications are mainly used in patients with heart failure. They help remove excess fluid that tends to accumulate when the heart becomes less effective.

They work by reducing the reabsorption of salt and water by the kidneys. Loop diuretics act on a region of the kidney where reabsorption is particularly important. As a result, they are among the most powerful medications for promoting fluid elimination.

They may be taken once or several times per day. The dosage is adjusted individually according to several factors, including:

Symptoms
kidney function
bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure
the amount of fluid to be removed

The most common side effects include:

dizziness
headaches
low bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure
increased urination

This increase in urination is normal and reflects the intended effect of the medication. Increased sensitivity to sunlight may also occur in some individuals.

B) Thiazide or thiazide-like diuretics

Hydrochlorothiazide [Hydrodiuril™], chlorthalidone [Hygroton™], indapamide [Lozide™], metolazone [Zaroxolyn™]

These medications are mainly used to treat high bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure and help reduce excess fluid buildup.

They may be prescribed alone or combined with other types of diuretics. Their effect on fluid elimination is generally less powerful than that of loop diuretics.

Most are taken once or twice daily. Metolazone [Zaroxolyn™], however, may be prescribed at different intervals, ranging from once weekly to daily use.

The most commonly reported side effects are:

dizziness
increased urination
increased sensitivity to sunlight

C) Potassium-sparing diuretics

Spironolactone [Aldactone™], eplerenone [Inspra™], amiloride [Midamor™], triamterene (available only in combination with hydrochlorothiazide) [Dyazide™]

These medications are mainly used to treat high blood pressure and help eliminate excess fluid. They may be used alone or in combination with other diuretics.

Their diuretic effect is generally milder than that of loop diuretics.

Spironolactone and eplerenone also play an important role in the treatment of heart failure, as they help improve heart function and reduce certain complications associated with this condition.

These medications are usually taken once daily.

The most common side effects include:

dizziness
headaches
increased urination

Unlike many other diuretics, these medications may increase potassium levels in the bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood.

BloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood tests are therefore often required a few days or weeks after starting treatment or after a dosage adjustment to monitor: