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Blood Pressure Drugs - Page 8

Diuretics

Loop Diuretics

(check with manufacturer for specific information)

Commonly prescribed brands:

Furosemide

Torsemide

Lasix

Demadex

How they are given:

  • Oral or injected through an IV line

What they are used for:

You should not be treated with them if:

  • You are unable to produce urine

Possible side dffects:

  • Lowered potassium levels (which can cause nausea, numbness, confusion, drowsiness, and weakness)
  • Increased blood sugar and cholesterol levels
  • Lowered calcium
  • Sensitivity to sun
  • Rash

Pregnancy/nursing:

  • The safety of these medications during pregnancy is unknown
  • The safety of these medications during nursing is unknown
  • Furosemide can enter a woman's breast milk, but it is not known if torsemide can enter a woman's breast milk

 

Thiazides & Related Diuretics

(check with manufacturer for specific information)

Commonly prescribed brands:

Chlorothiazide

Hydrochlorothiazide

Metolazone

Diuril

Microzide
HydroDIURIL

Mykcrox

How they are given:

  • Oral

What they are used for:

  • To treat high blood pressure
  • Additional therapy in swelling (edema) associated with congestive heart failure, liver cirrhosis, and corticosteroid and estrogen therapy

You should not be treated with them if:

  • You are unable to produce urine

Possible side effects:

  • Lowered potassium levels (which can cause nausea, numbness, confusion, drowsiness, and weakness)
  • Increased blood sugar and cholesterol levels
  • Lowered calcium
  • Sensitivity to sun
  • Rash

Pregnancy/nursing:

  • The safety of these medications during pregnancy is unknown; thiazides can cause some problems in infants, but no birth defects have been reported
  • The safety of thiazide diuretics during nursing is unknown. They can enter a woman's breast milk.

Potassium-Sparing Diuretics

(check with manufacturer for specific information)

Commonly prescribed brands:

Amiloride

Triamterene

Midamor

Dyrenium

How they are given:

  • Oral

What they are used for:

  • To treat high blood pressure and congestive heart failure. They are usually combined with thiazide or other diuretics to help restore normal potassium levels and prevent abnormally low potassium levels in the blood ( hypokalemia).

You should not be treated with them if:

  • You are taking other medication to maintain normal potassium levels
  • You have been diagnosed with kidney or liver problems
  • You have kidney disease as a result of diabetes
  • You are unable to produce urine
  • You have a high potassium level in your blood

Possible side effects:

  • Increased level of potassium in the blood (which can cause weakness, numbness, confusion, and heaviness in the legs)

Pregnancy/nursing:

  • The safety of these medications during pregnancy and nursing is unknown

 

Combination Diuretics

(check with manufacturer for specific information)

Commonly prescribed brands:

Amiloride & hydrochlorothiazide

Triamterene & hydrochlorothiazide

Moduretic

Dyazide
Maxzide

How they are given:

  • Oral

What they are used for:

  • To treat high blood pressure or swelling (edema), and some cases of chronic heart failure, in patients who cannot take thiazide diuretics alone because of concerns about low potassium (for example, patients with heart rhythm problems)

You should not be treated with them if:

  • You are taking another medication to maintain a normal potassium level (such as potassium supplements, spironolactone, amiloride, triamterene)
  • You are unable to produce urine
  • You have been diagnosed with kidney problems
  • You have kidney disease as a result of diabetes

Possible side effects:

  • Increased level of potassium in the blood (which can cause weakness, numbness, confusion, and heaviness in the legs)

Pregnancy/nursing:

  • The safety of these medications during pregnancy is unknown
  • The safety of these medications during nursing is unknown, but components of these drugs can enter a woman's breast milk

How do diuretics work?
Diuretics (sometimes called water pills) reduce the amount of fluid in the body by stimulating your kidneys to get rid of excess water and salt as urine. This lowers the amount of blood in the blood vessels, which in turn lowers blood pressure. Diuretics are also used to treat heart failure and kidney disease.
There are three types of diuretics used in the treatment of high blood pressure:

  • Loop diuretics work by making the kidneys get rid of more sodium and potassium than normal. When these substances leave the body as urine, water goes along with them. Of all the types of diuretics, these produce the greatest increase in urine flow.
  • Thiazide diuretics cause more salt to be excreted than other diuretics, and are the most commonly used diuretic to treat high blood pressure.
  • Potassium-sparing diuretics are less powerful at getting rid of water and lowering blood pressure than other types of diuretics, but they have the advantage of preventing your body from losing too much potassium (see below). They are often prescribed with another type of diuretic to treat high blood pressure.

Who should take diuretics?
Diuretics are the best initial drug for most men and women with high blood pressure.3 Thiazide diuretics are usually used first because they tend to have fewer side effects than other types of diuretics. Since most patients require two or more drugs to control hypertension, diuretics are often combined with other blood pressure lowering drugs such as ACE inhibitors, ARBs, beta blockers, and calcium channel blockers.

What are the possible side effects of diuretics?
Diuretics cause you to lose more than just salt and water – other substances including potassium, calcium, and magnesium are also flushed out. Your doctor may prescribe supplements to replenish this loss, or advise you to alter your diet (for example, eat more foods high in potassium, such as bananas). One of the most common side effects of diuretics (other than potassium-sparing diuretics) is potassium loss. Some patients may experience sensitivity to sunlight while taking diuretics, so they are advised to wear sunscreen and avoid tanning booths. Other common side effects of diuretics include frequent urination (which may last for up to 6 hours after a dose) and dehydration.

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