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What Are the Different Types of Diuretic Drugs?

Melissa Barrett
Melissa Barrett

Diuretics are medicines that cause the human body to produce more urine. Some of these medications, such as loop and thiazide diuretics, are categorized by the portion of the kidney which they affect. Other types of diuretic drugs, such as osmotic and potassium-sparing diuretics, are grouped by the ways in which they operate.

Loop diuretic drugs work by inhibiting the function of the area of the kidneys called Henle’s loop. This tiny loop is responsible for reabsorbing salt and water from urine. Due to the potency of loop diuretics, these drugs are generally reserved for the treatment of acute conditions, such as congestive heart failure and substantial hypertension.

Diuretic drugs are often prescribed as a first-line treatment for combating high blood pressure.
Diuretic drugs are often prescribed as a first-line treatment for combating high blood pressure.

Thiazide diuretics affect the distal convoluted tubule, a small portion of the kidneys near Henle’s loop. Although these drugs have fewer major side effects than loop diuretics, thiazides work in much the same way. Mild lethargy, skin irritation, and indigestion are possible with thiazide use. Blurry vision and headaches are also frequent complaints. Patients who experience severe nausea, vomiting, or unexplained muscle pain while using these diuretics are advised to contact their physicians as soon as possible.

Diuretics may cause people to urinate frequently.
Diuretics may cause people to urinate frequently.

The process by which osmotic diuretic drugs function is quite complicated. In essence, an osmotic drug siphons excess water into its structure. These water-laden molecules cannot be easily reabsorbed by the kidneys and are passed whole from the body. As osmotic diuretics do not affect the kidney directly, they are often used to increase urine output in patients with renal failure.

Diuretic drugs remove excess water from the body.
Diuretic drugs remove excess water from the body.

A major concern in the use of a diuretic drug is the possibility of a dangerous drop in potassium levels within the bloodstream. The resulting condition, termed hypokalemia, can lead to uncontrolled muscle spasms, abnormal heart rhythms, paralysis, and ultimately death. The likelihood of complications from hypokalemia is higher among patients with preexisting kidney or heart disease.

Certain diuretic drugs increase retention of potassium.
Certain diuretic drugs increase retention of potassium.

Potassium-sparing diuretic drugs, such as triamterene, may be prescribed with other classes of diuretic medications to reduce the risk of hypokalemia. The mechanism by which these drugs work varies, but the end result is potassium retention. These medicines are rarely used alone as their use can result in dangerously high potassium levels, or hyperkalemia. The primary and often only symptom of hyperkalemia is acute cardiac arrest.

Mild diuretics made from herbal ingredients may be purchased without a prescription. These over-the-counter products are frequently used for temporary weight loss. Like prescription diuretics, these products may cause hypokalemia.

Discussion Comments

anon357364

I take 2.5mg metolazone, 200 mg torsemide and 220 meq of potassium chloride every day. This is not enough to keep up with the fluid build up. Any thoughts?

melkerns

@babalaas: I am the author of this article. As a general rule, any new supplement that you take should be discussed with your doctor beforehand. The biggest risk with taking a potassium supplement without your doctors input is the possibility of hyperkalemia (too much potassium) which can be as dangerous as hypokalemia. A simple urine or blood test can determine potassium levels.

As for higher potassium foods, banana and potato are great sources. More exotic choices include dandelion greens and guava.

aplenty

Are there any natural solutions to mildly elevated blood pressure levels? High blood pressure runs in my family, and because I am black, I am also at a higher risk. If I should ever have high blood pressure I would not want to take any of these diuretic medications because they seem like they create as many unknown variables as the ailment it is trying to cure does. I understand that sometimes with hereditary hypertension, diet and exercise is simply not enough. What can I do to guard against hypertension?

highlighter

@babalaas- From what I read, you should not supplement with potassium unless directed to do so by your doctor. Thiazide diuretics have side effects of causing both hypokalemia and hyperkalemia so only your doctor should recommend supplements for deficiencies.

The drugs have a number of serious side effects that would warrant a call to your doctor should you experience them. According to the FDA, feeling weak, nauseous, drowsy, or light headed are serious side effects. Red, blistering skin rashes, flu like symptoms, jaundice, and weight gain are also serious side effects that require medical attention. You should strictly follow your doctor’s orders when taking these types of drugs since they are for serious problems and can have serious side effects.

Babalaas

It sounds like the side effects related to potassium deficiency are the most dangerous with these blood pressure medications. Is it advisable to take a potassium supplement or increase the amount of potassium containing foods in my diet if I take these drugs? If so, what are some types of potassium rich foods besides bananas that will help prevent hypokalemia? I would appreciate any information that anyone can spare.

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    • Diuretic drugs are often prescribed as a first-line treatment for combating high blood pressure.
      By: Monkey Business
      Diuretic drugs are often prescribed as a first-line treatment for combating high blood pressure.
    • Diuretics may cause people to urinate frequently.
      By: aerogondo
      Diuretics may cause people to urinate frequently.
    • Diuretic drugs remove excess water from the body.
      By: Yuriy Shevtsov
      Diuretic drugs remove excess water from the body.
    • Certain diuretic drugs increase retention of potassium.
      By: Rob Byron
      Certain diuretic drugs increase retention of potassium.
    • Thiazide diuretics often cause blurred vision and headaches.
      By: bellemedia
      Thiazide diuretics often cause blurred vision and headaches.
    • Some people who take thiazide diuretics experience lethargy and unexplained muscle pain.
      By: Coka
      Some people who take thiazide diuretics experience lethargy and unexplained muscle pain.
    • Overuse of diuretics may cause the kidneys to stop functioning properly.
      By: 7activestudio
      Overuse of diuretics may cause the kidneys to stop functioning properly.
    • Headaches are a common side effect of thiazide diuretics.
      By: MediablitzImages
      Headaches are a common side effect of thiazide diuretics.