Diuretic side effects, types, and how to avoid the serious consequences
June 17 2017 by
Ray Sahelian, M.D.


Diuretics, commonly called water pills, are a class of prescription medications that are used to treat high blood pressure, heart disease and certain kinds of kidney or liver disease. The drugs stimulate the kidneys to remove more water from the body, which is then passed through the urine. Loop diuretics are a strong type of diuretics. If you have an interest in treating high blood pressure naturally, see hypertension.


Side effects, especially in the elderly
The most common side effect of diuretics is increased urination. This occurs most frequently in people taking loop diuretics. People who take diuretics may also have too much potassium in their blood (hyperkalemia) if they take a potassium-sparing diuretic, or too little potassium in their blood (hypokalemia) if they take a thiazide diuretic. Other side effects of diuretics may include:

Low sodium in your blood (hyponatremia).
Increased blood sugar levels.
Increased cholesterol levels.
Weakness or fatigue, a feeling of lethargy.
Dizziness or lightheadedness.


Herbal Diuretics - Are they effective for weight loss? How do they compare to prescription water pills?

An herbal diuretic is an herb or herbal extract that leads to excess fluid excretion through the kidneys. Many prescription diuretics are used to lower blood pressure. There are several herbal diuretics that are found in certain herbal weight loss products. Some of these herbal diuretics are derived from caffeine. Most of the herbal diuretics are not toxic but have been known to interact with medications (for example, lithium, Lanoxin or conventional diuretics such as Lasix or Esidrex). Herbal diuretics do not provide enough water loss to be considered effective in losing weight.

Review of herbal diuretics
Herbal medicines as diuretics: a review of the scientific evidence.
J Ethnopharmacol. 2007; Wright CI, Van-Buren L, Kroner CI, Koning MM. Nutrition, Nutrition and Health Enhancement, Unilever Food and Health Research Institute, Olivier van Noortlaan, Vlaardingen, The Netherlands.
One class of clinical medicines used to lower blood pressure are known as diuretics and work by increasing the excretion of urine from the body as well as the amount of sodium in urine. There are a growing number of studies purporting diuretic effects with traditional herbal medicines. The aim of this article was to review these studies and identify which herbal extracts promote diuresis (which we assessed on terms of urine excreted and urinary sodium excretion) and also to identify the research needs in this area. We identified a number of species and genuses reporting herbal diuretic effects. Of these, the most promising, at the present time, are the species Foeniculum vulgare, Fraxinus excelsior, Hibiscus sabdariffa, Petroselinum sativum and Spergularia purpurea, and species from the genuses Cucumis (Cucumis melo and Cucumis trigonus), Equisetum (Equisetum bogotense, Equisetum fluviatile, Equisetum giganteum, Equisetum hiemale var. affine and Equisetum myriochaetum), Lepidium (Lepidium latifolium and Lepidium sativum), Phyllanthus (Phyllanthus amarus, Phyllanthus corcovadensis and Phyllanthus sellowianus) and Sambucus (Sambucus mexicana and Sambucus nigra). However, there the number of studies is limited and we recommend that further studies be conducted to confirm reported herbal diuretic effects.

Examples of herbal diuretics
Dandelion is a natural herbal diuretic. It may produce weight loss by decreasing body water, but this is not a healthy way to lose weight. Dandeiion may cause allergic reactions and heartburn.
Horse chestnut has aescin and aesculine which may influence fluid output.
Uva ursi is one of the most well-known herbal diuretics. Uuva ursi contains arbutin which may increase urine output.

I am taking prescription diuretics not for blood pressure issues but since I have ankle edema especially before my period. I need a natural substitute that will help with that problem.
    We are not aware of effective diuretics that are herbal but we await results of studies.


Types of Diuretics available by prescription

There are 3 types of diuretic medicines. Each type works a little differently, but they all lower the amount of salt and water in your body, which helps to lower your blood pressure.

Thiazide diuretics
Thiazide diuretics are used to treat high blood pressure by reducing the amount of sodium and water in the body. Thiazides are the only type of diuretic that dilates (widens) the blood vessels, which also helps to lower blood pressure.


Commonly used brand names in the United States: Aquatensen (methyclothiazide), Diucardin (hydroflumethiazide), Diulo (metolazone), Diuril (chlorothiazide), Enduron (methyclothiazide), Esidrix (hydrochlorothiazide), Hydro-chlor (hydrochlorothiazide), Hydro-D (hydrochlorothiazide), HydroDIURIL (hydrochlorothiazide), Hydromox (quinethazone), Hygroton (chlorthalidone), Metahydrin (trichlormethiazide), Microzide (hydrochlorothiazide), Mykrox (metolazone), Naqua (trichlormethiazide), Naturetin (bendroflumethiazide), Oretic (hydrochlorothiazide), Renese (polythiazide), Saluron (hydroflumethiazide), Thalitone (chlorthalidone), Trichlorex (trichlormethiazide), Zaroxolyn (metolazone)

Commonly used brand names in Canada: Apo-Chlorthalidone (chlorthalidone), Apo-Hydro (hydrochlorothiazide), Diuchlor H (hydrochlorothiazide), Duretic (methyclothiazide), HydroDIURIL (hydrochlorothiazide), Hygroton (chlorthalidone), Naturetin (bendroflumethiazide), Neo-Codema (hydrochlorothiazide), Novo-Hydrazide (hydrochlorothiazide), Novo-Thalidone (chlorthalidone), Uridon (chlorthalidone), Urozide (hydrochlorothiazide), Zaroxolyn (metolazone)

Potassium-sparing diuretics
Potassium-sparing diuretics are used to reduce the amount of water in the body. Unlike the other diuretic medicines, these medicines do not cause your body to lose potassium.


Commonly used brand names in the United States: Aldactone (spironolactone), Dyrenium (triamterene), Midamor (amiloride)

Commonly used brand names in Canada: Aldactone (spironolactone), Dyrenium (triamterene), Midamor (amiloride), Novospiroton (spironolactone)

Loop-acting diuretics
Loop-acting diuretics cause the kidneys to increase the flow of urine. This helps reduce the amount of water in your body and lower your blood pressure.
Commonly used brand names in the United States: Bumex (bumetanide), Demadex (torsemide), Edecrin (ethacrynic acid), Lasix (furosemide), Myrosemide (furosemide)

Commonly used brand names in Canada: Apo-Furosemide (furosemide), Edecrin (ethacrynic acid), Furoside (furosemide), Lasix (furosemide), Lasix Special (furosemide), Novosemide (furosemide), Uritol (furosemide)

Diuretics and Heart Failure

As the dosage of loop diuretics increases in patients with advanced heart failure, the risk of death also increases. Loop diuretics, especially when given at higher doses, activate a part of the nervous system known to increase the risk of death in heart failure patients. Loop diuretics, especially at higher doses, can also contribute to worsened kidney function and electrolyte abnormalities. Physicians should use loop diuretics at the lowest dose possible dose to relieve congestion but not to the point of keeping heart failure patients totally free of fluid in the lungs.


Is there any interaction between using a diuretic and taking the herb curcumin?
   I don't see any clear interactions that would occur.


Can a person take hyaluronic acid supplements while on diuretics?
   A. Each patient is different and it depends on the type of medication and dosage, but generally hyaluronic acid should not interfere with most medications.