Diuretics: Reactions with other drugs or substances

Last modified: Sunday, 31. May 2009 - 1:55 pm

Although over-the-counter diuretic preparations are available without a prescription, because of the risk for serious and potentially fatal complications and side effects, diuretics should always be taken under the recommendation and guidance of a trained healthcare professional.
Certain medications may impair or enhance the therapeutic effects of diuretic drugs. Anyone prescribed a diuretic should inform their physician of all other drugs and supplements they are taking in case of a possible interaction.
Drugs that are also known to decrease potassium levels, such as glucocorticoids and digoxin, should be avoided by anyone taking potassium-depleting diuretics. If they are prescribed, a physician should closely monitor the potassium levels of the patient. Potassium deficiency, or hypokalemia, can cause serious and potentially dangerous side effects (see Harmful side effects section).
Potassium-sparing diuretics, such as amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium), impair the ability of the kidneys to filter potassium from the body. This can result in a condition called hyperkalemia, or excessive potassium, a potentially dangerous situation (see Harmful side effects section). Anyone taking potassium-sparing diuretics should avoid excessive dietary intake of foods high in the mineral. Bananas, tomatoes, sweet potatoes, and oranges are some of the foods that are rich in potassium.
Diuretics may also interact with herbs and dietary supplements. Licorice (Glycyrrhiza glabra) can lower potassium levels, and should be avoided with potassium-sparing diuretics. In addition, herbal diuretics can amplify, or increase, the effect of prescription diuretics. Some of the more well-known diuretic herbs include bilberry (Vaccinium myrtillus), celery seed (Apium graveolens), dandelion leaf {Taraxacum offtcinale), and elder flower (Sambucus nigra, S. canadensis), goldenrod (Solidago virgaurea), horse chestnut seeds (Aesculus hippocastanum), horsetail (Equisetum arvense), juniper (Juniperus communis), parsley (Petroselinum sativum), St. John’s wort (Hypericum perforatum), and uva ursi (bear-berry; Arctostaphylos uva ursi). Just because a preparation is labeled natural does not mean it cannot cause harmful interactions with other medications and substances. Individuals should always check with their physician or healthcare professional before taking herbal and supplement products with diuretics.
Foods and beverages rich in caffeine, such as coffee, tea, and chocolate, can also have a diuretic effect at high doses, and should not be taken in excess with prescription diuretics. Alcohol has a diuretic effect as well, and should be avoided in individuals taking a diuretic medication.

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