Reducing Water Retention with Water Pills:  How Prescription Diuretics Work

Thousands of people who suffer from certain illnesses that cause water retention turn to what is commonly called a “water pill”.  Technically this medication is known as a diuretic.

Diuretics work within the kidneys to increase the production of urine, which makes the patient go to the washroom and eliminate extra water from their body.  This is called diuresis, the production of more urine.

What conditions are diuretics used for?

Diuretics are often used by patients who suffer from conditions that cause swelling, such as swelling of the hands, feet, ankles or belly.  This type of swelling is commonly seen in patients who have conditions such as:

• Kidney disease
• Liver disease
• Cancer
• Congestive heart failure
• High blood pressure
• Visible edema (water retention)

What are some common diuretic medications?

There are three types of diuretics, and each has a specific duty and affects a different part of the kidney.  The type of prescription diuretic used by a patient depends on its particular use and its side effects.

Thiazide Diuretics - These diuretics are usually prescribed to patients with high blood pressure and are not as strong as loop diuretics.  Examples of thiazide diuretics include:

• Hydrochlorothiazide (Microzide)
• Metolazone (Zaroxolyn)
• Indapamide (Lozol)
• Chlorothiazide (Diuril)

Potassium-sparing Diuretics – These diuretics increase diuresis without causing a loss of potassium.  Often they are prescribed along other medications to treat hypertension and congestive heart failure.  Examples of potassium-sparing diuretics include:

• Midamor (amiloride)
• Inspra (eplerenone)
• Aldactone (spironolactone)
• Dyrenium (triamterene)

Loop Diuretics - These diuretics work in the kidney in an area called the ‘loop of Henle’ and are most effective for patients who have impaired or weakened kidney function.  They are most often prescribed for patients who have hypertension and edema often as a result of having renal insufficiency or congestive heart failure.

Examples of loop diuretics include:

• Bumetanide (Bumex)
• Furosemide (Lasix)
• Torsemide (Demadex)
• Ethacrynic acid (Edecrin)

How is prescription Edecrin (ethacrynic acid) used?

Edecrin is a small pill taken once or twice a day with food during the day.   It is prescribed based on your medical conditions, other medications you take, and how well you respond to taking Edecrin.  The dose is usually low when first prescribed and increased if and when necessary based on how well it works for you and what your lab tests for potassium, sodium and chloride levels are.

Edecrin is meant to be taken on a regular basis, preferably at the same time of day each day.  It is not recommended that you take this medication within four hours of bedtime, as it may cause you to need to wake up to urinate.

Does Edecrin have side effects?

It is important to tell your doctor about your medical history and any medications you may be taking.  You should tell your pharmacist about your history of liver disease, kidney disease or gout.

Common side effects may include:

• Weakness
• Muscle cramps
• Upset stomach
• Diarrhea
• Dizziness

Tell your doctor if you notice any signs of dehydration such dry mouth, thirst, irregular or fast heartbeat, severe dizziness, confusion, or an unusual decrease in your need to urinate.

This is not a complete list of side effects. Speak to your pharmacist about other side effects that may occur.

Other precautions to be aware of when taking prescription Edecrin

This medication may interact with lithium and furosemide.    

Edecrin may affect your blood sugar levels, so if you have diabetes make sure to monitor your blood sugar levels and tell your doctor.

Because this medication may lower sodium and potassium levels in your blood, you may be instructed by your doctor to eat foods that are rich in potassium and/or to use more salt.  Speak to your doctor about your blood tests to ensure you are eating a healthy diet when taking this medication.