Side effects

Every drug has side effects – this is also the case with diuretics.The different groups of diuretics also have a different side effect profile, but some side effects are found in all drugs. In general, each drug carries the risk of developing hypersensitivity or allergy. This can lead to skin rashes, discomfort and even allergic shock.

In addition, a diuretic aims to increase the amount of water excreted from the body. In this way, water retention can be reduced and blood pressure lowered. However, if the blood volume decreases due to dehydration, the risk of developing a thrombosis is increased.

Likewise the blood sugar is lowered, this is to be considered before all with Diabetikern (diabetics), since if necessary the medication must be changed, in order to avoid the so-called Hypoglykämien, thus Unterzuckerungen. Likewise it comes in the course of the drainage to an increase of the uric acids in the blood. In patients suffering from gout, this can lead to an attack of gout.

Here, too, medication or nutritional measures can be taken to counteract this. Likewise, all diuretics affect the potassium level in the blood – it is either lowered (thiazides and loop diuretics) or increased (potassium-sparing diuretics). How the potassium level affects our body will be discussed separately in the next section.

Also, with all diuretics it is reported that some patients suffer from gastrointestinal problems such as diarrhea, constipation or nausea. In the case of loop diuretics, such as furosemide, in particular, there is a change in the absorption and excretion of salts and electrolytes – after all, this is what the urinary action is based on. This leads to an increased excretion of calcium, magnesium and potassium.

A long-term calcium deficiency can lead to osteoporosis, the fragility of the bones. Some patients also report hearing disorders when taking loop diuretics – but these are usually completely reversible after stopping the drug. The group of thiazides has as specific side effects in rare cases a change in blood count.

The doctor can determine this by means of a blood count. More often erectile dysfunction, i.e. a potency disorder, occurs, which is also reversible after discontinuation of the drug. In this case, patients should not be afraid to consult their doctor!

Particularly in older patients, there can be a sharp drop in the sodium concentration in the blood. This can manifest itself through sudden disorientation, confusion or clouding. In the case of aldosterone antagonists, there is the problem that the drug can also act in other parts of the body, especially with spironolactone.

For example, it can activate receptors for the sex hormones. In men this can result in gynecomastia (growth of breast tissue) or potency problems. In women, on the other hand, it can lead to the absence of periods (amenorrhea) or to so-called hirsutism, ultimately a masculinization of the woman.

It can also lead to voice changes such as hoarseness. The aldosterone antagonist Eplerenone, on the other hand, does not bind so strongly to the sex hormone receptors and does not show these side effects. If you notice any side effects of any kind, do not hesitate to consult your doctor.

Your doctor may change the dose of your medicine or change the medication. Diuretics affect the level of potassium in the blood. Here loop diuretics and thiazides lower potassium levels.

If the potassium level falls into a critical range, a variety of side effects may occur. These include cardiac dysrhythmia, dwindling muscle strength or even hyperacidity of the body (so-called metabolic acidosis). Studies have also shown that low potassium levels reduce glucose tolerance and thus damage the sugar metabolism.

Therefore, these diuretics are not recommended for young people and patients with diabetes (diabetes). The potassium-saving diuretics, on the other hand, can lead to a too high potassium level in the blood. This is similar to a lack of potassium with muscle weakness and cardiac arrhythmia. In any case, regular monitoring of the potassium level during diuretic treatment is recommended. Potassium-sparing diuretics are often combined with loop diuretics or thiazides to keep the potassium level stable.