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Diuretics

Also indexed as: Carbonic Anhydrase Inhibitors, Daranide®, Dichlorphenamide, Methazolamide, Neptazane®

Diuretics are a family of drugs that promote urination. They are used to reduce water accumulation or edema associated with heart failure, cirrhosis, and corticosteroid therapy, as well as to treat high blood pressure. Diuretics are classified as “potassium-depleting” if they cause loss of potassium in the urine, or “potassium-sparing” if they cause retention of potassium.

Interactions involving diuretics in general are described on this page. For interactions involving a category of diuretics or a specific drug, refer to the highlighted items below.

Carbonic anhydrase inhibitors, Potassium-Depleting

Thiazides, Potassium-Depleting

Loop diuretics, Potassium-Depleting

Potassium-sparing

Interactions with Dietary Supplements

Folic acid
One study showed that people taking diuretics for more than six months had dramatically lower blood levels of folic acid and higher levels of homocysteine compared with individuals not taking diuretics.1 Homocysteine, a toxic amino acid byproduct, has been associated with atherosclerosis. Until further information is available, people taking diuretics for longer than six months should probably supplement with folic acid.

Interactions with Herbs

Buckthorn, Alder Buckthorn (Rhamnus catartica, Rhamnus frangula, Frangula alnus)
Use buckthorn or alder buckthorn for more than ten days consecutively may cause a loss of electrolytes (especially the mineral potassium). Medications that also cause potassium loss, such as some diuretics, should be used with caution when taking buckthorn or alder buckthorn.2

Summary of Interactions for Diuretics

Depletion or interference Folic acid
Adverse interaction Buckthorn, Alder Buckthorn
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known
Interactions common to many, if not all, Diuretics are described in this article. Interactions reported for only one or several drugs in this class may not be listed in this article. Some drugs listed in this article are linked to articles specific to that respective drug; please refer to those individual drug articles. The information in this article may not necessarily apply to drugs in this class for which no separate article exists. If you are taking a Diuretic for which no separate article exists, talk with your doctor or pharmacist.

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866–70.

2. European Scientific Cooperative on Phytotherapy (ESCOP). Frangulae cortex, frangula bark. Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: University of Exeter, Centre for Complementary Health Studies, 1997.