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Diuretics

pusillanimous profile image
42 Replies

Has anyone found a particular diuretic effective for swollen feet? when I first reported them to my GP, she prescribed Indapamide - which had a marginal effect. I was due to see my cardiologist a short while later, and told him what I was taking, he said 'No, that's the wrong one' and said I needed a potassium sparing one and prescribed a low dose of Spironolactone ( half a tablet of a 25mg pill), This had no effect, so when I saw my GP, she increased the dose to a whole pill. These seemed to have the opposite effect - it seemed to cause urine retention not increase the flow. I can get up in the morning after taking a whole one, and battle to pass urine. I stopped taking it. The weird thing is, if I take an antibiotic for another reason, the swelling seems to disappear. The GP is puzzled, the Cardio says I do not have an infection, they both seem to think I'm going mad!!! My feet are fine when I get up in the morning but the swelling increases throughout the day. Can anyone suggest another diurectic that could work that I can suggest to my GP, who I will be seeing sometime in the next week for a review of my meds.! Thanks.

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42 Replies
10gingercats profile image
10gingercats

I take half a 25mg tablet of amdopoline and 20 mg of Furosimide.I was told Spirolactone was likely(and it did) cause heightened potassium problems. so the Spiro. was removed and the Amp. put in it place. I take this in the morning to prevent fluid accululating around my heart and in lungs. I seems to work.

BobD profile image
BobDVolunteer in reply to 10gingercats

Amlodopine caused bad ankle and foot swelling for me. Some people do react to calcium channel blockers that way. I have furosimide for when things get bad . Odd, that mine is paroxysmal for no apparent reason.

pusillanimous profile image
pusillanimous in reply to BobD

I was thinking of suggesting furosemide - I will do, thanks. I was taking a 120mg Verapamil which as you know is a calcium channel blocker, with a 10gm lisinopril tab for BP , but the Cardio said to stop that as Verapamil can cause foot swelling - made no difference to mine !

gbn_ profile image
gbn_ in reply to pusillanimous

Hi pusillanimous. I'm prescribed a 40 mg. tablet of furosemide daily in the morning, it really works.

pusillanimous profile image
pusillanimous in reply to gbn_

I'm seeing my GP tomorrow. Thanks for the info - I've just been lying in the warmth of the sun with my feet up - it's like a bottle being tipped up , within a very short time of having them up, they have gone back to normal size. How often do you have a blood test, because this is a Loop diuretic not a potassium sparing one ?

gbn_ profile image
gbn_ in reply to pusillanimous

Hi pusillanimous. Yes it's a loop type. So far blood tests every month, might change with upcoming appointment with doctor, don't really know yet, this is still relatively new stuff to me. I may very well be prescribed something totally different or the same at a different dose, or, just kept the same. I kind of like it being a loop type, I can keep track of the potassium with the higher potassium foods I enjoy, because if it gets too high, I can cut back on the foods. Forgive me if you have mentioned this possibly earlier, but do you have any kind of heart failure associated with the swelling?

pusillanimous profile image
pusillanimous in reply to gbn_

No heart failure. Saw the Cardio in September, and his report says' On echo she has normal left ventricular function, normal valves, no left atrial enlargement and the right heart is normal'

Desanthony profile image
Desanthony in reply to BobD

Same with me I take furosemide - only had this a couple of times currently on furosemide for slight swelling and just going down to a lower dose and hopefully can come off again soon.

pusillanimous profile image
pusillanimous in reply to Desanthony

That must be great - I've got a cupboard full of shoes I can't wear !!!!

SuziElley profile image
SuziElley in reply to BobD

Calcium channel blocker, Diltiazem, causes fluid retention for me. I take 20mg furosemide when needed, which is most days now. I also have compression stockings due to venous insufficiency and lymphoedema caused by Dercum’s so these together with the furosemide more or less keep it under control.

pusillanimous profile image
pusillanimous in reply to SuziElley

Furosemide seems to be a popular choice, so I'm definitely going to suggest that - is it potassium sparing, as the Cardio seems keen on that? - but there again, he is a dear sweet man I knew socially before consulting him professionally, who is not far off retirement, so may be a little fixed in his ways !

Dollcollector profile image
Dollcollector in reply to pusillanimous

It is not potassium sparing , nor is bumetanide which is similar to furosemide. I ended up in hospital twice with very low potassium causing bad episodes of afib. You need regular blood tests with these diuretics. Spironolactone can cause you to have too high a level of potassium, which can also be bad, but less likely l think. I want to change to that. You are lucky to have your cardiologist.

pusillanimous profile image
pusillanimous in reply to Dollcollector

The problem is with me, the Spironolactone causes fluid retention. I can check this by weighing myself . Not only do I get up in the morning after taking a pill the night before, and not pass any urine I can be 900gms heavier than my normal weight the day before. It frightens me, so I rush and drink two glasses of water in the hope of getting the system working ! I don't mind frequent tests, they are cheap and the path. lab receiving depot is just a couple of kilometers away in the medical centre where my doctoe is, so in fact I can go straight there from my appointment with her.

Dollcollector profile image
Dollcollector in reply to pusillanimous

Goodness me. I thought it was supposed to be diuretic, getting rid of the water, not retaining it.

pusillanimous profile image
pusillanimous in reply to 10gingercats

Thanks noted for my visit !

mav7 profile image
mav7 in reply to pusillanimous

pusillanimous Can you share what is causing the fluid retention ? If possible, best to treat the cause and hopefully eliminate the need for a diuretic which may cause side effects, especially when taken long term.

May want to ask your GP to consult with a Nephrologist (kidney expert) or Cardiologist for their input.

pusillanimous profile image
pusillanimous in reply to mav7

Hi Mav7, I honestly am not sure what the answer is to that. When I first showed it to my GP and asked her if it was my heart or my kidneys, she said my heart! When I went to my cardiologist, he was not overly concerned - the left side of my heart is fine, I have slight PH but am not heading for Cor Pulmonale (I specifically asked him) and my EF is 60. We do not have many nephrologists around where I am, I'll ask her again (I have to see her in the next few days, I just need to make an appointment) - although at one stage she did mention a vascular surgeon, so she will have the Cardio's report from my visit in September, when he told me was no change and the electrolytes test I had just before I saw him - which was fine

Qualipop profile image
Qualipop

Before any heart problems I was on furosemide for swollen ankles for years until they started to affect my kidneys and were stopped. I really didn't notice any difference in the swelling during or after stopping them.

pusillanimous profile image
pusillanimous in reply to Qualipop

It is a puzzle isn't it!

gbn_ profile image
gbn_ in reply to Qualipop

Hi Qualipop. What side effects did you have while on furosemide, how many mgs. and was it daily?

Qualipop profile image
Qualipop in reply to gbn_

I've no idea what the dose was. I stopped it 5 years ago now. Absolutely no side effects at all; it was probably the easiest medication I've ever taken. Maybe at first I went to the loo a bit more often especially on a morning but that settled down quickly. I honestly never even thought about it. Yes it was daily. I know I started on the lowest dose which was later doubled then after a couple of years went back down to the lowest dose. When I came off it after my heart attack I simply stopped- no tapering of the dose.

gbn_ profile image
gbn_ in reply to Qualipop

Hi Qualipop. Reason I asked is because even though it works, my bun/creatine jumped, just concerned with that. These meds are really tough to deal with in that they help in one area but are problematic in other areas it seems.

pusillanimous profile image
pusillanimous in reply to gbn_

I've just come from my GP and she has changed my diuretic to furosemide a loop diuretic, but has also prescribed a potassium supplement. I was on a potassium sparing one,( Spironolactone) but it made matters worse and interestingly the filtration rate went down when I was on it. When I stopped it, the next test showed it was back to previous levels !

Qualipop profile image
Qualipop in reply to gbn_

I was never given any test results so I've no idea what it did to me. I actually asked myself whether I needed t o continue with it because it didn't seem to be doing anything. A year later I noticed on my online records that it suddenly said "Stage 2 kidney failure". |No one had even mentioned it so of course, in a panic I rang the doctor and was t old it was simply because NICE or the NHS had just changed the levels at which they reported it, nothing at all to worry about sand perfectly acceptable at my age ( 73 at the time). It's never been mentioned again or appeared on my records. The only thing it ever says now is slightly low iron levels. I have my annual heart check up and bloods next week so I will be asking about the iron.

frazeej profile image
frazeej

Furosemide (generic of Lasix). 40mg each morning, then pee like a race horse for a few hours. Have not had fluid retention since starting several months ago,

JimF

pusillanimous profile image
pusillanimous in reply to frazeej

Sounds promising Jim, are you entered in the Derby this year ?

frazeej profile image
frazeej in reply to pusillanimous

Only if I can avoid the post race drug test!! 🐎😂

Tapanac profile image
Tapanac

I take Co-amilofruse which seems to be ok. Trouble is I lose about 2 hours in the morning not able to go out for needing the bathroom as my bladder these days not great.

Originally I was on another which unfortunately I can’t remember the name. During one of my spells in hospital I was put on furosemide, but the cardiologist said bit harsh for the kidneys as I only have one working one, so put me on the co-amolifruse. It definitely works in the winter, but on hot humid days not quite so well, but as we don’t have many of those in English weather that’s,ok

Good luck

pusillanimous profile image
pusillanimous in reply to Tapanac

Thanks for your input, another to present my GP when I see her on Friday - I live not far from the Indian Ocean in South Africa, so we do have some humid days, but I don't know what's happened to summer this year, as it rains every day (it is the rainy season) but it's chilly too 23c today !

Tapanac profile image
Tapanac in reply to pusillanimous

23 degrees sounds heavenly. Much nicer than our -3 wet and windy and snow showers yesterday……and so dull and murky!!!!

Qualipop profile image
Qualipop in reply to pusillanimous

IT hasn't stopped raining this winter in the North UK for around 8 weeks. We had an inch of snow late November for a couple of weeks but yesterday and today were the first dry days for months

Tykelady profile image
Tykelady

I take 1mg Bumetonide twice daily but when hospitalised it is changed to Furosimide as a short term measure because of the potassium. However I have found that Bumetonide doesn't seem to turn the tap on like it used to even though I have no swelling.

pusillanimous profile image
pusillanimous in reply to Tykelady

Is Bumetanide a potassium sparing diuretic?

Tykelady profile image
Tykelady in reply to pusillanimous

Yes, that's why I was taken off Furosemide.

pusillanimous profile image
pusillanimous in reply to Tykelady

Now I am confused - when I looked up Bumetanide it said it was a Loop diuretic- (see classes of diuretics below) which is apparently different from a potassium sparing diuretic and the same class as Furosemide . I don't know but maybe the 'ide' on the end is the indicator of the class. See extract re classes below!

There are several different classes of diuretics, including carbonic anhydrase inhibitors, loop diuretics, potassium-sparing diuretics, and thiazide diuretics. Each type works in a distinct way and in different parts of the kidney cell (called a nephron).

Dollcollector profile image
Dollcollector in reply to Tykelady

Bumetanide is not a potassium sparing diuretic. I am on it. That is why l want to change to spironolactone.

pusillanimous profile image
pusillanimous in reply to Dollcollector

I hope it suits you better than it does me- it seems to have the opposite effect on me as to what it is supposed to. At the moment I'm not taking a diuretic and my plumbing works perfectly although my feet are still swollen, but not so much as with the spironolactone!. I'm seeing my GP on Friday, so I'll see what she can come up with !!!! - I thought of some sort of drains in the feet , Heh, Heh,Heh!!!!!!!

Dollcollector profile image
Dollcollector in reply to pusillanimous

No.

Dollcollector profile image
Dollcollector

Medication is a minefield . You just have to find the drug that suits you , which isn't easy. Maybe you are better without the drugs. I would put your feet up every time you sit down, that helps me and my ankles and feet. It's the water round my organs that l haven't a solution for. I take the least drugs l can get away with. I will always take my anticoagulant.

pusillanimous profile image
pusillanimous in reply to Dollcollector

I think you have the right attitude - I confess I fear not being able to get my Eliquis !

Quick refresher course on the Krebs cycle…

That is the mechanism where sodium switches places with potassium to create energy with the help of a switch known as ATP… if you are low on magnesium… the ATP performs poorly.. potassium stays locked out.. sodium stays locked in .. water gets retained in the cell.. legs balloon..

Just supplementing with magnesium glycinate 350mg for women 450mg for men daily should make you notice how much more you can pee how much less you retain… it is quite safe to increase to 500 mg twice a day .. if you are severely bloated... diuretics just throw all the minerals out… lower potassium sodium and magnesium..

Modern diets do not hold much magnesium and Doctors are fooled into thinking it’s not important because 1% only shows in blood tests.. 60% remains in bones and 39% in tissue in normal health.. those in poor health these levels are lower in water logged people.

People with very low magnesium.. break bones very easily.. it is not calcium that makes bones flexible.. it is magnesium.. brittle bones consist of too much calcium.. take a stick of chalk and drop it on the floor.. it will break.. soak one in magnesium.. dry it out then repeat.. the chalk stick will not break….Magnesium needs to balance with calcium.. again calcium channel blockers get used because people do not have enough magnesium in their diets.. amazing mineral that activates 300 bodily enzymes…. And most of people in the west are low.. which is why we are taking medication that masks the problem..

Sorry for the long winded reply.. but I tried to make it as simple as I could..

think you know what to do… research .. try.. be well… best wishes.

gbn_ profile image
gbn_ in reply to

Good info right here above.

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