Diuretics use for treating blood pressure

[ListlessLimpet]

The cardiologist has prescribed indapamide (I'm also on perindopril) to help my heart, reduce my BP and lessen the chance of oedema (which I've suffered once in 10 years). I've been on them for 3 days now and due to the diuretic effect, I have lost nearly three kg. I am also getting muscle aches and occassional cramps. More importantly, I've yet to see any reduction in BP.

How long do you think I should give the indapamide to work?

And, as a related question, do you think it's a good thing to use a diuretic? I mean that the body has a natural water content and I'm not convinced that messing with that is necessarily a good thing.

[nellie237]

Hi ListlessLimpet,

To answer your question "How long do you think I should give the indapamide to work?"

"Indapamide will start to work within 2 hours of taking it. However, it may take up to a week to see an initial effect on your blood pressure and up to 12 weeks for the full effect to be seen. NHS"

I was prescribed Indapamide 1.5mg by my GP to try and help my High BP, (also taking Bisoprolol 2.5mg & Losartan 100mg..........so, quite a heavy load.....I had an MI & stent in 2012).

I'm sure Indapamide is beneficial for many and understand that it is a 1st line medication and considered safe. Unfortunately, it wasn't safe for me, and your sudden weight loss especially if not suffering oedema together with the cramps is quite disturbing in my opinion.

What happened to me

Like you, it took me just 3 days to feel very unwell. I don't know if I lost weight, but I don't 'retain water' anyway, and have never had oedema. On the 3rd day I woke up very, very confused with a major headache and upper GI pain. My symptoms were so severe that I called an ambulance (for only the 2nd time in my life....the 1st being when I had the MI). I stopped the Indapamide immediately.

A&E sent me home with a diagnosis of 'likely tension headache due to ? reaction to change in medication' and told me "Your Sodium is a little low".........a week later a blood test revealed Acute Kidney Injury stage 2 (my kidney function had dropped from 85% to 29%). I obtained a copy of my notes from A&E, which showed that although my kidney function hadn't shown any cause for concern (yet), that my electrolytes were way off.

I am pleased to say that my kidney function has recovered. Ironically, the GP when prescribing the Indapamide had told me that I didn't need to get U&E's checked 2 weeks after starting, as had always been standard with previous BP meds.

My advice to you would be to speak to your GP asap.

[ListlessLimpet in reply to nellie237]

Thank you for replying. If it can take up to a week to see any changes then I'll stick with it for a few more days. I'll keep your words in mind though and see what each new day brings. If I start with any GI pain, or major headache and/or confusion, then I'll be on the phone to the GP.

[MountainGoat52 in reply to ListlessLimpet]

If you have got this far without any major side effects, then hopefully you will be okay and the medication will start to work. At various times I have been prescribed thiazide and loop diuretics, both of which have had an almost immediate negative effect and I have become very unwell as they stripped out my potassium.

[ListlessLimpet in reply to MountainGoat52]

Thank you for your reply. It sounds that both you and nellie237 had bad experiences of diuretics, and that's not good to hear.

I'm 4 days in now with taking them and I have yet to experience what I'd call bad side effects. The weight loss is to be expected I guess, as people use diuretics (or 'water pills') for exactly that reason.

That said, I previously had a gum infection that became sinusitis and that's lingering and making me feel a bit heady. That might be masking something I suppose. I'll give that some time to clear too before I reach for the phone.

[MountainGoat52]

Yes, diuretics are not for me unless they are of the potassium-sparing variety. I was given Furosemide after my bypass op which made me very unwell and after just two doses I refused to take any more. By 1 a.m. my O2 stats were down to 73% (not at all pleasant) and I was seen by the junior doctor on night duty. I think that she consulted with others, as I was given Amiloride intravenously around 4 a.m. I was later told that this was against protocol. Well it sorted me out and by 7 a.m. I was more or less back to normal. I hope lessons were learned.

[ListlessLimpet]

Thanks for the replies people, particularly the warnings re potassium leaching. The diuretic I am taking (indapamide) can cause potassium loss so this is something I will definitely keep an eye on.

I'm now 5 days in and whilst the first couple of days weren't the best, things appear to have now stabilised. I've lost no more weight, the muscle cramps have gone and whilst the muscles still ache and tingle I think I can tolerate that in the meantime. Most importantly, it does feel easier on my heart now and the chest discomfort has reduced. My energy levels haven't increased and breathing is still not what I'd call easy, but I do feel better. So I guess that's the main thing considering the context.

It's only a month prescription. I think the intention was to make things a tad more comfortable for me until the echo is done. I'm not sure it was ever intended as a long term prescription.

Thanks again all. It's great to be able to bounce these things off of people.