which diuretic with prednisolone?

[RT18]

I posted a while ago about diuretics - thanks for the responses.

Mum was put on furosemide which worked for the odema, but within a week had diarrhoea which meant it was stopped and we ended up with a bad uti with haemorrhage due to the diarrhoea……

It may have been the furosemide causing the diarrhoea- it could have been coincidence but it is v unlike mum to get diarrhoea. Will consider the furosemide once more but not if any further diarrhoea happens..

I’ve looked and seen there are quite a few different types of diruretic and I wondered which ones people have used well alongside prednisolone and what side effects they have experienced?

Thanks 😊

[PMRnewbie2017]

Hi, firstly I see you are in the UK too. Prescribing here generally follows the NICE guidelines but IMHO it never hurts to do a bit of research yourself just to check things out.

Diuretics are an effective way of treating high blood pressure and fluid retention. With oedema it helps to know why fluid is pooling in the tissues and where, and I see Mum is an elderly lady so several factors must be considered. The biggest problem with diuretics is dehydration and electrolyte imbalances (sodium, magnesium and potassium) especially if diarrhoea occurs. Furosemide is a loop diuretic but there are other types such as thiazides (bendroflumethiazide) being another. The trouble with this class is they can cause diabetes and disturbances to uric acid levels (gout). Whilst diuretics have their place, newer medicines are available such as ACE inhibitors (angiotensin converting enzyme), ARB's (angiotensin receptor blockers and CCB's (calcium channel blockers).

There is lots of information on the NHS website which is accurate if you want to take a look, but since all these meds are only available on prescription the choice has to be made by Mum's GP or practice Prescribing Pharmacist and they will take into account a whole host of other things about Mum's medical history in making their choice.

Hope this helps.

Me: Retired Pharmacist.

[Zareda]

I took hydrochlorothiazide (HCTZ) the entire 4 years that I was on prednisone without any complications. Everyone responds differently to medications and side effects could be dosage related, I was on a low dose of 12.5mg, but that was enough to control any fluid retention for me. It’s always a matter of trial & error.

[winfong]

I take both furosemide and HCTZ without any issues

[RT18]

thank you. It is the steroid and loss of previous mobility causing mum’s odema. Her heart had full workout last year and is fine! We’re looking for something where the minimum harm is in the short term as she has late stage dementia but at the moment still has quality of life. I find the GP flies in and out…is surprised at my questioning and doesn’t always seem clued up on all the interactions - he wasn’t going to test potassium until I requested. We know where dementia is going but I still want to maximise quality of life at present….

[Odosmum]

I have been on Furosemide for around four and a half years now, with no ill effects (except having to pee all the time!). My blood pressure, when monitored 5x day, had been all over the place. No pattern at all. I ended up in hospital on 4 hour OBS (not related) and when I saw the consultant, told him what had happened at home. Hmmm, he said, I've seen this before. Furosemide and after 3 days a regular 120/70 every time. It's still working.