Examples of Potassium-Sparing Diuretics
Combinations (Dyazide, Moduretic, Aldactazide, Maxzide)
The potassium-sparing diuretics are usually combined with one of the other diuretics to reduce excessive potassium depletion. However, the potassium-sparing diuretics in turn may cause excess potassium, called hyperkalemia, which can also be dangerous. Symptoms of too much potassium include muscular weakness, fatigue, numbness and tingling, and irregular heartbeat.
What Do They Do in the Body? Reduce fluid and water retention in such a way that the body retains potassium.
What Are They Prescribed For? In conjunction with loop and thiazide diuretics prescribed for high blood pressure and CHF, to reduce the loss of potassium, to treat aldosteronism (an excess of the adrenal hormone aldosterone, which causes the body to hold on to salt and excrete potassium), and to treat a variety of conditions involving potassium loss.
Spironolactone reduces the level of aldosterone, an androgen (male hormone), so it has been used to treat excess hair growth, acne, and other symptoms of excess androgens. Considering that this drug promotes tumor growth in rats and can cause unexplained uterine bleeding in women at high doses, it seems frivolous to use it other than short-term in life-threatening situations.
Triamterene is mainly used to treat edema, or water retention, especially when it is caused by aldosteronism.
What Are the Possible Side Effects? Excess potassium (hyperkalemia), dizziness, nausea, vomiting, and appetite loss. Liver and kidney problems may get worse. The peripheral neuropathy (numbness in the extremities) caused by diabetes may get worse.
Spironolactone affects sex hormones by reducing aldosterone levels. Aldosterone is an androgen, or male hormone. Taking spironolac-tone can cause a reduction in male hormones, and as a consequence, causes breast enlargement and other feminizing effects in men. It also promotes the growth of a variety of malignant tumors in rats. Spironolactone can cause lethargy, mental confusion, headaches, stomachaches, irregular menstruation, and thirst.
Triamterene may promote the formation of kidney stones and can raise blood sugar levels. It can also induce kidney failure.
Think Twice About Taking These Drugs If . . .
• You have kidney or liver problems.
• You have diabetes.
• You have urinary tract problems such as an enlarged prostate that interferes with urination. Diuretics can make you even more uncomfortable by increasing the number of times you have to urinate.
What Are the Interactions with Food? If you consume too many electrolytes, such as in sports drinks, you may get too much potassium. Eating a lot of high-potassium foods in combination with taking the drugs can also raise potassium levels too high. Some common high-potassium foods include bananas, citrus fruits, melons, almonds, green leafy vegetables, potatoes, carrots, avocados, and soybeans.
Licorice (the root or herb used medicinally, or the candy with real licorice flavoring) can be an antidiuretic and may reduce the effect of these drugs. Licorice also contains a component called glycyrrhizin, which is similar to aldosterone, the very hormone that spironolactone is prescribed to reduce, so taking a lot of (real) licorice could negate those effects.
Eating a lot of meat can increase uric acid even more, increasing the possibility of gout.
Spironolactone levels may be increased by eating a lot of protein or fat at one sitting. Levels may be decreased by a high-fiber diet. If you’re eating fiber-rich cereals or taking a fiber supplement such as psyllium, take it a few hours apart from taking this drug.
If you are sensitive to MSG, its negative effects may be exaggerated when you’re taking diuretics.
What Nutrients Do They Deplete or Throw out of Balance? Minerals, especially sodium, potassium, calcium, magnesium, and zinc. Zinc is crucial to proper immune system functioning, wound healing, and thyroid function. Diuretics can cause a depletion of vitamin A, which many Americans are already deficient in.
What Else to Take While Taking These Drugs. A good mineral formula that includes zinc, copper, boron, iodine, cobalt, manganese, molybdenum, vanadium, chromium, selenium, and if you’re a premenopausal woman, iron.
Be sure you’re getting both beta-carotene and vitamin A in your multivitamin formula. Eat plenty of fresh fruits and vegetables.
Prescription Alternatives: Hundreds of Free, Natural, Prescription-Free Remedies to Restore & Maintain Your Health, by Earl L. Mindell, R.Ph, Ph. D, & Virginia Hopkins, M.A. Published by McGraw-Hill.