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Diuretics



Depletions

Diuretics/Nutrient Depletion:
  • CalciumCalcium: According to secondary sources, loop diuretics including furosemide (Lasix®), bumetanide (Bumex®), ethracrynic acid (Edecrin®) and torsemide (Demadex®) at high doses may reduce serum calcium levels because they increase urinary calcium excretion in urine.
  • Coenzyme Q10 (CoQ10)Coenzyme Q10 (CoQ10): Based on secondary sources, diuretics may reduce CoQ10 concentrations. Specific diuretics mentioned in anecdotal reports include benzthiazide, chlorthiazide, hydrochlorothiazide, indapamide, methyclothiazide, metolazone, and polythiazide.
  • CopperCopper: Based on human evidence, diuretics, particularly thiazide diuretics, have been found to alter copper levels (2010578).
  • FolateFolate: Limited human data suggests that diuretics may increase excretion of folic acid (10498160). Reduced red blood cell folate levels, possibly contributing to increased homocysteine levels, a risk factor for cardiovascular disease, were found in one group of people taking diuretics for six months or longer. Based on in vivo evidence, triamterene inhibits the intestinal absorption of folic acid in a dose-dependent manner (3760669).
  • MagnesiumMagnesium: According to human study, diuretics may interfere with the kidney's ability to regulate magnesium concentrations (12639869, 3551599). Long-term use of loop diuretics or thiazide diuretics may impair the magnesium-conserving ability of the kidneys and lead to hypomagnesemia (3662705). Based on human evidence, loop diuretics may increase urinary excretion of magnesium (19187399). Conversely, long-term use of potassium-sparing diuretics has been found to increase renal tubular reabsorption of magnesium, which may cause hypermagnesemia in patients also receiving magnesium supplements, especially in patients with renal insufficiency (6536835).
  • MelatoninMelatonin: Based on evidence from human and animal studies, medications that reduce levels of vitamin B6 in the body (such as loop diuretics) may also deplete melatonin levels (8872867).
  • PyridoxinePyridoxine:Based on a human study, intravenous furosemide administration may increase the urinary excretion of pyridoxine in patients with chronic renal failure (10681666).
  • PotassiumPotassium: In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels (10376573).Loop diuretics, including furosemide and torosemide, may reduce serum potassium based on human evidence (8111802, 19187399), however, this effect may be dependent on its tubular concentration. Based on human evidence, thiazide diuretics, such as hydrochlorothiazide, may also reduce serum potassium levels (19120715).
  • RiboflavinRiboflavin: Based on animal evidence, thiazide diuretics may increase depletion of riboflavin (14391968).
  • SodiumSodium: Based on human evidence, diuretics may cause increased sodium excretion (19114909).
  • ThiamineThiamine: Based on human evidence, loop diuretics, particularly furosemide (Lasix®), have been associated with decreased thiamine levels in the body by increasing urinary excretion (and possibly by decreasing absorption and increasing metabolism) (14712323). Animal evidence suggests that the increase in urinary excretion of thiamine may be associated with furosemide, acetazolamide, chlorothiazide, amiloride, and mannitol (10482307).
  • Vitamin CVitamin C: Based on human study, intravenous furosemide administration may increase the urinary excretion of vitamin C in patients with chronic renal failure (10681666).
  • ZincZinc: Based on human evidence, loop and thiazide diuretics may increase urinary zinc excretion (6152785).

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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