Diuretics

A diuretic, also called a water pill, is a type of medicine that helps the body get rid of salt (sodium) and water. For children with heart conditions, it reduces blood pressure and gets rid of extra water in the body.

It comes in liquid or pill form.

Some diuretics cause a loss of electrolytes, which are minerals in the blood like sodium and potassium. Other medicines can help return the important minerals that your child needs.

Diuretics are grouped by how they work. Your child may be on 1 or multiple diuretics depending on their heart condition. The most common types are:

• Thiazide diuretics: Diuril (chlorothiazide), Hydrodiuril (hydrochlorothiazide), Zaroxolyn (metolazone)
• Loop diuretics: Lasix (furosemide), Bumex (bumetanide), Demadex (torsemide)
• Potassium-sparing diuretics: Aldactone (spironolactone)

• Give it as prescribed by your child’s healthcare provider.
• Give the diuretic at the same time every day.
• Diuretics work best when a certain level is in your child’s blood at all times. This happens when the doses are spaced apart in equal amounts of time.
• If your child takes it 2 times a day and the nighttime dose is making them wake up to go to the bathroom, you can give it when they wake up and late afternoon (4 to 5 p.m.).
• It begins to work about 1 to 2 hours after taking it.

Call your pharmacy when you are close to running out of medicine. Have at least a 3 day supply of your child’s cardiac medications. Your pharmacy will contact us about refills. The clinic visit is the best time to make sure your child is getting the right dose and has enough medicine.

• Skip the dose you forgot and resume the regular schedule.
• Do not try to catch up or give 2 doses at the same time.

• If you missed the morning dose, but remember before 12 noon, give the dose when you remember and stay on the regular schedule.
• If you missed the evening dose, but remember before 12 midnight, give the dose when you remember and stay on the regular schedule.
• If you miss more than 2 doses in a row, call your child’s healthcare provider or the Heart Center.

• If you think your child could be sick with vomiting or diarrhea, please call your child’s cardiologist for more advice about whether to continue giving the diuretics. Your child may get dehydrated if they continue to take the diuretics.
• If your child throws up immediately after taking the diuretic and you do not think your child is sick with anything else, give the dose again. Give the next dose at the regular time.
• If your child throws up more than 5 minutes after taking the diuretic, do not give the dose again right away. If you do not think your child is sick with anything else, give the next dose at the regular time.

Since diuretics help the body get rid of extra water, your child is at risk for dehydration, especially if your child gets sick with something else. Call your child’s cardiologist if your child has any of these problems:

• Infants: eating poorly or less than 4 to 5 diapers in 24 hours
• Eyes that look sunken, few or no tears when crying (a sign of dehydration)
• Small amount of urine when peeing
• Not drinking fluids as much as usual, especially during warm weather
• Tiredness or irritability
• Vomiting or diarrhea

If you miss more than 2 doses in a row, call your child’s healthcare provider or the Heart Center.

• Bring a list of your child’s medicines to each clinic appointment.
• Keep all medicines out of the reach of children.