Diuretic-Related Side Effects: Development and Treatment

Domenic A. Sica, MD

In This Article

Adverse Drug Interactions

Loop diuretics can potentiate aminoglycoside nephrotoxicity.[83] By causing hypokalemia, diuretics increase the risk of digitalis toxicity.[84] Plasma lithium (Li+) concentrations can increase with thiazide therapy with significant volume contraction due to the associated increase in Li+ absorption.[85] However, some diuretics, such as chlorothiazide or furosemide, with significant carbonic anhydrase inhibitory, can increase Li+ clearance, thus leading to a fall in blood levels.[86,87] Whole-blood Li+ should be closely monitored in patients administered Li+ in conjunction with diuretics. Nonsteroidal anti-inflammatory drugs can both antagonize the effects of diuretics and predispose diuretic-treated patients to a form of functional renal insufficiency. The combination of indomethacin and triamterene may be particularly dangerous, in that acute renal failure can be precipitated.[88]