What Is the Best Water Pill for You? Review All Types of Diuretics

Benefits of water pills
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Water pills, or diuretics, are some of the most commonly used medications. In fact, in 2019, two different water pills were among the top 20 medications prescribed in the U.S.

But what exactly are these water pills? And when do people take them? Well, that depends on each case, as there’s more than one type of water pill out there. There’s even over-the-counter (OTC) water pills available.

Read on to learn about water pills — what they are, how they work, and the different types available.

What are water pills (diuretics)?

First off, water pills aren't made of water. They also don’t make you more hydrated. They’re commonly called “water pills” because of how they work in the body.

You see, there’s a class of medications, called diuretics, that work in the kidneys. They help you remove excess fluid from the body through urination. In other words, diuretics are pills that help you get rid of extra water — hence the name “water pills.”

What do water pills do?

Did you know your kidneys filter more than 200 liters of blood per day? That's a lot of work! What your kidneys are doing is helping keep your body balanced by getting rid of waste and extra fluids, among other things. This is turned into urine, passed to the bladder, and then removed from the body by urinating.

What we’ve found is that we can actually change how the kidneys filter certain substances. Diuretics usually make you filter out more fluid. But each type of water pill does this in a different way.

By removing extra fluid, diuretics can help manage different medical conditions, like high blood pressure, heart failure, and swelling from fluid buildup (edema). As such, many people take diuretics for these health conditions.

Types of water pills

There are many diuretics available for people to take. Most have been on the U.S. market for several decades and have generic versions available. So regardless of which one your healthcare provider suggests for you, they’re generally inexpensive.

Diuretics can be broken into different classes based on how they work in the kidney. Depending on how they work, this can make them a more preferred treatment option for certain conditions. Some diuretics make you lose more water than others, and side effects can vary between classes.

Let's take a look at the most common diuretic classes. Keep in mind this list isn’t all-inclusive. There are other, less prescribed water pills used in certain situations.

Thiazide and thiazide-like diuretics

Thiazide and thiazide-like diuretics are some of the most commonly used diuretics. They’re first-choice water pills for hypertension (high blood pressure). At higher doses, they can also help treat edema. Because they work in the kidneys, you’ll need blood tests to make sure these water pills aren’t hurting them.

Common thiazide and thiazide-like diuretics include hydrochlorothiazide and chlorthalidone. Hydrochlorothiazide is commonly added to other blood pressure medications to help boost their effects. If you see the letters “HCTZ” on your prescription label, it means hydrochlorothiazide is in the medication.

Loop diuretics

Loop diuretics are another common class of diuretics. They get rid of the most fluid of all the available water pills. They’re a preferred option for relieving edema, especially for people with heart failure.

However, one of the biggest issues is that loop diuretics can remove electrolytes, like potassium and sodium, from your blood. This can lead to dehydration, low potassium levels, and low sodium levels. Loop diuretics can also be tough on the kidneys. So you'll need regular blood tests to make sure everything is OK while taking a loop diuretic.

Some common loop diuretics include furosemide (Lasix), torsemide, and bumetanide (Bumex). 

Potassium-sparing diuretics

Potassium-sparing diuretics are water pills that get rid of extra fluid. But they don’t cause your potassium levels to drop, unlike thiazide, thiazide-like, and loop diuretics.

Because these medications affect how your body gets rid of potassium, they can cause potassium levels to get too high. This is called hyperkalemia, and it can become serious. You’ll need blood tests regularly to make sure this isn’t happening to you.

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Potassium-sparing diuretics include two different types of medications: aldosterone antagonists and epithelial sodium channel blockers.

Aldosterone antagonists

Aldosterone antagonists include spironolactone (Aldactone) and eplerenone (Inspra). These medications work by blocking a hormone called aldosterone in the body. Aldosterone causes the body to hold on to more sodium (and fluid) but get rid of potassium. By blocking aldosterone, these water pills stop your body from holding on to extra fluid.

Aldosterone antagonists aren't really good at lowering blood pressure or swelling on their own. But they can be helpful as add-on medications when other treatments aren’t working well enough. Spironolactone can also be used off-label to treat non-heart conditions, such as acne.

Epithelial sodium channel blockers

The other group is epithelial sodium channel blockers. They’re often just referred to with the more broad term potassium-sparing diuretics. This class includes triamterene (Dyrenium) and amiloride (Midamor).

These water pills work by blocking small openings in the kidneys where sodium is absorbed. The more sodium the kidneys absorb, the more fluid the body holds onto. By blocking these openings, these water pills stop the body from hanging on to extra water.

Epithelial sodium channel blockers don’t lower blood pressure or relieve swelling much on their own either. But they can be used instead of a potassium supplement to help raise potassium levels.

What water pills are available over the counter?

There are several products available OTC that cause a diuretic effect. Most of these use either caffeine or pamabrom as the key ingredient. Both of these water pills stimulate the kidneys to make urine faster than usual. They’re intended to help with bloating or slight swelling, usually due to menstrual cramps. They shouldn’t be used as a replacement for prescription diuretics. They also shouldn’t be combined with prescription diuretics unless a healthcare provider has told you to do so.

What is the best water pill for you?

Which water pill is best for you often comes down to your medical history. As discussed above, some of these medications work better to lower your blood pressure or treat heart failure.

Other health problems you may have or medications you’re taking may limit which diuretic you can take. For instance, if you have a history of gout, your healthcare provider may avoid prescribing you diuretics to help prevent a gout attack. Another consideration is how well your kidneys work since these medications work in the kidneys.

If you’ve been prescribed a diuretic, be sure to ask your healthcare provider why they chose it for you. They can help you understand why that water pill is the best one for you.

— Update: 14-02-2023 — cohaitungchi.com found an additional article Take A Hard Pass On Water Pills If You’re Trying To Lose Weight from the website www.womenshealthmag.com for the keyword benefits of water pills.

Maybe you ate way too much on your vacation last week. Maybe you haven’t been as *ahem* regular as you normally are. Maybe it’s just that time of the month. Whatever it is, you’re swollen and puffy and it’s super uncomfortable.

Sooo…should you just pop a few OTC water pills to help you ditch the bloat and feel normal again?

Hold on, what are water pills, anyway?

Water pills (a.k.a. diuretics) basically pressure your kidneys into flushing out excess water and salt through your pee.

There are actually three classes of diuretics that work in different ways, says Ellen Lunenfeld, M.D., an internist with Summit Medical Group in New Jersey—thiazide, loop-acting, and potassium-sparing diuretics. Each class works on a different part of the kidney’s nephron where urine is made, says Lunenfeld.

They sound pretty harmless, right? After all, you’re just peeing more.

Actually, it goes a little deeper than that. Here’s what you need to know about water pills—and why you should definitely skip self-prescribing them.

1. Water pills are one of the most commonly prescribed medications.

Take note of that word: prescribed. Water pills are meant to help reduce blood pressure, prevent fluid buildup, and reduce swelling respectively, says Linda Anegawa, M.D., an internist at Pali Momi Medical Center in Hawaii.

They’re usually given to people with health issues like hypertension, heart failure, and idiopathic edema (unexplained swelling)—not people looking to cure mild bloating or lose weight. Most doctors recommend against using water pills for those purposes.

2. OTC water pills are different from prescription water pills.

It might be tempting to pick up an OTC water pill at the drugstore if you’re experiencing mild bloating, but Lunenfeld warns against this. That’s because OTC water pills and prescriptions water pills aren’t the same thing.

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“The problem with OTC meds like these is that you’re not sure exactly what they’re giving you,” she explains. “They’re not FDA controlled, so they may not be doing what they claim to and in fact might be making you dehydrated.” (With an Rx, a doctor will monitor your dosage and length of use—that doesn’t happen with OTC water pills, hence the dehydration risk.)

Going a step further, OTC water pills could even be toxic and interact badly with other medicines you’re taking, says Anegawa. (Again, with a prescription, a doctor will be monitoring this.) OTC water pills also haven’t been studied in research trials to prove their efficacy, she adds.

3. Water pills aren’t addictive, but they can be dangerous.

Water pills aren’t habit-forming or dangerous, says Anegawa—again, as long as you’re getting them through your doctor. When you start taking them on your own without a recommended dosage, however, you could do some serious damage to your body.

“[Taking them] can cause worsening kidney function, and lightheadedness or dizziness as a result of being dehydrated,” says Lunenfeld. Other scary symptoms caused by dehydration and loss of electrolytes includes heart palpitations, weakness, confusion, and severe dizziness.

3. They don’t really help you lose weight…

Sure, water pills help you shed excess water that’s making you feel super bloated—but only temporarily. Once you stop taking them, your kidneys go back to reabsorbing the normal amount of water and salt for your body, so you’ll go back to your typical body weight soon after you stop taking them.

“When you’re weighing yourself, [you’re adding up] bone, fat, muscle and water,” says Lunenfeld. “When you’re looking to lose weight, you’re looking to lose fat and maintain muscle mass. With a diuretic, you’re just losing water weight, which isn’t really getting you any significant weight loss.”

4. In fact, they might make you gain weight.

Yep, you read that right. If you take any type of diuretic over a long period of time, your kidneys will eventually compensate for their use and you’ll end up holding on to more water weight than you did before you started taking them.

It’s called diuretic-induced edema, which happens when your kidneys start retaining more sodium and water than they need and your body starts to swell, says Anegawa—kind of the opposite of what a water pill is supposed to do.

5. Prescriptions water pills can be helpful if you’re on your period.

While it’s not recommended for healthy women to take any kind of water pills, there is one exception: to reduce period bloating. According to Anegawa, it’s fine for women to take prescription water pills to help de-puff unexplained leg swelling or bloating caused by PMS, says Anegawa.

Again, that’s prescription-only, so don’t head to your nearest drugstore for diuretics. Instead, bring up the issue to your ob-gyn, who may prescribe water pills to take before your period or whenever you tend to feel super-inflated. Since your physician will be keeping an eye on your dose, you’ll reduce your risk of serious side effects and have someone to call if something feels off.

— Update: 14-02-2023 — cohaitungchi.com found an additional article Water Pills for Bloating—Do They Really Work? from the website www.byrdie.com for the keyword benefits of water pills.

Water pills—they sound relatively harmless, no? After all, water is generally associated with all things good: glowing skin, a speedy metabolism, and the ultimate hangover cure. Yet here’s an interesting tidbit: If not taken appropriately, water pills (known as loop diuretics in the medical community) can actually be pretty dangerous, and should only be taken under a doctor's supervision. Why? Because prescription water pills are for people with high blood pressure or patients recovering from heart failure. Yet they’re more casually known as an expedited way to try to shed pounds and/or water weight—by people with perfectly pumping hearts.

The term “water pill,” in fact, has nothing to do with the scientific composition of the medication and everything to do with their prescribed purpose: to relieve fluid retention. As we know all too well, one doesn’t have to be recovering from a heart attack to retain some extra water.

So it’s easy to see where things could become, shall we say, murky. Though valid when needed for legitimate health concerns, over the counter water pills tout some understandably tempting claims. But are water pills a safe solution in the fight against bloat? We tapped a couple of experts—Neeru Bakshi, MD, and Tara Condell—to get their medical stance on the topic. The general consensus: If you are looking into water pills, be sure to only take them under a doctor's supervision.

Ahead, learn everything you need to know about water pills, including how they work and the difference between prescription and over-the-counter diuretics.

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What Are Water Pills?

Essentially, Bakshi tells us, “Water pills—also known as diuretics—are a class of medication used to help the kidneys decrease the amount of water in the body.” Typically, she adds, they’re prescribed to a patient by a medical professional to help with high blood pressure, heart failure, and edema. “If taken at the prescribed dosage, they can be very useful for people who actually need to take them,” she says. Some people have likened water pills as a solution to migraines, but there's little evidence to back this up, and experts agree you should only take them as directed by your physician.

How Do Water Pills Work?

Water pills “work by having the kidneys remove sodium from the body, and the water then follows the sodium,” says Bakshi. This decrease in fluids running through your veins and arteries is what gives water pills their “anti-bloating” properties. When it comes to your natural fluid intake while on diuretics, it's best to listen to the instruction of your doctor—especially if you have kidney or heart issues—as this depends on your individual calorie intake and weight.

From a nutritional standpoint, Condell notes that diuretics are useful for a variety of medical conditions—even for treating acne—but should always be used under the care of a physician. Typically, water pills are taken orally once a day, and you may notice more urine passing within the first two weeks of use.

Common Risks and Side Effects


When it comes to water pills, there are common side effects and then there are more serious ones, especially when they're not being taken under the care of a doctor. Nasty side effects include but aren't limited to “excessive urination, dehydration, constipation, dizziness, low blood pressure, muscle cramping, and elevated heart rate,” in addition to potential interactions with other medications. Which is why, Bakshi says, you should really only take these types of pills while monitored by your physician. 

It’s important to note, however, that when taken as prescribed, diuretics can be safe. Side effects are still a possibility, but if taken under the care of a medical professional, these symptoms can be dealt with in a prompt and safe manner.

Prescription vs. Over-the-Counter Water Pills

There's an important differentiation when it comes to water pills: diuretics that are prescribed and diuretics that are sold over-the-counter. Considering that water pills are often taken as a weight-loss solution, it's important to get information from both a medical and nutritional standpoint.

This is important. Unlike prescribed diuretics, over-the-counter water pills are not regulated by the FDA. In other words, “The ingredients listed on the box may not actually be what is in the pill you are taking,” says Bakshi. She continues, “There is also no guarantee of the concentration of the ingredients or promise that the listed benefits of the drug are what you should achieve.” (In other words, a functioning, healthy human shouldn’t need to take water pills in the first place).

Which left us wondering, how are water pills even allowed to be sold over the counter? According to Bakshi, oftentimes, certain once-prescribed medications can be sold over the counter once deemed safe to do so. “This is the case for diuretics and other medications, like ones for heartburn. That being said, when a medication is able to be sold over the counter, it can lose the oversight by the FDA (as noted earlier) and thereby, not need to follow the same regulations as prescribed medication for safety.” She adds: “Just because a medication is available over the counter does not mean that it is safe for all people to take.”

Do Water Pills Cause Weight Loss? 

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According to our nutritional expert, Condell, “[water pills] should not be a method for tackling weight loss.” And again, she adds that they should be used under the care of a physician. (Do we sound like a broken record yet?). Bakshi, backs her up, explaining that historically, diuretics have been a medication that people use to try to lose weight, though it's not an effective strategy, and if anything, they might cause you to gain weight. 

“Diuretics do not help in weight loss but can temporarily decrease someone’s weight on the scale as they are losing water. As a response to this, the body may try to retain more water, causing swelling and an increase in weight as measured on a scale. In turn, the person may think that they need to take even more diuretics, leading them down a dangerous path.”

The Takeaway

In short, it’s imperative to talk to a medical professional before taking water pills or any other type of diuretic. Be wary of over-the-counter options, and don't treat them as a quick de-bloating trick, which can result in dangerous side effects. To best determine if water pills are right for your health needs, speak to your personal physician.


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About the Author: Tung Chi