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What are Water Pills?

Mary McMahon
Updated Mar 03, 2024
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Water pills are natural or manufactured substances that people typically ingest to cause the kidneys to excrete more sodium and produce more urine. Better known as diuretics, they come in four major varieties that vary in mechanism and effectiveness. Doctors prescribe them as a treatment for a variety of conditions such as high blood pressure and edema. Some people use them for weight loss, as well, but this is controversial and not recommended, especially for long-term results. Manufacturers often use natural substances such as coffee as a base for diuretic formulations, so in some cases, a person can fall back on these natural ingredients to get the same effects the pills offer.


Doctors have four major types of water pills they typically prescribe, and they may prescribe more than one kind at a time, depending on a person’s needs. The first two types, loop and thiazide, work very similarly. They interfere with the amount of sodium the kidneys reabsorb. The body has to pull water from the blood to flush this excess sodium away, so the volume of urine the kidneys make usually goes up.

An important distinction between these two kinds of diuretics is that loops act on the thick ascending limb of the loop of Henle in the kidney, which is responsible for as much as 25 percent of sodium reabsorption. Thiazides, by contrast, act on the distal tubule. This part of the kidney handles only about 5 percent of sodium reabsorption, so thiazides are not as effective in producing significantly more urine.

The third class is potassium-sparing. Loop and thiazide diuretics cause the body to lose potassium because of how they interact with sodium. This is potentially dangerous because a proper amount of potassium plays a role in causing the heart to beat properly. Potassium also relates to nerve and muscle function. Potassium-sparing versions compete with aldosterone or block sodium channels, so they have a slightly different mechanism, but the end result is still a small increase in urine output.

Carbonic anhydrase inhibitors are the last type of water pill. They help prevent sodium reabsorption by effecting the movement of bicarbonate. These versions act on the proximal convoluted tubule of the kidneys and aren’t very strong.

Medical Uses

One common use of diuretics is as a blood pressure treatment. These medications take some water from the blood in order to flush extra sodium from the body, so they lower overall blood volume. The result is a decrease in blood pressure. This can lessen strain on the heart and lower the risk of damaged arteries and aneurysm. It also may reduce the odds of developing kidney disease.

The reduction of blood volume that occurs with use means that capillary hydrostatic pressure goes down. Subsequently, the amount of fluid that moves out of the capillaries and into the surrounding tissues decreases. Physicians therefore give people water pills if edema, or retention of water in the body tissues, is a problem.

Diuretics act on differing parts of the kidneys, which are primary filtration organs for the body. Medical professionals therefore may give water pills to patients as a means of flushing toxins from the body. Toxins are highly varied, however, so the way the body handles them is not always the same. The effectiveness varies depending on what toxins are involved.

Weight Loss

Weight loss is a highly controversial use of water pills. Water is heavy and can contribute to a puffy or overweight appearance, so removing excess water is one way to shed pounds and look a little trimmer. Celebrities often use techniques to shed water weight before photo shoots and other events for this reason.

Using diuretics in this way is problematic for multiple reasons. They can create electrolyte imbalances because of how they affect sodium and potassium levels, which can cause problems such as muscle cramps and irregular heartbeat. Problems such as dizziness and fainting can happen if dehydration and a drop in blood pressure are too extreme. Lastly, the body naturally will try to replenish its supply of water once diuretic use ends, so weight loss under this method is not sustainable.

Psychologists and psychiatrists are especially concerned about the use of both water pills and laxatives in cases of anorexia nervosa and bulimia nervosa. Even though these medications are not meant to be taken for an extremely long time even in cases of medical necessity, individuals suffering from these conditions use them over extended periods to keep weight as low as possible. Stopping the use often means working through intense mental and behavioral issues such as distorted body image.

Natural Versus Manufactured Diuretics

Most prescription diuretics are formulated drugs people ingest. Manufacturing ensures that patients get better dosing and sometimes offers improved control of side effects. Many natural substances have a diuretic effect, however, and some manufacturers use them as a base for their formulations. Coffee, for example, is a well-known diuretic. Parsley, juniper, goldenrod and bearberry are additional alternatives.

The fact that natural substances can remove water from the body means that a person sometimes can control issues like high blood pressure, edema, kidney disease, electrolyte imbalances and dehydration through dietary changes, at least to a small degree. Some people find this to be more palatable and less cumbersome than taking medication, and they like that the dietary alternatives can eliminate potentially harmful additives. Regardless of what the source of the diuretic is, safety still requires a doctor’s supervision.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments

By anon990910 — On May 15, 2015

Question: how long does it take for water pills to start working?

By anon924457 — On Jan 04, 2014

I'm on chemo. I've doubled my weight. Can I take a water pill?

By anon293716 — On Sep 27, 2012

For higher blood pressure, consider trying magnesium and trying serrapeptase. This dropped both my readings within two weeks. They dropped further when the Advil could be discontinued as well.

By anon288353 — On Aug 29, 2012

I started taking hydrochlorthiaz 12.5 6 days ago. I was so tired of my feet and legs swelling up like tree trunks, being tired all the time, left arm feeling dead and heavy and my face and hands swelling up. Within hours, the swelling was gone and has not returned. I sleep better than I have in the last eight years, and I have actually dropped eight pounds, which is a good thing, since I've gained 45 pounds in the last eight years. I am hopeful that I am on my way to getting back my old self and life.

By anon278628 — On Jul 08, 2012

I'm a diabetic with high blood pressure and my GP put me on half a water tablet daily. I began to feel unwell and came off them after five days, returning back to the doctor who changed my blood pressure tablet. After being off these water tablets for five days, I am still feeling sick and often feel like I have a stomach upset. Is this what the water tablets have caused?

By anon238922 — On Jan 05, 2012

My mom is diabetic and has a high BP number. The docs prescribed a water pill and I am worried if she will lose sodium and potassium more than she is supposed to. She also takes insulin and other medication related to her problem. Do you think this is going to work for her.

By anon215132 — On Sep 17, 2011

I have been on water pills (HCTZ) for five years and am petite, a long distance runner, eat no red meat, eat lots of good food and couldn't figure out why I was in the 150/80 BP range. Water pills lowered me to the 130's but I hate to get up at night to pee so have kept a thorough diary for three months on eating less salt and adding potassium and magnesium. It was the magnesium that really did the trick.

Now I have added three magnesium pills a day (400mg each) and I cut my hctz in half and blood pressure is 110/66. I take Magnesium glycimate and it's one of the better ones. I am now going to cut back to one half of an hctz pill every other day and ween myself of these pills. If the BP goes up (I don't think it will) I will just use 1/2 pill daily (12.5 mg)I really wish doctors would suggest trying the potassium and magnesium first.

By anon200559 — On Jul 27, 2011

I have been taking water pills for almost six years and I just recently got off of them and now

I am gaining weight. They say it is bad for your

kidneys to be on them so long. Are they really

harmful for you if you are actually on a small dose?

By anon185938 — On Jun 13, 2011

I just started taking water pills, two different ones. I have had severe legs cramps twice. could this be because of water pills.

By anon180769 — On May 27, 2011

My HCTZ has unfortunately given me a potassium deficiency. I have to take potassium power once a day along with my heart pills for the rest of my life. Bummer.

By anon179674 — On May 24, 2011

I've been on 12 and a half mill of hydroclorazide one time a day. I have dizzy spells and at times double vision. I've told my doctor he doesn't seem concerned. He has never checked my electrolytes so now i take a multi vitamin every day and will see if it helps.

By anon171098 — On Apr 28, 2011

Is it safe to take a diuretic while passing a kidney stone?

By anon169646 — On Apr 22, 2011

At least 98 percent of the questions post on this site should be discussed with your physician. Please don't turn to anonymous people to ask important health questions.

To the remaining 2 percent of the people: water pills are just that. They make you pee out the excess water, and they will make you thirsty, so you drink even more water. Sodium and potassium are vital in maintaining a healthy, functioning body. Too much, or too little of either can cause perm. damage, that's why the Doctor orders your lab work. Stay on top of your health.

By anon166731 — On Apr 10, 2011

A nurse practitioner put me on a diuretic after a few high BP readings (155/100 range). I hate it. I am urinating all the time and she makes me come in every other week for BP/weight checks and bloodwork. It is horrendous and expensive.

By anon156649 — On Feb 28, 2011

to the THC post: THC does not store in your fat. THC is out of your system within days.

Our bodies create a metabolite to counter THC and that metabolite is stored in your fat cells. A THC drug test does not test for THC, it tests for the metabolite.

The only way to pass a drug test is by drinking enough water that you are urinating water. Vitamin B2 will turn your urine yellow so the tester doesn't see clear pee and send it to a lab. I have passed several drug tests this way. It is the only way to do it.

By anon145265 — On Jan 22, 2011

I just had a kidney stone removed and have to drink 2 1/2 liters of water a day. However I'm putting on weight now. About 10 pounds. My gut is bloated. Is this water retention and is this temporary?

By anon138535 — On Jan 01, 2011

would varicose veins have anything to do with feet and legs swelling?

By anon138524 — On Jan 01, 2011

My mother had her femur repaired from a fall and she is 94, since she came home from the hospital her feet and legs swell right up to the knee. The doctors keep giving her a fluid pill and she has been taking these for about four months. I would like another opinion this. I don't think fluid pills are the answer. please comment

By anon126683 — On Nov 13, 2010

My mam has been on water pills for years due to swollen ankles and legs. now she is really confused and exhausted due to the low sodium and potassium level in her blood, so the tablets have been taken off her for a couple of days in order to raise the sodium in her body again. I was wondering what the best water tablet is for her to take, that does not lower the sodium level so much.

By anon112333 — On Sep 19, 2010

Be very careful with water pills. whether they are over the counter or a prescription. Not only do you lose excess water, but you also lose potassium, magnesium (which helps your body to absorb vitamins and minerals) and B vitamins to name a few. This would lead to low levels and certainly cause you to feel tired and drained.

I am on a prescription water pill but also take supplemental vitamins to help replace some of what I am losing with each pill and get B-12 shots monthly, I also have monthly blood work done to monitor those levels.

Importantly, watch your salt intake, even though it helps remove some excess sodium, too much salt and the pill can't work effectively and you'll only retain even more water, so read labels and try using onion or garlic powder, even Mrs Dash to season your food. I love it on my vegetables.

If the pill is affecting your sleep with getting up in the middle of the night to use the bathroom, you should try taking the pill before 3-4 p.m. Later you take it and if you eat later that evening, the pill will kick in and keep you running back and forth all night long when you would rather be sleeping.

Ibuprofen, such as Motrin or Advil, also decrease the effectiveness of a water pill. Since they can cause headaches (brain is mostly water), it is safe to take acetaminophen, such a Tylenol.

For those suffering from severe feet and ankle swelling, yes you should elevate your feet but never above heart level, and you should see a doctor since there is more than likely a chance you are suffering from an underlying condition that requires more than just a water pill.

I hope this information has helped some of you with your questions.

By anon108668 — On Sep 03, 2010

I started to experience swelling around my feet and ankles my tummy is bloated big time someone asked if I was pregnant. How embarrassing was that. Today I looked at my feet and they looked like two hams. I'm like what? I called mom and my sister and they both told me that it I was retaining salt and water.

I went to the pharmacy and bought over the counter meds, diurex water pills. I've felt exhausted for the past week. I took two pills and every four to six hours take another dose. Should I be seeing my doctor or have any concerns with the meds and how I feel. should I have my feet elevated? It's been very hard putting my clothes like jeans on because of the bloating. Will this medication help me. Please help me out and give me some advice. Thanks, now I have to go pee pee. )

By anon93914 — On Jul 06, 2010

My blood pressure is I guess pretty normal 96/64. I don't have any real health problems. I just purchased natural water pills to relieve a bloated feeling. it recommended not to take more then five days. can problems occur in this short amount of time.

By anon93206 — On Jul 02, 2010

Well i am a 17 year old female and i have a PCOS. It's a condition that a lot of women get and it comes with a lot of problems. One of my problems are that my body contains a lot of water and it makes it very hard for me to lose weight. I haven't talked to my doctor yet about taking water pills. But in general, would it be a good idea because of my condition?

By anon80678 — On Apr 28, 2010

i have been on thiazide for three weeks for high blood pressure, and i get up at least three times in the night for a pee. I take the pill around 6 p.m., my BP is now down 30 pts to 115/75 which is perfect.

By anon75099 — On Apr 05, 2010

I'm trying to lose at least 35 pounds and I've been working out about two times a week, also eating healthy, and for some reason, I can't seem to lose a pound. Do you think if I start water pills it will be OK?

By anon73358 — On Mar 26, 2010

I'm tyring to lose at least 35 pounds and I've been at the gym five times a week, also eating healthy, and for some reason, I can't seem to lose a pound. It's driving me nuts.

Do you think if I start water pills and continue the diet, etc., I'll lose a few pounds? And after reading so much about water pills and peeing I have to pee now.

By anon72612 — On Mar 23, 2010

is it safe to take water pills with one kidney?

By anon67516 — On Feb 25, 2010

I take prednisone (steroids) for a condition i have. would it be bad to take water pills also?

By trela — On Feb 22, 2010

Ive been on 2 water pills for about 3 months now they have helped a lot with the edema but I feel drained and worn out more as if the water pills are taking my natural energy from me, also Im 40 years old (if that makes a difference?)

By anon66918 — On Feb 22, 2010

My dad is 50years old and overweight and his body is swelling. He has a lot of water in his body. What's the best medication he can use?

By anon62668 — On Jan 27, 2010

Was not told that it contained sulfur.

Am deathly allergic to anything containing sulfur. Almost died as a kid from a severe reaction and spent six months in intensive care.

Docs dismissed my recent complaints about HCTZ (put on 10 meds to combat side effects - tossed all when I realized allergic reaction/extreme side effects - and blood pressure is now normal - one year after stopping diet coke addiction).

By anon62524 — On Jan 27, 2010

My mother had a stroke because she was on a water pill. In the emergency room, they were pouring potassium into her. Her doctor did not insist that she take a blood test to watch her potassium level. Water pills without lots of potassium and drinking water, can cause strokes. Look it up.

By anon61504 — On Jan 20, 2010

On a serious note, I am a 40 year old woman who was diagnosed with Stills Disease two years ago. My BP was a little high and many counts were off. Docs put me on water pill and the bloating in my face/neck etc seemed to leave within 24 hours! Problem was, I lost 35 pounds in one week and had to go off of it! Too much, too fast!

By anon60270 — On Jan 12, 2010

water pills' worst side effect is impotence - loss of libido. no thanks.

By anon48547 — On Oct 13, 2009

As a 39 year old male who was diagnosed with mysterious massively high blood pressure, I was prescribed water pills along with two other treatments. I have since quit the water pills and have seen a dramatic improvement in quality of life. Thank you, but I will gladly shave five years off my life in exchange for not crapping my pants on a regular basis. Water pills = good times. I was even on the most gentle variety available. Certainly, you should consult your doctor first if you care about your health. I value quality of life over quantity.

By anon48378 — On Oct 12, 2009

Take it from someone who takes fluid pills for health reasons. It's not all that it's cracked up to be. I at first loved the fact that I lost weight especially right after having a baby but the weight kept dropping. Oh-- and don't talk about all the almost missed bathroom times. Just be very careful with these because they have very serious side effects.

By anon44796 — On Sep 10, 2009

It made me poop purple and my pee was green. Did that happen to anyone else?

By bumbleb — On Aug 12, 2009

Please Help! My weight has always been 110 lbs. In the last 4 months I gained 15 lbs and feeling bloated all the time. My doctor said I'm in the pre-menopause stage. what is the best water pill on the market to help me? I don't like being fat. Thank you.

By anon40861 — On Aug 11, 2009

i take water pills for bloating also and my urine is greenish. is that normal?

By anon40180 — On Aug 06, 2009

Um, as for the guy who posted about the THC... THC is stored in the fat, not in the urine, my friend. Taking water pills and drinking large quantities of water does *not* flush THC or any other recreational drug out completely. Basically what is happening is all that water that is coming out in the sample cup is the massive amount of water you drank. It's highly diluted making the test come out negative. Do not trust in the method any more than the method of drinking a cap full of bleach. It takes 30 days for THC to rid your system thanks to the fact that it is stored in fatty tissues.

By anon31010 — On Apr 28, 2009

Is it OK to take a water pill and viagara simultaneously?

By elrababy — On Mar 29, 2009

What is the firm that produced it?

By anon28683 — On Mar 20, 2009

i was wondering, i already have low blood pressure so is it safe for me to take the water pills? i am retaining some fluid in my body. please let me know. what are other side effects? i'm not too good with side effects.

By anon24358 — On Jan 11, 2009

My Blood Pressure was so bad, that I was about to have a Stroke, or Heart Attack, then I found a new Doctor, and he put me on a water pill, which worked immediately.

But I also take two others,please don't ask me to remember the names of Medication.One is small white one, and second one is two-toned blue capual--and I wondered if I could get along with just the Water Pills? I may try,and get back to you

By anon24195 — On Jan 08, 2009


I am pretty thin and petite, but I seems to retain some water, like my cheeks are a little bloated. Would water pills help this? If so, which would be best? (I have blood pressure that is in the low, but still normal range) Thank you!

By anon23894 — On Jan 04, 2009

My wife has been taking water pills to help with the bloating. For some reason here urine has turned greenish. Should we be worried?

By Linz0702 — On Nov 20, 2008

I have several male friends who have said that they take about 4 water pills throughout a 24 hour period and drink about 3 water bottles before a drug test. They said that this tactic they have been using works very well and they always pass the drug test. Please tell me a little more about this tactic they are using..does it really eliminate all of the THC (abd other drug chemicals) out of your body? what are the health risks involved?

By anon19220 — On Oct 08, 2008

"Loop diuretics interfere with the body's ability to absorb sodium, meaning that more water appears in the patient's urine, because water is normally pulled along with sodium." Seems a little more dangerous than they stressed. especially when it is used regularly

By climbnvolley — On Oct 06, 2008

does anyone else have to pee after reading about water pills?

By anon17013 — On Aug 20, 2008

so a water pill and aphetermine are not suggested ...of course what are the dangers...when one pill elevates and the water pill decreases....wouldn't it balance each other out and how long before kidney damage is two months tooo long?

By anon6977 — On Jan 14, 2008

what are the banes of the common diuretic pills?

Mary McMahon

Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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