Over-the-Counter Diuretic Water Pills: All You Need to Know

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

Diuretics, commonly known as water pills, are medications designed to reduce excess fluid in the body. There are both OTC and prescription diuretics available, each with different purposes and methods of action.

While prescription diuretics are primarily used for managing high blood pressure by reducing fluid in the blood vessels, OTC diuretics serve a different purpose.

These OTC options, typically containing pamabrom or caffeine, are used to alleviate minor swelling or bloating, such as that experienced during premenstrual syndrome (PMS). However, they are not substitutes for prescription diuretics, which treat conditions like high blood pressure or congestive heart failure.

Key takeaways:

• Diuretics or water pills are medications used to reduce excess fluid in the body.
• There are both OTC and prescription diuretics, with different purposes and methods of action.
• Prescription versions of diuretics may be used to treat high blood pressure and congestive heart failure.
• OTC diuretics are generally intended for reducing mild swelling or bloating, such as from PMS.
• The main ingredient in OTC diuretics is either pamabrom or caffeine, which act as natural diuretics.
• There are also herbal supplements with diuretic properties, such as dandelion or green tea extract.
• OTC diuretics should not be used as substitutes for prescription versions, and consulting a doctor is recommended before starting any new medication.

Continue reading this article to learn more about OTC diuretics.

Table of Contents

• What are Diuretics?
• How Do Diuretics Work?
• Can You Get Over-The-Counter Diuretics?
• What Are the Best Over-The-Counter Diuretics?
• Diuretic Types
• How Can DrHouse Help You?

What are Diuretics?

Diuretics, also known as water pills, are a type of medication used to increase the amount of water and salt removed from the body through urine.

Prescription diuretics are most commonly used to treat high blood pressure because they reduce the amount of fluid in the blood vessels, consequently lowering blood pressure.

Congestive heart failure is another condition that may be treated with diuretics. This is because congestive heart failure leads to inefficient pumping of blood throughout the body, which results in a buildup of fluids. This condition, called edema, can be remedied with diuretics, which reduce the fluid buildup.

How Do Diuretics Work?

Most diuretics work by helping the kidneys to release more sodium into the urine. This increase in sodium then helps to remove water from the blood, leading to an overall decline in fluid levels in the veins and arteries.

The different types of diuretics work in different ways.

For example, thiazide diuretics reduce the amount of sodium and water in the body by preventing its reabsorption in a part of the nephron called the distal convoluted tubule. 

Loop diuretics instead cause the kidneys to increase the urine flow rate. 

Potassium-sparing diuretics reduce the amount of water in the body. One type of potassium-sparing diuretic is spironolactone, which prevents the action of aldosterone. Inhibiting this steroid hormone causes the kidneys to remove excess water and sodium while reducing the loss of potassium.

Can You Get Over-The-Counter Diuretics?

Some diuretics are only available as a prescription, but there are also some over-the-counter (OTC) diuretic options. In these OTC medications with diuretic effects, the main ingredient is either pamabrom or caffeine, which act as natural diuretics.

They are intended to help with slight swelling or bloating, such as bloating that occurs with premenstrual syndrome (PMS). As such, they are not meant to replace prescription diuretics used to treat high blood pressure or congestive heart failure. Additionally, it is not recommended to take OTC diuretics in addition to prescription diuretics unless your doctor says to.

There are also supplements available OTC that have diuretic properties, such as dandelion, ginger, caraway, parsley, green tea, hawthorn, and hibiscus. However, these herbal remedies should not be used as a treatment for medical conditions such as fluid retention or high blood pressure.

It’s important to remember with diuretics, that regular monitoring of your urine output, body weight, electrolyte level, and blood pressure should be completed to ensure that you are not causing more damage than good while taking them. Despite taking an OTC variety of diuretics, it is still essential to monitor these factors.

What Are the Best Over-The-Counter Diuretics?

Diurex and its generic versions are diuretics available OTC in different forms. They are available at most pharmacies and even come with caffeine-free options.

Taking these OTC diuretics can help promote fluid balance and stop regular and menstrual bloating.

As for herbal supplements with diuretic properties, it is essential to remember that these products are not regulated in the same way prescription medications are, and they may end up causing drug interactions. Because of this, it is always recommended to talk to a doctor before starting a supplement.

Diuretic Types

There are three types of diuretic medications, which are called loop, thiazide, and potassium-sparing diuretics. They all have the same goal of helping the body excrete more fluid through urine, but they accomplish this by affecting different parts of the kidneys.

Of note, these three types of diuretics are only available as prescription medications.

Thiazide Diuretics

This type of diuretic is the most commonly prescribed, typically for those with high blood pressure. In addition to decreasing fluid levels, thiazide diuretics also help the blood vessels relax, further aiding the decline in blood pressure levels.

Some examples of thiazides include:

• hydrochlorothiazide
• chlorthalidone
• indapamide
• metolazone

Loop Diuretics

Loop diuretics are often prescribed for those with heart failure. Some examples of loop diuretics include:

• furosemide
• torsemide
• bumetanide

This type of diuretic gets its name because it affects the loop of Henle, which is a part of the kidneys.

Potassium-Sparing Diuretics

The two types of diuretics listed above can cause you to lose potassium, which is an important nutrient. When you lose too much potassium, heart problems such as arrhythmia can occur.

Potassium-sparing diuretics are a type of medication that lower fluid levels without causing a loss in potassium, and they are often prescribed for those at risk of low potassium. This includes those that take other medications that can lower potassium levels.

However, potassium-sparing diuretics are less effective at reducing blood pressure than other diuretic types.

Types of potassium-sparing diuretics include:

• triamterene
• amiloride
• eplerenone
• spironolactone

How Can DrHouse Help You?

Diuretics are generally safe to take with potential mild side effects of headaches, muscle cramps, dehydration, and dizziness. If you experience any of these symptoms, DrHouse can connect you with an online doctor in just 15 minutes to discuss your symptoms and if they recommend anything to remedy them.

Whether you want to discuss a supplement or ensure that it is safe to take a particular diuretic, your online doctor can consider your symptoms and guide you on the safest way to balance your fluid levels.

In Conclusion

Diuretics, also known as water pills, help to reduce excess fluid in the body. Prescription versions of diuretics may be used to treat high blood pressure and congestive heart failure.

Diuretics are also available OTC, but they utilize caffeine or pamabrom for their diuretic qualities and are generally intended for reducing mild swelling or bloating, such as from PMS.

With diuretics, it is crucial to ensure that too much fluid or potassium loss does not occur, which is why it is recommended to discuss any diuretic use with a doctor.

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• Faris, R., Flather, M., Purcell, H., Poole-Wilson, P., & Coats, A. (2012). Diuretics for heart failure. Cochrane Database Of Systematic Reviews. doi: https://www.doi.org/10.1002/14651858.cd003838.pub3 
• Zillich, A. J., Garg, J., Basu, S., Bakris, G. L., & Carter, B. L. (2006). Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension (Dallas, Tex. : 1979), 48(2), 219–224. https://doi.org/10.1161/01.HYP.0000231552.10054.aa 
• Musini, V., Nazer, M., Bassett, K., & Wright, J. (2014). Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. Cochrane Database Of Systematic Reviews. doi: https://www.doi.org/10.1002/14651858.cd003824.pub2 
• Di Girolamo, G., Sánchez, A. J., De Los Santos, A. R., & González, C. D. (2004). Is acetaminophen, and its combination with pamabrom, an effective therapeutic option in primary dysmenorrhoea?. Expert opinion on pharmacotherapy, 5(3), 561–570. https://doi.org/10.1517/14656566.5.3.561