Certain medications may pull water from the body, increase the amount you urinate, or cause fluid loss via side effects like vomiting or diarrhea, explains Aaron Emmel, PharmD, the founder of PharmacyTechScholar.com in St. Augustine, Florida. RELATED: 6 Unusual Signs of Dehydration You Should Know About If your medication lists dehydration as a possible side effect, you should not stop taking the drug. Talk to your doctor about any concerns and how best to deal with possible dehydration. For the most part, making an effort to drink more water — but not overdoing it — will be key. Signs and symptoms of severe dehydration include tremors, weakness, and blurry vision, says Jessica Nouhavandi, PharmD, the co-CEO and cofounder of Honeybee Health, in Culver City, California. In extreme cases, dehydration can be fatal, so it’s always important to hydrate appropriately, pay attention to any signs and symptoms of dehydration, and alert your doctor. While it’s good to always get a complete rundown of common side effects from your pharmacist when you start a new medication, here are tips on eight drugs that have a track record of contributing to dehydration.
1. Laxatives for Constipation
If you have constipation, laxatives can help bring back regular bowel movements (BMs). They’re safest if taken for a short period of time, notes the Mayo Clinic. Laxatives are readily available over-the-counter, but you can also get prescription laxatives, such as plecanatide (Trulance), which treats irritable bowel syndrome (IBS) with constipation. By speeding up bowel movements, laxatives can cause your body to flush out too much water. “Laxatives stimulate bowel movements, and increased BMs to the point of diarrhea may cause the body to become dehydrated due to the loss of fluids,” says Dr. Nouhavandi. That’s why laxative abuse is dangerous. Always use these as prescribed, she says. RELATED: What the Color of Your Poop Says About Your Health
2. Oral Medications for Type 2 Diabetes
If you have type 2 diabetes, you may take a sodium glucose co-transporter 2 (SGLT2) inhibitor, an oral tablet that controls glucose and hemoglobin AIC (HbA1C) levels and helps prevent diabetes-related complications. Options include Invokana (canagliflozin), Farxiga (dapagliflozin), and Jardiance (empagliflozin), according to the Johns Hopkins Patient Guide to Diabetes. SGLT2 inhibitors work in your kidneys, ultimately causing more sugar to escape into your urine, explains Mitchell Howard, PharmD, a clinical assistant professor in the University of Toledo College of Pharmacy and Pharmaceutical Sciences. As a result, your kidneys will pull water from your body in order to dilute your urine, he says. This diuretic effect may have an upside: If you have hypertension, your blood pressure may drop, he says, and lower your risk of heart disease. Metformin is another common oral medication for type 2 diabetes; it’s associated with GI upset and diarrhea, and may contribute to dehydration, according to a May 2017 article published in the Journal of the American Geriatric Society. The risk of this side effect is particularly high in individuals who are just starting out with metformin, those who are taking high doses, and those on non-long-acting formulations. The NHS recommends taking small sips of water if you’re on metformin and feeling ill, and to avoid taking any medications to treat GI upset unless your doctor has okayed it.
3. Excedrin Migraine for Migraine
An over-the-counter migraine medication, Excedrin Migraine contains a combination of acetaminophen, aspirin, and caffeine. The caffeine is designed to provide another layer of pain relief and enhances the effects of acetaminophen, according to the Mayo Clinic, but it can also have a mild diuretic effect, says Ashley Ellis, PharmD, CDCES, the director of clinical operations at Compwell in Collierville, Tennessee. It’s important to treat migraine promptly, as there’s no reason to try to last through the pain, but keep in mind that you may want to hydrate while you do. RELATED: 8 Natural Hangover Remedies
4. Potassium-Sparing and Thiazide Diuretics for High Blood Pressure
There are a few different classes of diuretics (also called “water pills”), including thiazide and potassium-sparing diuretics. Both types of diuretics are common drug treatments for high blood pressure, says the Mayo Clinic. Diuretics in general trigger your kidneys to release sodium in your urine, which then takes water from your blood, helping you urinate out excess water. With less fluid in your veins, your blood pressure decreases, the medical center explains. As such, these can also contribute to dehydration. Continue to drink water normally to balance hydration levels (rather than under- or overconsuming H20).
5. Loop-Acting Diuretics for Heart Failure
If you have heart failure, you may be prescribed a diuretic, and one type is a loop diuretic. Furosemide (Lasix) and bumetanide (Bumex) are two popular loop diuretics, says Dr. Howard. These work by flushing built-up fluid in your body to relieve stress on your heart. Though these drugs may cause fluid loss, that’s the point, so you should not consciously drink more fluid to make up for what you may have lost. But that doesn’t mean you should become parched. “Continue to drink your healthy, normal amount that maintains your hydration,” he recommends. Because this medication increases urination, take it in the morning so you’re not up all night going to the bathroom, adds Howard. Talk to your cardiologist and primary care doctor about how to best monitor your hydration (clinically called fluid/volume status). They may ask you to weigh yourself daily to look for trends that suggest dehydration or a need to adjust your medication dosage. RELATED: How to Prevent and Treat Heart Disease
6. Apremilast for Plaque Psoriasis
Apremilast (Otezla) is a tablet that improves moderate-to-severe psoriasis by targeting a specific enzyme that reduces inflammation. One of the most common side effects is diarrhea, which can become severe enough to send patients to the hospital, the drug manufacturer notes. In their clinical studies, 17 percent of patients reported diarrhea compared with 6 percent in a placebo group. Nonetheless, diarrhea should go away in the first two weeks. Ask your doctor about what your plan should be if this side effect happens to you. And, if you have symptoms of dehydration in addition to diarrhea, talk to your doctor about the best way to rehydrate.
7. Chemotherapy Drugs for Cancer
Chemotherapy is frequently used to treat cancer, and these drugs come with a host of side effects, including nausea and vomiting. “The degree of vomiting that some of these drugs cause can be substantial,” says Dr. Emmel. There are many different factors that determine if your course of treatment will lead to these side effects, including type of drug, how it’s given to you, dose, and more, says the American Cancer Society (ACS). You may be given anti-emetic medication, which will help control nausea, the ACS points out. Other strategies include keeping a fluid diary to track hydration, prioritizing water-rich foods like soups, fruits, and vegetables or popsicles, and trying ice chips, suggests the organization. RELATED: What Are Some Signs and Symptoms of Cancer?
8. Lithium for Bipolar Disorder
According to the National Alliance on Mental Illness (NAMI), lithium (Eskalith, Eskalith CR, Lithobid) is a mood stabilizer that treats bipolar disorder. “Lithium can cause an increase in urination,” says Emmel. If you find that you have an insatiable thirst and you’re drinking way more than usual, notify your doctor. This drug can lead to diabetes insipidus, a rare condition in which you urinate a large volume of diluted urine; certain medications can treat it, but you’ll also want to drink enough to offset this urination, recommends the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
