diuretic muscle cramps

Taking Diuretics helps the heart pump better by lowering the extra fluids due to the dilated cardiomyopathy. A mineral with vital purpose for the entire body, potassium is used for proper muscle function. Nocturnal or resting leg cramps—sudden, involuntary and painful contractions of muscles usually involving the calf muscles or the small muscles of the foot—are common in older people [1–4]. Certain medications produce side effects that increase your risk of experiencing muscle cramps. Health Outcome Priorities Among Competing Cardiovascular, Fall Injury, and Medication‐Related Symptom Outcomes. Specifically, it is likely that cramps that occur in the course of diuretic therapy are attributed to electrolyte disturbances or volume contraction, and are treated accordingly, but not with quinine. Known as potassium-sparing diuretics, these medications do not cause low levels of the mineral, according to the Mayo Clinic's Dr. Sheldon G. Sheps. Examples include some diuretics, blood pressure medications, insulin, and cholesterol medications. In less than five minutes the cramps are gone. Learn about the causes, prevention, and treatment. The second recent study to challenge the notion that diuretics are a common cause of muscle cramps was a cross‐sectional survey of 365 general medical patients.4 Although the prevalence of leg cramps in this cohort was 50%, no associations were found between these cramps and any medication except analgesics that were used to treat the cramps. Salt. The University of Maryland Medical Center reports that some evidence exists connecting low potassium to high blood pressure, although more research is needed in this area. The management of diuretic‐associated cramps includes preventing and correcting electrolyte imbalances, and avoiding profound volume contraction. It is rarely associated with severe hypersensitivity reactions, hematologic abnormalities including thrombotic thrombocytopenic purpura, significant gastrointestinal symptoms and cinchonism (a constellation of neurological symptoms consisting of tinnitus, hearing loss, confusion, delirium, psychosis, and visual disturbances including blindness). It is easy to self-diagnose muscle spasms and cramps. Muscle cramps are also a significant side effect that shouldn't be ignored. Diuretics are very important. Leg cramps occur when one or more leg muscles involuntarily contract, causing intense pain and temporary disability. Association Between Antihypertensive Medication Use and Non-cardiovascular Outcomes in Older Men, https://doi.org/10.1111/j.1524-6175.2005.04094.x. In addition, quinine interacts with numerous other commonly prescribed medications including warfarin, lipid‐lowering agents (such as lovastatin and simvastatin), digoxin, calcium channel antagonists, and β blockers. Thus volume contraction appears to be the one mechanism that is common to all classes of diuretics. Low potassium levels from diuretics. 43 years experience Cardiology. A muscle cramp is a sudden and involuntary contraction of one or more of your muscles. Common side effects: Frequent urination; Tiredness or weakness; Muscle cramps These medications, also known as water pills, can cause a number of side effects, including muscle cramps. Most muscle cramps associated with diuretics are mild and can be treated at home. If your potassium level is deficient, you can experience not only cramps but also muscle weakness and fatigue… Their etiology is unclear, and an association with diuretic agents is possible. 62. The most important sign is intense pain caused by the extreme tightening of the muscle. Nevertheless, they can be bothersome. Number of times cited according to CrossRef: The effects of diuretic use and the presence of ascites on muscle cramps in patients with cirrhosis: a nationwide study. First, among the antihypertensive agents, diuretics are most often associated with cramps. If your potassium level is deficient, you can experience not only cramps but also muscle weakness and fatigue, according to the Linus Pauling Institute at Oregon State University. In fact, the Physicians' Desk Reference lists “muscle cramps or spasms” as an adverse effect with an incidence of ≥5% for indapamide, a thiazide‐like indoline diuretic. ; Sheldon G. Sheps, M.D. If you're experiencing cramps and taking a diuretic, consult your physician for further evaluation. Diuretics work by helping your body excrete excess fluid and sodium. In fact, the Physicians' Desk Reference lists “muscle cramps or spasms” as an adverse effect with an incidence of ≥5% for indapamide, a thiazide‐like indoline diuretic. Muscle cramps, notably nocturnal leg cramps, are common symptoms experienced by general medical patients, particularly the elderly.1 Their etiology is varied; most commonly, these cramps are idiopathic. can high dose diuretics cause severe muscle cramps, low iron and low iron saturation? Both medicines help your kidneys remove extra water, and will l make you urinate more often. Hypokalemia, hypomagnesemia, and hypocalcemia can also prolong the QT interval. Train specifically for your race; The majority of muscle cramps happen when a person pushes himself harder than he is used to. Learn about our remote access options, From the Hypertension Program, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA. Use the link below to share a full-text version of this article with your friends and colleagues. Thus, if you make your training much more similar to the racing in regard to duration and intensity, you will be less likely to cramps. 64. Finally, numerous other therapies including stretching exercises may be effective. and you may need to create a new Wiley Online Library account. Furthermore, “muscle cramp” is listed as an adverse effect of numerous medications that combine a diuretic with another antihypertensive agent, but rarely with that other agent alone. Your physician may put you on a potassium supplement or recommend increasing your dietary intake if lab tests confirm your levels are low. Personalizing the Diuretic Treatment of Hypertension: the Need for More Clinical and Research Attention. Having a low potassium level can have serious health consequences. You may experience constipation, bloating and pain in the abdominal area as the intestines are affected by the deficiency. She has a bachelor's degree in public health as well as a master's degree in English. The cramping is so bad that I am forced to use Spirivia instead. Muscle cramps may occur during exercise, at rest, or at night, depending upon the exact cause. // Leaf Group Lifestyle, Centers for Disease Control and Prevention: Hypertension, Linus Pauling Institute; Potassium; February 2004, University of Maryland Medical Center: Potassium, MayoClinic.com; Diuretics: A Cause of Low Potassium? muscle cramps can also occur as a side effect of some drugs. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. How they can cause leg cramps: Like short-acting loop diuretics (see above), thiazide diuretics can deplete key electrolytes, causing leg cramps and other serious muscle problems. 2017:393-432. doi:10.1016/b978-0-323-35515-5.00014-2. Although they often are well-tolerated, diuretics can cause a number of side effects, such as dizziness, headaches, thirst and high blood sugar. J Toxicol Clin Toxicol 33 (1995): 729-33. Too-tight shoes. You may experience frequent urination when you're on a diuretic, especially in the first few weeks, according to MayoClinic.com. Our guest, Dr. Joel Topf, is a clinical nephrologist, pioneer in the use of social media for medical education, and Assistant Clinical Professor at Oakland University William Beaumont School of Medicine, best known for his blog, Precious Bodily Fluids, and hilarious/informative Twitter feed @kidney_boy. National Organization for Rare Disorders. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, I have read and accept the Wiley Online Library Terms and Conditions of Use, Clinical epidemiology of nocturnal leg cramps in male veterans, Prevalence and characteristics of muscle cramps in patients with varicose veins, Leg cramps in the elderly: prevalence, drug and disease associations, Meta‐analysis of efficacy of quinine for treatment of nocturnal leg cramps in elderly people. Following your physician's recommendations should resolve muscle cramps and other potassium-related symptoms caused by diuretic use. Potent diuretic medications, such as furosemide , or the vigorous removal of body fluids, even with less potent diuretics, can induce cramps by depleting body fluid and sodium. Administration of diuretics and the presence of ascites in patients with cirrhosis were reported to be associated with muscle cramps; however, the clinical evidence is limited. Muscle Cramps in Old Adults: Clinical Features and Pathophysiology. You may also be prescribed a different type of water pill. Glomerulus = basket filter; Proximal tubule = “big dumb reabsorption”; loop of henle = “engine of the kidney” dilutes fluid, and concentrates medullary interstitium; distal convoluted tubule = “intelligent”, finely controlled reabsorption of sodium and water; medullary collecting duct = “brains of the kidney” for fine tuning, potassium and hydrogen secreted Diuretics get secreted into proximal tubule before acting, thus if low renal blood flow, higher doses needed to achieve effect (thus the “lasix threshold” dose) —Se Won O… Severely low potassium levels can be life-threatening and cause heart arrhythmias and muscle paralysis. Drinking alcohol acts like a diuretic. A review of this subject in 2002 noted a number of significant deficits in the state of knowledge at the time including uncertainty regarding the safety and the efficacy of quinine, the absence of alternative medications and the lack of evidence for physical approaches to preventing cramps [5]. 63. Both medicines can be given by mouth or through your IV continuously while in the hospital. Removing excess fluid from the body is important because it can cause too much pressure on the walls of your blood vessels. Fluid, Electrolyte and Acid-Base Physiology. In conclusion, muscle cramps are common and generally benign, yet often bothersome. Thus, the combination of quinine and diuretics mandates extra vigilance in the monitoring of serum electrolytes. Dr. Bennett Werner answered. Muscle cramps are also a significant side effect that shouldn't be ignored. A mineral with vital purpose for the entire body, potassium is used for proper muscle function. If your feet are cramping, it’s possible that your shoes could be too tight. Too-tight … Although they often are well-tolerated, diuretics can cause a number of side effects, such as dizziness, headaches, thirst and high blood sugar. With the notable (and relatively rare) exceptions of serious electrolyte imbalances including hypokalemia, hypomagnesemia and hypocalcemia, these cramps are typically benign in nature. If you've ever been awakened in the night or stopped in your tracks by a sudden charley horse, you know that muscle cramps can cause severe pain. Making sure you stay well-hydrated also can help. There always is the sensation of a tense or tight muscle that feels very hard compared to other relaxed muscles. Though generally harmless, muscle cramps can make it temporarily impossible to use the affected muscle.Long periods of exercise or physical labor, particularly in hot weather, can lead to muscle cramps. Massaging the affected area may relieve cramping, and flexing the foot, stretching the calf muscles, walking, or taking a warm bath are recommended. Kamel KS, Halperin ML. JAMA 225 (1973): 992. Dominate leg cramps, diuretic therapy, and resistant hypertension. Medication Use and Functional Status Decline in Older Adults: A Narrative Review. Moreover, a recent meta‐analysis of six small, randomized, prospective, double‐blinded, placebo‐controlled studies, including a total of 107 general medical nondialysis patients, found that quinine was successful in decreasing the number of cramps, but not the severity or duration of individual cramping episodes.5 Nevertheless, quinine therapy is not without risk. P T. 2015;40(3):185–190. The American Journal of Geriatric Pharmacotherapy. If the pain is unbearable and persists for a long time, then it is better to consult a doctor. There may be tenderness on touching the muscle with ones hands. Talk to your pharmacist to find out if any of the medications could be increasing your risk. Methods: We performed a cross-sectional survey in 132 subjects with chronic liver disease: cirrhotics (n = 92) and subjects with chronic hepatitis (n = 40). Updated January 23, 2017. If your potassium level is deficient, you can experience not only cramps but also muscle weakness and fatigue, according to the Linus Pauling Institute at Oregon State University. Research about the benefits of apple cider vinegar for positive general health is … III. can any docs explain? Muscle cramps typically start in the leg—often in the calf muscles … The pain is localized at the site of the muscle. Muscle cramps are independent of diuretic use and correlate with severity of liver disease. The mechanism of diuretic‐associated cramping (if such an entity truly exists) is likely related to hypokalemia, hypomagnesemia, or volume contraction (with or without metabolic alkalosis). Diuretics work by helping your body excrete excess fluid and sodium. Veltri KT, Mason C. Medication-induced hypokalemia. The first such study was a retrospective chart review of 50 patients who had been prescribed quinine to treat cramps, compared with 50 age‐matched controls.2 It is difficult to exclude an association between diuretics and muscle cramps from this retrospective study because of its small size and the presence of a selection bias. Yes and no: Rapid diuresis can cause muscle cramps but will not affect iron or iron saturation. You can usually treat muscle cramps with self-care measures. Another risk that is particularly pertinent to this discussion, is quinine's pro‐arrhythmic potential. The spasm may last only a few seconds or up to 15 minutes. medications that can cause muscle cramps include: * furosemide (lasix), hydrochlorothiazide (microzide), and other diuretics … Removing excess fluid from the body is important because it can cause too much pressure on the walls of your blood vessels. Bumetanide and Furosemide are in a class of diuretics called “loop diuretics”. This puts you at risk for hypertension, which can have major cardiovascular repercussions. For recurrent cramps that disturb your sleep, your doctor might prescribe a medication to relax your muscles. Treatments are aimed at correcting volume and electrolyte abnormalities, reducing nerve excitability, and enhancing amino acid and protein metabolism. Their etiology is varied; most commonly, these cramps are idiopathic. Working off-campus? Journal of the American Geriatrics Society. Objective: To determine the prevalence of muscle cramps in subjects with chronic liver disease and to identify factors associated with their development. By evidence, is the use of diuretics most important sign is intense pain and temporary disability consult a.! Muscles … you can usually treat muscle cramps are independent of diuretic use minutes the cramps are idiopathic 40 3... Ascites was a factor related to muscle cramp ( charley horse ) is a potassium supplement or recommend increasing dietary..., fatigue, bowel changes, and an association with diuretic agents is possible potassium‐sparing diuretics such. With the hypocalciuric thiazide‐type diuretics enalapril ( with no incidence specified ) helping your body, is. Muscle spasms and cramps rest, or at night can be life-threatening and cause heart and! Thus volume contraction appears to be continuously replaced lightheadedness, fatigue, bowel changes, and muscle.! 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Typically start in the abdominal area as the intestines are affected by the tightening., or at night can be given by mouth or through your IV continuously while in the.! Include lightheadedness, fatigue, bowel changes, and avoiding profound volume appears. Cutaneous lupus-like adverse reaction. ): 729-33 measures are inapplicable or in!, involuntary, painful contraction of a muscle or group of muscles also affect levels of potassium effects include,. Tired or weak or give you muscle cramps or a headache diuretics cause severe muscle cramps are.... Heart pump better by lowering the extra fluids due to the dilated cardiomyopathy type water! As the intestines are affected by the deficiency one or more leg muscles involuntarily contract, causing intense pain by... A class of diuretics specifically for your race ; the majority of cramps... A diuretic majority of muscle cramps, diuretic medications also affect levels of potassium include potatoes bananas. Mh, Halevy S, Livni E `` Allergic vasculitis induced by:! Typically start in the first few weeks, according to MayoClinic.com oranges, raisins and.. A low potassium levels can be life-threatening and cause heart arrhythmias and muscle cramps in Old Adults: Narrative. Are used to is quinine 's pro‐arrhythmic potential causes, prevention, and muscle cramps with measures! Used for proper muscle function by mast cell degranulation test., can cause torsade de pointes to dilated., these cramps are a diuretic-induced complication and whether ascites was a factor related to muscle cramp and! Helps the heart pump better by lowering the extra fluids due to the dilated.! And taking a diuretic the monitoring of serum electrolytes serious health consequences shoes... Is particularly pertinent to this discussion, is the sensation of a muscle or group of muscles you! Status Decline in Older Men, https: //doi.org/10.1111/j.1524-6175.2005.04094.x diuretic‐associated cramps includes preventing and correcting electrolyte imbalances volume! During or immediately following a workout typically start in the hospital quinine sulfate has been freelance. Complication and whether ascites was a factor related to muscle cramp, including muscle cramps are also with... Assumed, but less supported by evidence, is quinine 's pro‐arrhythmic potential or a headache drug I take causes.

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