What Foods To Eat And Avoid When Taking Furosemide (Lasix)

Even if you haven’t heard of the medication furosemide, you’ve probably heard its informal name – “water pills.” 

Furosemide can alter your fluid balance and has potential side effects and risks. 

Adjusting your diet while taking furosemide can help reduce the chances of having severe side effects or complications.

Keep to reading to learn what foods you should avoid when taking furosemide, and which foods you should include in your diet.

What is furosemide?

Furosemide is a prescription loop diuretic or “water pill.” The common brand name for furosemide is Lasix. Furosemide is typically prescribed in 20-80 milligram doses, either once daily or split into multiple doses.

What is furosemide used for?

Furosemide can treat various health conditions, including congestive heart failure, high blood pressure, kidney disease, fluid retention (edema), and other health conditions.

The main reason for using furosemide is to help remove extra fluid from your body, which can worsen health conditions like heart failure and kidney disease.

How does furosemide work?

Furosemide is a diuretic, which means it helps your body get rid of fluid and sodium through increased urination. Furosemide helps your kidneys remove more sodium from your body, which pulls water along with it. This means you urinate more often while taking furosemide, which is beneficial if you suffer from fluid retention.

Foods to avoid when taking furosemide 

Below are some foods you should avoid when taking furosemide.

Certain herbs

Some herbs have diuretic properties and should be avoided while taking furosemide. Dandelion, uva ursi, juniper, buchu, hibiscus, and parsley are all herbs that may have a diuretic effect, so you should avoid them while taking furosemide.

Licorice is another herb that might negatively interact with furosemide. Licorice root contains glycyrrhizic acid, which can lower your blood potassium levels (1). Taking licorice root with furosemide might lead to hypokalemia, a condition where your blood potassium levels are too low (more on that later).

High-sodium foods

The point of diuretics is to remove excess fluid from your body. Eating a sodium-rich diet causes your body to hold on to more fluid, which counteracts the action of furosemide. 

Eating too much sodium can worsen health conditions that furosemide is meant to treat, such as high blood pressure and heart failure.

Sodium is found in table salt, which is what most people think of when they think of a low-sodium diet. However, table salt isn’t the main source of sodium in most people’s diets. Instead, processed and convenience foods are the leading culprit for sodium. 

Some examples of high-sodium foods include:

• Smoked, cured, or canned meats, including bacon, deli meat, sausage, sardines, anchovies, etc.
• Frozen dinners like burritos, pizzas, and other “TV dinners.”
• Canned meals like chili, soups, “Spaghetti-O’s,” etc.
• Canned beans and vegetables with salt added.
• Salty snacks like chips, microwave popcorn, pretzels, etc.
• Quick-bread mixes like pancakes, muffins, etc. – contain baking soda, which is very high in sodium.
• Salad dressings, sauces, marinades, etc.
  

Processed cheeses are much higher in sodium than natural cheese. One 21-gram slice of processed American cheese contains 273 milligrams of sodium, while 28 grams (larger portion) of mozzarella contains 175 milligrams of sodium.

According to the American Heart Association, these six popular foods (known as the Salty SIx) can add high levels of sodium to your diet:

1. Bread and rolls
2. Pizza
3. Sandwiches
4. Cold cuts and cured meats
5. Soup
6. Burritos and tacos

Aim to keep your sodium intake below 2,300 milligrams (the current recommended daily amount). Below 2,000 milligrams is ideal.

Foods to eat while taking furosemide

Now we’ve discussed which foods you should avoid, below are some foods you should eat when taking furosemide.

Potassium-rich foods

Because furosemide is a potassium-wasting (can lower your potassium levels) diuretic, you should try to eat enough potassium in your diet to counteract the loss of potassium.

The recommended amount of potassium for men aged 19 and older is 3,400 milligrams per day and 2,600 milligrams per day for women 19 and older. 

Potassium is in many plant-based foods like fruits and vegetables. Aim to include plenty of fruits and vegetables as part of a healthy diet while taking furosemide.

Some potassium-rich foods include:

Fruits

• Apricots
• Bananas
• Cantaloupe
• Dried fruit
• Honeydew melon
• Kiwi
• Mango
• Nectarines
• Oranges and orange juice
• Papaya
• Pomegranate and pomegranate juice
• Prunes and prune juice
• Pumpkin
• Raisins
• Tomatoes, tomato sauce, and tomato paste

Vegetables

• Acorn squash, butternut squash, Hubbard squash
• Avocado
• Artichoke
• Beets
• Baked beans, black beans, refried beans
• Broccoli (cooked)
• Brussels sprouts
• Kohlrabi
• Lentils
• Okra
• Onions (fried)
• Parsnips
• Potatoes
• Rutabagas
• Spinach (cooked)
• Vegetable juice

Other foods

• Bran products
• Chocolate
• Coconut
• Creamed soups
• French fries
• Granola
• Ice cream
• Milk 
• Miso
• Molasses
• Nuts
• Peanut butter
• Potato chips
• Salt substitutes
• Seeds
• Tofu
• Yogurt

Magnesium-rich foods

If you’re taking furosemide, there’s a good chance you might have heart problems like heart failure or high blood pressure. Eating magnesium-rich foods can help your blood vessels relax, which can help reduce high blood pressure.

Magnesium is in plant-based foods like vegetables, whole grains, nuts, and seeds. 

Examples of magnesium-rich foods are:

• Pumpkin seeds
• Almonds
• Spinach
• Cashews
• Peanuts
• Soymilk
• Black beans
• Edamame
• Dark chocolate
• Peanut butter
• Whole wheat bread

What foods are diuretics?

Some foods and drinks act as diuretics by making you urinate more. You should take caution when eating and drinking diuretic foods and drinks while taking furosemide so that you don’t lose too many fluids and become dehydrated.

Caffeinated beverages

Caffeine is a diuretic and can increase how much you urinate. While it’s likely safe to have small amounts of caffeine while on furosemide, avoid excessive amounts from drinks like espresso beverages and energy drinks.

Some fruits and vegetables

Fruits and vegetables have high water content, so they contribute to your total fluid intake. Some fruits and vegetables are especially high in water, so they can have a diuretic effect if you eat enough. 

Some fruits and vegetables with a diuretic effect include:

• Lemons
• Celery
• Garlic
• Onions
• Bell peppers
• Watermelon
• Cucumbers
• Ginger
• Grapes
• Asparagus
• Pineapple

Alcohol

Drinking alcohol suppresses the hormone vasopressin, which usually helps the kidneys hold on to fluid. With vasopressin suppressed, more fluid is lost through urine.
In addition, drinking alcohol reduces the production of a hormone called antidiuretic hormone (ADH), which prevents the loss of fluid through diuresis.

Other things to avoid while taking furosemide

Avoid taking laxatives

Laxatives can put you at greater risk of dehydration and electrolyte imbalances while taking furosemide. If you suffer from constipation while taking furosemide, ask your healthcare provider what they recommend to help relieve constipation.

Don’t drink excessive amounts of alcohol

Lasix can make you feel lightheaded. Drinking excessive amounts of alcohol can worsen your lightheadedness and may also contribute to dehydration by acting as a diuretic. 

Avoid exposing your skin to excessive sunlight

Taking furosemide might make you more sensitive to sunlight and prone to sunburn. Getting sunburned increases your risk of getting skin cancer. 

Practice safe sun tips while taking furosemide like:

• Wearing sunscreen every day. Don’t forget to re-apply if you sweat or have been exposed to water.
• Avoid sun in the middle of the day, from about 10 a.m. to 3 p.m. The UV rays that cause skin damage are highest at this time.
• Wear protective clothing like lightweight long sleeves and slacks, a wide-brimmed hat, etc., especially if you don’t have access to shade.
• Wear sunglasses that filter UV light.

Avoid taking furosemide if you’re pregnant or nursing

Furosemide is a pregnancy category C drug, which means it’s not clear if it could cause harm to an unborn baby. In animal studies, furosemide caused unexplained maternal deaths and abortions among pregnant rabbits.
Taking furosemide while breastfeeding could lower your breastmilk supply and could affect your baby, so you should avoid it while nursing.

What do I need to know before taking furosemide?

We’ve already covered many of the important aspects of furosemide, such as how it works, what it’s used for, and food and drinks to avoid while taking it. 

Before taking furosemide, you should have a clear understanding of why you’re taking it. Other things you should clarify with your healthcare provider include:

• How much furosemide to take, and at what time(s)
• What to do in the event of a missed dose
• What types of side effects you should report to your healthcare team
• How long you’re expected to take furosemide

Should furosemide be taken with food?

Furosemide can be taken with or without food but may be more effective when taken on an empty stomach. If you experience an upset stomach from taking furosemide, then taking it with food or a glass of milk can help reduce stomach upset.

What is the best time to take furosemide?

Patients should take Lasix once or twice a day, typically in the morning and around lunchtime. Always follow your healthcare provider’s instructions which are printed on the label of your prescription medication.

Any other safety concerns? 

Side effects

Furosemide comes with potential risks and side effects. While most people only notice increased urination as a side effect, there are more serious side effects to watch out for. Most of the more serious side effects result from dehydration and electrolyte imbalances.

• Dehydration. Furosemide causes your body to lose more fluids and electrolytes than it normally would, which can lead to dehydration.
• Electrolyte imbalances. Along with dehydration, electrolyte imbalances are possible while taking furosemide. Some of the most prevalent electrolytes in the human body are sodium, potassium, and chloride.

Symptoms related to dehydration:

• Muscle cramps
• Weakness
• Tiredness
• Confusion
• Severe dizziness
• Low blood pressure
• Dry mouth
• Unusual thirst
• Irregular heartbeat
• Nausea/vomiting
• Constipation
• Headache
• Blurred vision

Hypokalemia

Furosemide is known as a potassium-wasting diuretic (some other types of diuretics are considered potassium-sparing), which means it can lower your blood potassium levels. Low blood potassium is called hypokalemia, and it can be dangerous.

Low potassium levels can impact your heart and cause palpitations and heart failure. According to a study, hypokalemia among cardiovascular patients increased the risk of heart issues and mortality by up to 10-fold (2).

Symptoms of hypokalemia include:

• Constipation.
• Heart palpitations (irregular heartbeat)
• Extreme tiredness
• Muscle weakness/spasms
• Tingling and numbness
• Muscle twitches and/or cramps
• Severe muscle weakness which can lead to paralysis
• Low blood pressure (hypotension)
• Lightheadedness
• Abnormal heart rhythms 
• Excessive urination 
• Excessive thirst 

How to reduce the side effects of furosemide

Take furosemide as prescribed

Be sure to follow your healthcare provider’s dosage instructions carefully. Never increase your dose on your own, which can increase the risk of serious side effects while taking furosemide.

Eat plenty of potassium-rich foods

To avoid hypokalemia, include potassium-rich foods in your daily diet. Your healthcare provider might also recommend a potassium supplement if you’re at risk of low potassium levels from taking furosemide.

Stay hydrated

You might be tempted to avoid drinking a lot of fluids because you don’t want to urinate even more than you are while taking furosemide. It’s important to stay hydrated while taking furosemide to reduce your risk of dehydration and electrolyte imbalances.

Take it with food

If you experience nausea from taking furosemide, take it with a meal instead of on an empty stomach. If you don’t have time for a meal, take it with a glass of milk to help reduce GI symptoms.

• For constipation: if you develop constipation from taking furosemide, try increasing your water and fiber intake. Aim to get at least 25 grams of fiber per day. Fiber-rich foods include fruits, vegetables, whole grains, legumes, nuts, and seeds.
• For diarrhea: you might fall on the other end of the spectrum and experience diarrhea while taking furosemide. Avoid eating an extremely high fiber diet when you’re experiencing diarrhea, and be sure to replace lost fluids and electrolytes (sports drinks work well for severe diarrhea). Soft, bland foods like a BRAT diet (bananas, rice, applesauce, toast) can help with diarrhea, as can soda/saltine crackers and other low-fiber foods.

Conclusion

Furosemide helps remove excess fluid and salt from your body to treat edema and other health conditions impacted by your fluid balance. 

Avoid high-sodium foods and diuretic foods and drinks while taking furosemide. Try to increase your intake of potassium-rich foods to help prevent electrolyte imbalances, and be sure to stay hydrated to prevent dehydration while taking furosemide.

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