Uncontrolled hypertension is a serious medical condition that can lead to organ damage or sudden vascular events. A major complaint about hypertension medications is the increased urination that accompanies some of them. There are ways to adjust to frequent urination and avoid stopping your treatment.
Give It Time
You need to give it time before changing your medication. After days or weeks of taking the medication, you should notice your urine output returns to normal. In the beginning, there is often excess fluid and salt in your body and the diuretic is removing it from your body. Make sure you are taking your medication early in the day or after you wake up, depending on your schedule. This will typically prevent frequent urination from disturbing your sleep. Additionally, be mindful of the timing of drinking fluids, especially caffeinated ones. Stop caffeine by early afternoon and avoid drinking too many fluids within a couple hours of bed time.
Adjust The Diuretic
Many hypertension medications are combination medicines, which means they might have an ACE inhibitor or beta-blocker combined with the diuretic, hydrochlorothiazide (HCTZ). If frequent urination is still an annoyance, talk with your doctor about lowering the HCTZ. The amount in your current prescription might be 25mg and your doctor might allow you to try the same version of your current medication with 12.5mg or 6.25mg of HCTZ. Another option is to take two separate pills instead of the combination pill. This makes it easier to adjust the dose of HCTZ independently of the anti-hypertensive.
Eliminate The Diuretic
Adjusting the diuretic to a lower dose, either by changing the prescription or taking it separately should make a difference in frequent urination. If you are still having problems, your doctor may need to consider whether having a diuretic is absolutely necessary. Eliminating the diuretic will depend on how your blood pressure responds with an ACE inhibitor or beta-blocker alone and if you have any other signs of vascular issues. For example, some people must stay on a diuretic if they have evidence of significant fluid retention, such as swollen ankles that remain dimpled when pressed (pitting edema). If your doctor determines your blood pressure is well-controlled with the anti-hypertensive, it may not be necessary to keep the diuretic.
Many people stop or skip their hypertension medications because of frequent urination. Since the problem usually goes away with continued treatment, it makes little sense to stop taking your medication. Working with your doctor can help you find a treatment that is effective for hypertension without the frequent urination.