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3 things to avoid when taking furosemide

Be careful of these food and drinks when taking the diuretic medication

You’ve probably experienced bloating and fluid retention at some point. Excess water and sodium retention can happen if you consume a large amount of salt. But It can also occur due to certain medical conditions, like liver, heart, or kidney problems. 

If you have fluid retention caused by health problems, your provider may prescribe furosemide. Also known by the brand name Lasix, the diuretic is commonly used to decrease edema (fluid retention) in patients with chronic health conditions. Currently, furosemide has approval from the Food and Drug Administration (FDA) to treat hypertension (high blood pressure) or edema caused by congestive heart failure, heart disease, liver disease, and kidney disease (including nephrotic syndrome).

If you’re taking a diuretic like furosemide, you might be wondering what foods to avoid and which to include in your diet. Here’s what you need to know.

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How furosemide works

Furosemide is a prescription drug that is available as a tablet or liquid. It belongs to a class of medications called loop diuretics. Diuretics, also known as water pills, increase urine output, says Denise Pate, MD, a board-certified physician and medical director at Medical Offices of Manhattan in New York. 

The kidneys are in charge of purifying the blood, eliminating waste, and controlling how much water and salt we have in our bodies. Furosemide works on the kidneys to help minimize water retention, says Dr. Pate. It works by opening channels in the kidneys that allow more fluid to escape into the urine, explains Fred Kuhn, MD, a board-certified cardiologist at The Heart Center at Mercy in Baltimore. “Think of the channels as a series of faucets that open and close; furosemide opens the faucet,” Dr. Kuhn says. 

In short, furosemide increases urine output and decreases the quantity of water and salt in the body, says Dr. Pate. She says it helps alleviate symptoms such as bloating, ankle or leg swelling, and trouble breathing due to illnesses such as heart failure, liver disease, or kidney difficulties.

3 foods and beverages to avoid with furosemide

Furosemide may be affected by certain foods and beverages, so your healthcare provider may recommend avoiding or limiting their intake. For example, you may wonder if you must avoid grapefruit juice, which interacts with many medications. Good news if you’re a grapefruit lover—according to Dr. Kuhn, the citrus fruit doesn’t interact with furosemide. That said, if you’re taking furosemide, you’ll want to watch your intake of high-sodium foods, caffeine, and alcohol.

1. High-sodium foods

Are you a fan of potato chips? You’ll want to pass on that extra salt if you’re taking furosemide. If someone is on a diuretic medication, they are probably already experiencing fluid retention, says Eric Ascher, DO, a board-certified family medicine physician at Northwell Health’s Lenox Hill Hospital in New York. 

Too much sodium causes our bodies to hold onto more water, potentially increasing swelling and fluid retention, Ascher explains, and advises to watch out for these foods in particular, which are all packed with sodium:

  • Frozen meals
  • Canned and jarred soups
  • Processed meats, including deli meats and hot dogs
  • Jarred condiments and sauces

If you’re unsure how much sodium a specific food contains, check the nutrition labels on its packaging. The American Heart Association recommends no more than 2,300 milligrams of sodium daily. Less than 1,500 milligrams is ideal for optimal heart health and blood pressure. 

And you’ll want to take it easy on the salt shaker, advises Dr. Kuhn. He suggests avoiding salty items in favor of fresh fruits, meats, and vegetables, which naturally contain much less sodium. Some natural foods like cheese and poultry, however, also have a high sodium content, so be aware of those items when considering your daily sodium intake.

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2. Caffeine

You love your daily latte—but is it safe to mix furosemide with caffeine? Caffeine also has diuretic characteristics, which can accelerate body fluid loss by increasing urine production. “Caffeine and furosemide used together may cause significant fluid loss and dehydration due to the combined diuretic effects,” Dr. Pate says.

It’s not just coffee you need to watch out for: The stimulant can be found in tea, energy drinks, and sodas, too. You may not need to give up caffeine altogether, according to Dr. Ascher. Moderation is key, he says, so be sure to speak with your healthcare provider about a safe amount. 

3. Alcohol

Whether your preference is a glass of wine or a hot toddy, it’s best to skip the alcohol when taking furosemide. That’s because alcohol is also a diuretic, and combining the two can cause severe dehydration, says Dr. Kuhn. 

Alcohol may even counteract your treatment by causing increased blood pressure and stress to your body, asserts Dr. Ascher. Alcohol can also worsen side effects of furosemide, such as dizziness, lightheadedness, and fainting, notes Dr. Pate. So, if you’re on furosemide, it’s best to go for a non-alcoholic mocktail instead.

What should you eat while taking furosemide?

Furosemide works by adjusting the way electrolytes like calcium, potassium, and magnesium are absorbed and secreted by the kidneys. As the drug works to rid the body of excess fluid, Dr. Ascher says loss of electrolytes often also occurs. 

That can be problematic because the body needs electrolytes for essential functions like fluid regulation and heartbeat. That’s why many patients taking furosemide receive advice to consume potassium-rich foods for electrolyte regulation, says Dr. Kuhn. Other patients may have health problems or other medications that actually cause potassium to go too high. It is best to get personalized medical advice on how much potassium you should get in the form of diet and supplements.

Potassium-rich foods to add to your diet if directed by your medical professional include:

  • Bananas
  • Apricots
  • Tomatoes
  • Potatoes
  • Orange juice
  • Spinach
  • Brussels sprouts
  • Dairy products

In some cases, your provider may recommend a prescription potassium supplement taken as a pill or capsule, says Dr. Kuhn, adding that patients taking furosemide need their potassium levels monitored periodically with a simple blood test.   

To assist with the absorption of furosemide, Dr. Pate encourages incorporating fiber-rich foods, such as whole grains, fruits, and vegetables, into your diet. Adequate hydration, consistent meal plans, and spacing out doses can help improve absorption as well.

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Other things to avoid with furosemide

In addition to certain food and drinks, there are other things you should avoid when taking furosemide, including over-the-counter (OTC) nonsteroidal anti-inflammatory medicines (NSAIDs). NSAIDs such as ibuprofen and naproxen can reduce furosemide’s effectiveness and diuretic impact, Dr. Pate explains. Moreover, the combination increases the risk of kidney problems. 

It’s important to tell your healthcare provider about all prescription medications and any vitamins and supplements you are taking, so they can advise you on possible drug interactions with furosemide.

Dr. Kuhn says herbal supplements like dandelion, hibiscus, and parsley, which have diuretic properties, can modestly increase the drug’s dehydrating effects. It’s best to avoid natural licorice, too, he advises. That’s because it increases blood pressure and decreases levels of potassium.

Dr. Kuhn also recommends the following lifestyle measures to help reduce or avoid excess fluid retention:

  • Stay active to help mobilize fluid trapped in the body’s tissues when we rest.
  • Keep your feet elevated above your heart to help drain built-up fluid from the legs and feet.
  • Avoid excessive heat and limit direct sun exposure as both heat and sun trigger the body to retain fluid as a natural way of cooling. 
  • Use sunscreen outdoors or stay in the shade, as furosemide increases sun sensitivity.

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Gastrointestinal side effects of furosemide

Furosemide can induce a number of adverse gastrointestinal (GI) effects. The most common side effects of furosemide affecting the GI system include:

  • Nausea and vomiting
  • Diarrhea or constipation
  • Abdominal discomfort or upset stomach

“A healthy diet rich in fiber, such as fruits, vegetables, and whole grains, can help support regular bowel motions,” Dr. Pate says. “While furosemide can cause diarrhea in some people, a high-fiber diet may exacerbate this symptom in others.” 

Although rare, it’s possible to experience gastrointestinal bleeding, fever, irregular heartbeat, weakness, or fainting, Dr. Ascher says. If any of these severe side effects occur, seek immediate medical attention.

It’s best to discuss any concerns or potential interactions with your healthcare provider, who can provide customized guidance based on your specific health situation and prescription regimen.