Diuréticos tiazídicos
Revisado por pares por Dr Surangi Mendis, MRCGPÚltima actualización por Dra. Rachel Hudson, MRCGPLast updated 1 Nov 2023
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En esta serie:Presión arterial altaVivir con presión arterial altaMedicina para la presión arterial alta
Los diuréticos tiazídicos se utilizan principalmente para tratar la hipertensión arterial. También se usan ocasionalmente para la insuficiencia cardíaca.
At a glance
Thiazide diuretics are a type of medicine, sometimes called 'water tablets'.
They are commonly used to treat high blood pressure.
They work by helping your kidneys pass out more fluid and by widening blood vessels.
Possible side effects include changes in blood sugar, uric acid, and salt balance.
They are usually taken once a day in the morning.
Most people do not notice a great increase in urine with these diuretics.

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Video picks for Medicamentos para el corazón y la sangre
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What are thiazide diuretics?
A diuretic is a medicine which increases the amount of water that you pass out from your kidneys. A diuretic causes an increase in urine, called a diuresis. So, they are sometimes called 'water tablets'. There are different types of diuretics which work in different ways and thiazide diuretics are one type of diuretic.
Thiazide diuretics are a common treatment for presión arterial alta (hipertensión). They are also occasionally used to clear fluid from the body in conditions where your body accumulates too much fluid, such as insuficiencia cardíaca. However, a different type of diuretic called a loop diuretic is more commonly used to treat heart failure.
Thiazide diuretic examples
Volver al contenidoThere are a number of thiazide diuretics - they include:
Each drug has a number of different brand names.
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How thiazide diuretics work
Volver al contenidoOne of their effects is to make the kidneys pass out more fluid. They do this by interfering with the transport of salt and water across certain cells in the kidneys.
Thiazide diuretics tend to have only a weak action on the kidneys so you don't notice a great increase in urine if you take these (compared with loop diuretics).
They also have the effect of widening (dilating) blood vessels. A combination of these two effects reduces the blood pressure.
Thiazide diuretics side-effects
Volver al contenidoSide-effects are uncommon, as the dose needed to lower blood pressure is low. The leaflet which comes in the tablet packet provides a full list of possible side-effects. So, it is important to read that leaflet if you are prescribed a thiazide diuretic.
Common or serious possible side-effects include:
A possible increase in your blood sugar level. Some people with diabetes may need more treatment to keep the blood sugar level normal.
A possible increase in the level of uric acid. So, if you have gout, you may have more gout attacks. A first attack of gout is sometimes triggered by taking a diuretic.
The salt balance in the bloodstream is sometimes upset which can cause a low blood level of potassium, sodium and magnesium, and a high level of calcium. These effects may cause weakness, confusion and, rarely, abnormal heart rhythms to develop. You may be advised to have a blood test to check for these problems.
Other problems, such as:
Malestar estomacal.
Dizziness on standing - due to too baja presión arterial (hipotensión).
Erection problems (impotence) - often reversible on stopping treatment.
Skin sensitivity to sunlight.
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Otras consideraciones
Volver al contenidoMost thiazide diuretics are taken once a day in the morning. Any reduction in blood pressure is maintained throughout the 24 hours by this once-a-day dose. However, the effect of passing extra urine wears off within 12 hours.
So, you will not have to get up in the night to make extra trips to the toilet. Indeed, the dose used to treat high blood pressure (hypertension) is quite low, and many people barely notice an increase in the amount of urine that they pass.
Patient picks for Medicamentos para el corazón y la sangre

Tratamiento y medicación
Diuréticos de asa
Los diuréticos de asa se utilizan comúnmente en el tratamiento de la insuficiencia cardíaca. En esta condición, el líquido se acumula en su cuerpo, debido a que el corazón no bombea sangre por el cuerpo tan bien como lo haría normalmente. Por lo tanto, puede quedarse sin aliento (ya que el líquido se acumula en los pulmones) y sus tobillos y piernas pueden hincharse con líquido extra en los tejidos (edema). Los diuréticos de asa también se utilizan para tratar otras condiciones que causan acumulación de líquido en el cuerpo, como ciertos trastornos del hígado y los riñones. A veces también se utilizan para tratar la presión arterial alta (hipertensión). Sin embargo, generalmente, un tipo diferente de diurético llamado diurético tiazídico se utiliza más comúnmente para tratar la presión arterial alta. Hay diferentes tipos de diuréticos. Los diuréticos de asa son un tipo. Incluyen furosemida, bumetanida y torasemida. Cada uno viene en diferentes nombres de marca.
por el Dr. Colin Tidy, MRCGP

Tratamiento y medicación
Aspirina y otros medicamentos antiplaquetarios
La mayoría de las personas que tienen una enfermedad cardiovascular (por ejemplo, angina, enfermedad arterial periférica, o un ataque al corazón previo, ataque isquémico transitorio (AIT) o accidente cerebrovascular) toman una aspirina de baja dosis (75 mg) cada día o clopidogrel (75 mg) cada día. Esto reduce el riesgo de ataque al corazón en aproximadamente un tercio. Reduce el riesgo de tener un accidente cerebrovascular en aproximadamente un cuarto. Una dosis baja diaria de aspirina también reduce el riesgo de desarrollar varios tipos de cáncer comunes, pero no se aconseja que toda la población tome aspirina por esta razón. Esto se debe a que en algunas personas la aspirina puede aumentar el riesgo de sangrado estomacal y úlceras estomacales, que a veces son fatales.
por la Dra. Toni Hazell, MRCGP

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Preguntas frecuentes
What is the main difference between thiazide diuretics and other types, like loop diuretics?
Thiazide diuretics work by interfering with the transport of salt and water in the kidneys, and they also widen blood vessels, which helps reduce blood pressure. They have a weaker effect on increasing urine output compared to loop diuretics. Loop diuretics are more commonly used when the body has too much fluid, such as in heart failure, whereas thiazide diuretics are a common treatment for high blood pressure.
Will I need to go to the toilet frequently throughout the night if I take a thiazide diuretic?
No, you should not need to make extra trips to the toilet during the night. Thiazide diuretics are usually taken once a day in the morning, and while they help reduce blood pressure for 24 hours, the effect of passing extra urine typically wears off within 12 hours. The dose used for high blood pressure is often low, and many people barely notice an increase in urine.
Can taking this medication affect my blood sugar or uric acid levels?
Yes, taking a thiazide diuretic can potentially increase your blood sugar level, which might mean people with diabetes need more treatment to maintain normal levels. It can also increase uric acid levels, which might trigger more gout attacks if you already have the condition, or even a first attack.
What should I do if I experience dizziness after starting a thiazide diuretic?
Dizziness upon standing can be a side-effect of thiazide diuretics, often due to blood pressure becoming too low (hypotension). This is one of the possible side-effects of the medication.
Are there any effects related to the salt balance in my body, and will I need blood tests?
Yes, thiazide diuretics can sometimes upset the salt balance in your bloodstream. This could lead to low levels of potassium, sodium, and magnesium, and a high level of calcium. These imbalances might cause weakness, confusion, and rarely, abnormal heart rhythms. You may be advised to have a blood test to check for these potential problems.
Will drinking more water help prevent side-effects or improve how the medication works?
The article suggests that thiazide diuretics interfere with salt and water transport in the kidneys. It does not provide guidance on whether drinking more water helps prevent side-effects or improves the medication's effectiveness.
Can taking a thiazide diuretic cause issues with sexual function?
Yes, erection problems (impotence) are listed as a possible side-effect of thiazide diuretics. This particular side-effect is often reversible if the treatment is stopped.
Lecturas adicionales y referencias
- Hipertensión en adultos: diagnóstico y manejo; NICE (agosto 2019 - última actualización noviembre 2023)
- Burnier M, Bakris G, Williams B; Redefining diuretics use in hypertension: why select a thiazide-like diuretic? J Hypertens. 2019 Aug;37(8):1574-1586. doi: 10.1097/HJH.0000000000002088.
- Pham D, Grodin JL; Dilemmas in the Dosing of Heart Failure Drugs: Titrating Diuretics in Chronic Heart Failure. Card Fail Rev. 2017 Nov;3(2):108-112. doi: 10.15420/cfr.2017:10:1.
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About the authorView full bio

Dra. Rachel Hudson, MRCGP
General Practitioner and Medical Author
MBChB, MRCGP (2008), BSc (Medical Science), DFSRH, DRCOG, DCH
Dr Rachel Hudson, is an NHS GP working in the North West of England.
About the reviewerView full bio

Dra. Surangi Mendis, MRCGP
Consultant and Medical Author
MBBS, BSc (1st), MRCGP (2014), DFSRH, PGcert otology and audiology
Surangi Mendis is a consultant in Audiovestibular Medicine and Neuro-otology at The Royal National ENT and Eastman Dental Hospitals, UCLH.
Historial del artículo
La información en esta página está escrita y revisada por pares por clínicos calificados.
Próxima revisión: 30 de octubre de 2028
1 Nov 2023 | Última versión

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