Bendroflumethiazide, sometimes referred to as bendrofluazide, is a medication classified as a thiazide diuretic. It is widely used in clinical practice to manage high blood pressure (hypertension) and fluid retention (edema), particularly in patients with heart failure, liver disease, or certain kidney disorders.
What Is Bendroflumethiazide Used For?
This medication helps remove excess fluid and lower blood pressure, offering benefits in several conditions:
- Hypertension: Often prescribed alone or in combination with other antihypertensive drugs
- Edema: Reduces swelling due to heart failure, cirrhosis, or nephrotic syndrome
- Nephrogenic diabetes insipidus (off-label use): Helps reduce excessive urination in this rare kidney condition
How Bendroflumethiazide Works
Bendroflumethiazide acts on the distal convoluted tubule in the kidneys, where it:
- Blocks the reabsorption of sodium and chloride, leading to increased urine output (diuresis)
- Lowers blood volume, helping to reduce blood pressure
- Promotes vasodilation, which further supports its antihypertensive effect
Dosage Guidelines
For High Blood Pressure:
- Typical dose: 2.5 to 5 mg once daily
- Lower doses are often effective for long-term blood pressure control
For Edema:
- Dose range: 5 to 10 mg per day
- Usually taken in the morning to prevent waking at night due to urination
Always take this medication exactly as prescribed by your healthcare provider.
Potential Side Effects
Common Side Effects of Bendroflumethiazide:
- Electrolyte disturbances:
- Low potassium (hypokalemia)
- Low sodium or magnesium levels
- High calcium levels
- Increased blood sugar (especially in diabetics)
- High uric acid levels, which may trigger gout
- Dizziness or lightheadedness, particularly when standing quickly
Rare But Serious Reactions:
- Inflammation of the pancreas (pancreatitis)
- Increased sensitivity to sunlight (photosensitivity)
- Severe sodium depletion (hyponatremia)
Drug Interactions
Use caution when combining bendroflumethiazide with:
- NSAIDs (e.g., ibuprofen): May reduce the medication’s effectiveness
- Digoxin: Low potassium increases the risk of digoxin toxicity
- Lithium: Can raise lithium levels, increasing the risk of side effects
- Other blood pressure medications: May cause additive blood pressure lowering
Contraindications & Warnings
Do not use bendroflumethiazide in the following cases:
- Severely reduced kidney function (eGFR <30 mL/min)
- Anuria (complete lack of urine output)
- Advanced liver disease
- Known sulfonamide allergy (cross-reactivity is possible)
- Pregnancy, unless the benefits outweigh the risks
Monitoring Recommendations
During treatment with bendroflumethiazide, routine monitoring is essential:
- Blood electrolytes, especially potassium and sodium
- Kidney function (creatinine, eGFR)
- Blood pressure readings
- Blood glucose (in patients with diabetes)
Helpful Tips for Patients
- Your doctor may recommend combining bendroflumethiazide with a potassium-sparing diuretic (e.g., amiloride) to reduce the risk of low potassium
- Unless advised otherwise, eating potassium-rich foods like bananas, oranges, or spinach may help maintain proper potassium levels
- Take the medication in the morning to reduce nighttime trips to the bathroom
Conclusion
Bendroflumethiazide is a trusted and effective diuretic that plays a crucial role in managing hypertension and edema. However, it should be used carefully, with appropriate monitoring, especially regarding electrolyte balance and kidney function.
Always follow your healthcare provider’s advice and attend regular checkups to ensure the medication is working safely and effectively.