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Is Furosemide Effective For Water Retention In The Legs In An Elderly Person?

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Posted on Wed, 13 Jul 2016
Question: I have wife 85 with water retention in her legs. how good are potassium pills and/or Furosemide for her ? i read that the latter is not recommended for "elderly people" She may have kidney problem. Has a lower left lung collapsed Has to use nebulizer twice a day to help her breathing Takes 2mg warfarin daily monitored bi-weekly. How can she rid water in legs without too much danger ???? XXXXXXX

doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
furosemide will help

Detailed Answer:
Hello,

if the water retention is due to some degree of heart failure (which sounds very likely at her age) then furosemide will help. Potassium has to be used only when low potassium levels are detected or anticipated. For example if she has a very low (but normal) potassium level, giving furosemide to her will cause the potassium to get even lower (and become abnormal). In such a case the anticipated potassium deficiency would be a good reason for supplementation. Otherwise measuring serum potassium is the right way to find out if potassium is needed or not.

The nebulizer (if a bronchodilator like salbutamol is used) will also lower her potassium levels a bit, so caution is required.

Other ways to get rid of the water is to raise the legs so that gravity will move the water towards the rest of the body. Furosemide would still be required to facilitate water excretion through the kidneys.

I suppose you meant 20mg of furosemide because 2mg is too low and doctors never prescribe such a small dose. 20mg is a low dose too but it's usually sufficient for mild to moderate cases of water retention. You should measure her body weight every day (if possible). Significant weight loss will be attributed to water loss due to furosemide. After 3-4 days you should be able to tell the difference regarding her leg size.

On the other hand, individuals with compromised renal functionality may have trouble to excrete the right amount of potassium. Therefore potassium supplementation may end up in high potassium levels.

So in conclusion, I believe that furosemide is an excellent choice for most cases of leg swelling but the effectiveness depends on the cause. Potassium supplementation requires prior measurement of potassium levels to be on the safe side.

I hope it helps!
Please contact me again, if you'd like any clarification or further information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (45 hours later)
You mention potassium. Not clear about role it plays in water retention. clarify please About heart failure term you usr, What symptom or form does it take ?
doctor
Answered by Dr. Panagiotis Zografakis (55 minutes later)
Brief Answer:
potassium has nothing to do with water retention

Detailed Answer:
Potassium has no role in water retention. It's just that the treatment for water retention is a drug (furosemide) that causes potassium to be eliminated from the body by excreting it in the urine. I hope it's clear now!

Heart failure may present with various symptoms. Some common symptoms are shortness of breath particularly on exertion, cough, leg swelling, fast heart rate, fatigue, etc. Clinical examination and - even better - a heart echo can help the doctor diagnose heart failure.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (11 minutes later)
Interesting reply. In the event the problem is --heart failure- what can one do to strengthen the heart----remedy---- of course we will talk with her doctor but wanted to field the question so to have a legs up. Can you explain ? BIG THANKS. XXXXXXX
doctor
Answered by Dr. Panagiotis Zografakis (30 minutes later)
Brief Answer:
no real remedy, just help the heart with drugs...

Detailed Answer:
You're welcome!

Heart failure does not have a real remedy besides heart transplantation. Its consequences can be handled (adequately most of the times) with drugs. Diuretics are very important in this regard. Other potentially useful drugs include antihypertensive medications, low-dose beta-blockers and spironolactone in advanced heart failure. Of course, you'll have to talk with a cardiologist and do some tests before starting any drug.

A temporary solution for her legs would be elevation. Elevating them above the heart level will make the water leave the extremities and reduce swelling.

I want to clarify that I'm not diagnosing anything right now. I'm just suggesting potential causes and solutions. Her case could be even simpler, like chronic venous insufficiency which only requires leg elevation and nothing more. Clinical examination and laboratory testing are important to provide clues to the doctor.

Kind Regards!
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3810 Questions

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Is Furosemide Effective For Water Retention In The Legs In An Elderly Person?

Brief Answer: furosemide will help Detailed Answer: Hello, if the water retention is due to some degree of heart failure (which sounds very likely at her age) then furosemide will help. Potassium has to be used only when low potassium levels are detected or anticipated. For example if she has a very low (but normal) potassium level, giving furosemide to her will cause the potassium to get even lower (and become abnormal). In such a case the anticipated potassium deficiency would be a good reason for supplementation. Otherwise measuring serum potassium is the right way to find out if potassium is needed or not. The nebulizer (if a bronchodilator like salbutamol is used) will also lower her potassium levels a bit, so caution is required. Other ways to get rid of the water is to raise the legs so that gravity will move the water towards the rest of the body. Furosemide would still be required to facilitate water excretion through the kidneys. I suppose you meant 20mg of furosemide because 2mg is too low and doctors never prescribe such a small dose. 20mg is a low dose too but it's usually sufficient for mild to moderate cases of water retention. You should measure her body weight every day (if possible). Significant weight loss will be attributed to water loss due to furosemide. After 3-4 days you should be able to tell the difference regarding her leg size. On the other hand, individuals with compromised renal functionality may have trouble to excrete the right amount of potassium. Therefore potassium supplementation may end up in high potassium levels. So in conclusion, I believe that furosemide is an excellent choice for most cases of leg swelling but the effectiveness depends on the cause. Potassium supplementation requires prior measurement of potassium levels to be on the safe side. I hope it helps! Please contact me again, if you'd like any clarification or further information. Kind Regards!