Dear doctors: My problem is with my diuretic, indapamide 2.5 mg. My doctor told me that I have a normal prostate enlargement for my age. I am 80, and I take the indapamide once daily.
My problem is that I seem to urinate very often, because the prostate only allows a little through at a time. I do not sleep well, and this adds to my sleeping problem. Please advise me on this.
W.F.
Indapamide is a diuretic most commonly used for elevated blood pressure (hypertension), but it can be used in other conditions as well.
Diuretics force your kidneys to excrete more salt and water than they ordinarily would.
The result is that the pressure in the blood vessels is decreased, just the way a water balloon isn't as tight if you let a little water out.
However, after a few days, the amount of water coming out of the system is equal to the amount of water coming into the system.
People on diuretics don't urinate more often than people who are not on diuretics, only faster.
This is especially true for a short-acting diuretic, like furosemide (Lasix).
Benign enlargement of the prostate is also very common. It often restricts urine flow. The urethra, which carries the urine out of the bladder, goes right through the prostate gland, and can be constricted when the gland is enlarged.
You can try taking the diuretic very early in the day so that you make less urine in the evening and nighttime. It's also important not to drink too much fluid after about 4 p.m., if getting up at nighttime is a problem.
A second treatment would be to reduce the prostate's size, and there are very effective treatments for that.
Doctors Donohue and Roach regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors at P.O. Box 536475, Orlando, FL 32853-6475.
