Did Drugs (Furosemide & Metoprolol) Trigger Diabetes?

Q. I take furosemide and metoprolol for high blood pressure. After several years on this regimen I was diagnosed with type 2 diabetes. Now I need to take metformin for elevated blood sugar. Everything I read says it is not good to take metformin with furosemide.

What can you tell me about side effects of furosemide, metoprolol and metformin? I often have muscle cramps and wonder whether they might be due to my medicine.

A. Furosemide (Lasix) is a fairly powerful diuretic that can deplete your body of essential minerals like potassium and magnesium. When such electrolytes are depleted from the body, muscles cramps are not unusual.

More disturbing, though, a diuretic like furosemide can raise blood sugar and might contribute to the development of type 2 diabetes. Beta blockers such as atenolol and metoprolol might also contribute to this problem. Diuretics like Lasix may also increase uric acid levels which could trigger a gout attack.

Here is an overview of side effects of the three medications you are taking:

FUROSEMIDE SIDE EFFECTS

• Potassium depletion
• Magnesium depletion
• Muscle cramps
• Dizziness
• Weakness
• Loss of appetite
• Blurred vision
• Ringing in the ears
• Nausea
• Increase in cholesterol
• Increase in triglycerids
• Rash
• Elevated liver enzymes
• Blood disorders

METOPROLOL SIDE EFFECTS

• Fatigue
• Slow heart rate
• Rash
• Diarrhea
• Dizziness
• Depression
• Difficulty breathing
• Cold hands and feet

METFORMIN SIDE EFFECTS

• Heartburn
• Stomach ache
• Diarrhea
• Gas
• Headache
• Nausea
• Loss of appetite
• Weakness
• Rash
• Lactic acidosis (symptoms may include irregular heart rate, nausea, stomach pain, lethargy, anxiety, low blood pressure and rapid heart rate)

Please discuss your medications with your MD. If the furosemide and the metoprolol are contributing to your diabetes, you may want to ask if there are other medications that would be appropriate. NEVER stop beta blockers like metoprolol or diuretics like furosemide suddenly or without medical supervision as this could lead to serious complications.

To help you with this conversation you may wish to consider our book, Best Choices From The People’s Pharmacy. We have a very thorough chapter on blood pressure control, diabetes management and medications. It will explain why beta blockers such as atenolol and metoprolol are no longer considered first line treatments for most patients with hypertension. Furosemide is also a heavy gun when it comes to treating mild to moderate high blood pressure. There are many other options including many non-drug approaches. Only you and your doctor can determine which approaches will be best for you. We hope this information can help in that process.