Medicines for Ascites

Diuretics, such as spironolactone and furosemide, are a key treatment for ascites. They help the kidneys eliminate salt and water from the body. When diuretic medicines are combined with a low-salt diet, 90 out of 100 people are able to control their ascites.^{footnote 1}

Side effects of diuretics may include:

• Frequent urination.
• Increased thirst.
• Dry skin and eyes.
• Reduced levels of potassium, magnesium, and sodium in the blood. Very low levels of these salts (electrolytes) can lead to serious irregular heartbeats (arrhythmias).
• Increased levels of uric acid (which may lead to gout), calcium, blood sugar (which may complicate control of diabetes), triglycerides, and cholesterol.
• Weakness.
• Muscle cramps.
• Breast swelling and tenderness in males (gynecomastia) when spironolactone is used.

Higher doses can cause excess fluid loss from the body (dehydration), decreased kidney function (renal insufficiency), and fainting, especially in older adults. People who are taking diuretics to treat ascites caused by cirrhosis need to have their body weight, electrolytes, and kidney function carefully monitored while taking the medicines.

People who continue to have ascites despite the standard treatment with diuretics and a low-sodium diet may need additional treatments, such as repeated paracentesis.