Water pill helps with nighttime urination

A diuretic, or "water pill," used to treat high blood pressure appears to be an effective treatment for frequent nighttime urination or "nocturia" in men who have failed to respond to standard drug treatment, new research suggests.

Hydrochlorothiazide, which is available under several different trade names, may be an appropriate treatment for men with both high blood pressure and nocturia, senior investigator Dr. Jae-Seung Paick told Reuters Health, since it is effective, safe, and inexpensive.

In the journal Urology, Paick and colleagues at Seoul National University College of Medicine, Korea report on their study of 72 men who showed little improvement in nocturia after treatment with the first-line drug, terazosin, (Hytrin) for 4 weeks.

The patients were then treated for another 4 weeks with daily terazosin and hydrochlorothiazide. "The patients were instructed to take the hydrochlorothiazide 8 hours before bedtime and the terazosin at bedtime," the team notes.

In all, 53 of the men completed the study. There were no serious side effects and no dose reductions were required in any of the patients, the investigators report.

Fourteen patients had a reduction in nocturia symptoms of 25 percent or more, 31 achieved a reduction of up to 24 percent and the remaining patients had an increase in symptoms.

The researchers concede that the study had limitations including no tracking of blood pressure, something they suggest may be particularly important to do in elderly patients.

Nevertheless, they conclude that the "findings suggest that the use of a diuretic agent, such as hydrochlorothiazide, might be a reasonable second-line treatment option for these patients."

SOURCE: Urology, March 2009.