Other diuretics (loop, potassium-sparing, aldosterone antagonists)
Loop, potassium-sparing, and aldosterone antagonists are other classes of diuretics. They are used less commonly for the management of blood pressure.
ethacrynic acid (Edecrin)
Loop diuretics are strong diuretics most often used for treating congestive heart failure and edema. They are generally not used for treating high blood pressure (HBP) unless the goal of treatment is also to relief edema. However, loops are preferred over thiazide diuretics in patients with chronic kidney disease whose kidney function has been significantly compromised (GFR < 30 ml/min).
amiloride hydrochlorides (Midamor)
Potassium-sparing diuretics are poor antihypertensive agents when used alone. Even when combined with other diuretics (thiazide or loops), they provide very little blood pressure (BP) management benefits. They are generally used with diuretics to decrease the impact of potassium loss from diuretic use.
Aldosterone antagonists are potassium-sparing diuretics that are more effective for lowering BP. These agents are used in patients who continue to have elevated BP despite treatment with multiple medications. For instance, spironolactone is recommended in patients with persistently elevated BP despite treatment with the preferred three-drug regimen (an ACEI or ARB + long-acting CCB + long-acting thiazide diuretic).