Taking certain medicines when you are dehydrated or very unwell can result in you developing a more serious illness. This is because they can increase the risk of dehydration and lead to potentially serious side effects. This is known as Medicine Sick Day Rules. These medicines should be temporarily stopped ( after you have taken medical advice *) if you are at risk of becoming dehydrated with any of the following:
- Vomiting or diarrhoea (unless only minor)
- Fevers, sweats or shaking
You can restart the medication after 24 to 48 hours of eating and drinking normally. Do not take extra for missed doses.
Which medications should I consider stopping?
- ACE inhibitors: names ending in ‘pril’ - examples: lisinopril, perindopril, ramipril. A medicine for high blood pressure and heart conditions. If you are dehydrated, these medicines can stop your kidneys working properly.
- ARBs: names ending in ‘sartan’ - examples: losartan, candesartan, valsartan. A medicine for high blood pressure and heart conditions. If you are dehydrated,
these medicines can stop your kidneys working properly. - Diuretics: sometimes called ‘water pills’ - examples: furosemide, bendroflumethiazide, indapamide, spironolactone. Used for excess fluid and high blood pressure. These medicines can make dehydration more likely.
- SGLT2 inhibitors: names ending in ‘flozin’ - examples: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin. A medication used in the treatment of Diabetes, Kidney disease or Heart Failure. These medicines can make dehydration more likely and if you have diabetes can cause acid to build up if you are unwell.
What actions should I take?
If you develop a dehydrating illness, you should contact your Pharmacist, GP, specialist nurse or cardiac team as to whether you should stop temporarily stop taking any medicine listed here, and any other medicine identified by your health professional. It is very important that you restart your medicine once you have recovered from the illness. This would normally be after 24 to 48 hours of eating and drinking normally. When you restart your medicine, just take them as normal. Do not take extra for the doses you have missed.