Diuretics change what your kidneys keep and what they throw away, so their supplement interactions are almost all mineral interactions — magnesium, zinc, calcium and lithium. Which direction the risk runs depends on which kind of water pill you take.
Below is every interaction Magellan documents for this class — 5 entries across 4 supplements, each with the mechanism as the cited reference states it, how serious that reference treats it, and where to take the question next.
Magellan’s Medication Safety Check runs entirely on your device — type the medicines you take and it flags every documented interaction in this dataset. Nothing you type is sent anywhere.
Open the Medication Safety Check →Chronic use of these diuretics increases urinary magnesium loss and can lead to magnesium depletion, which may affect how much supplemental magnesium is needed or how levels should be monitored.
These diuretics reduce urinary excretion of magnesium and can raise magnesium levels; combining with magnesium supplements may increase the risk of elevated magnesium, particularly with impaired kidney function.
Thiazides decrease urinary calcium excretion; combined with vitamin D supplements (which increase intestinal calcium absorption), this can lead to hypercalcemia, especially in older adults or those with impaired kidney function or hyperparathyroidism.
These diuretics increase urinary zinc excretion, which can lower serum zinc concentrations over time.
Thiazide and loop diuretics decrease lithium clearance by the kidneys, increasing lithium levels and toxicity risk.
Medicines in this group include: Hydrochlorothiazide (Hctz, Microzide), Chlorthalidone (Thalitone), Indapamide (Lozol), Furosemide (Lasix), Bumetanide (Bumex), Torsemide (Demadex), Spironolactone (Aldactone), Eplerenone (Inspra), Amiloride (Midamor), Triamterene (Dyrenium).
Brand names are listed in brackets after the generic ingredient. If the name on your bottle is not here, the generic name on the label almost always is — and the Medication Safety Check accepts either.
These are the warning signs that go with the medication classes on this page. They are general safety-netting, not a prediction that any supplement will cause them.
If something feels seriously wrong, do not wait for an appointment. Call 911 (US) or your local emergency number.
Severity describes the interaction as the cited reference frames it, not how a specific person will react. A “minor” entry in someone with kidney disease, on five other drugs, can matter more than a “major” one in someone on nothing else.
This is a curated set of interactions with citations — not an exhaustive pharmacology database. An interaction that is absent here has not been ruled out; it may simply not be documented in the references Magellan curates from. Supplements are also not batch-tested for identity or contamination the way prescription drugs are, so what is on the label is a claim rather than a guarantee. And most of these entries come from case reports and mechanistic work rather than randomized trials, which is exactly why the sensible response is a pharmacist review rather than either alarm or dismissal.
5 documented interactions in total.
4 documented interactions in total.
3 documented interactions in total.
4 documented interactions in total.
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Magnesium, Vitamin D3, Zinc, Low-dose lithium (lithium orotate) — 5 documented entries in total (1 major, 3 moderate, 1 minor). Each entry on this page names the reference it came from.
In this dataset the class includes Hydrochlorothiazide, Chlorthalidone, Indapamide, Furosemide, Bumetanide, Torsemide and others. Brand names are mapped to their generic ingredient inside the Medication Safety Check, so typing the name on your bottle works.
Usually not. Most entries here call for one of three things: separating the doses by a few hours, monitoring a lab value or a home reading for a couple of weeks, or a prescriber-led dose adjustment. The decision belongs to the clinician who manages the prescription — what this page is for is making sure the conversation happens before you start rather than after something goes wrong.