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Most practitioners recommend stopping the previous medication and starting the new one at the lowest dose with standard titration

Some research also suggests it can aid in recovery by supporting hormone balance and reducing pain perception

Adverse Effects Electrolyte imbalance: hypokalemia, hyponatremia, hypocalcemia Dehydration and hypotension Ototoxicity (especially with rapid IV administration or with aminoglycosides) Hyperuricemia may precipitate gout Hyperglycemia (mild) Contraindications Severe electrolyte depletion (e.g., hypokalemia, hyponatremia) Anuria (no urine output) Hypersensitivity to sulfonamides (use with caution) Drug Interactions Aminoglycosides: risk of ototoxicity Digoxin: risk of digoxin toxicity due to hypokalemia NSAIDs: reduce diuretic effect Other antihypertensives: additive hypotensive effects Key Counseling Points Take in the morning to avoid nighttime urination

If the patient is pregnant or breastfeeding, inform the prescriber usually, injections continue as needed, and B even passes into breast milk (beneficial)

doi: 10.1038/nature09922 11 LiangYLiYLeeCYuZChenCLiangC