What is dehydration?

Dehydration is a condition where the body loses more water than it takes in, resulting in an imbalance that can lead to various health problems.

How Can Dehydration Happen?

• Vomiting, diarrhoea and fever (high temperature, sweating or shaking) can cause dehydration.
• If you have experienced sickness or dehydration once, it's unlikely that you are currently dehydrated. However, if you have had two or more  episodes of sickness or dehydration, you may be at risk and should be aware of "sick day rules."
• If you are currently taking medication for a long-term condition, please continue reading to learn more about managing your health during illness.

Sick Day Rules

"Sick day rules" refer to guidelines for managing medications when you are ill. Here are some general recommendations

1. Continue taking your prescribed medications unless instructed otherwise by your GP
2. If you develop a dehydrating illness, you should temporarily stop taking certain medications mentioned on this leaflet.
3. After recovering from illness, it is important to restart your medication once you can eat and drink normally, typically within 24-48 hours. Please
   remember to resume taking your prescribed medication as directed.
4. Do not take any extra pills or missed pills.

Ace inhibitors: Blood pressure and heart medication

Examples: Lisinopril, Enalapril, Ramipril, Perindopril etc. ( end in ‘pril’)

If you are dehydrated, these medicines can stop your kidneys working properly.

ARBs: Blood pressure and heart medication

Example: Losartan, Candesartan, Valsartan, Irbesartan

If you are dehydrated, these medicines can stop your kidneys working properly.

Diuretics: sometimes called ‘water pills’

Example: Furosemide, Bumetanide, Bendroflumethiazide, Indapamide, Spironolactone

These medicines can make dehydration more likely.

Flozins ( SGLT2 inhibitors): Used for Diabetics, Chronic Kidney Disease or in Heart Failure.

Examples: Dapagliflozin, Empagliflozin, Canagliflozin

These medicines can make dehydration more likely. You may have to do extra blood sugar or ketone readings.

Metformin: Used for Diabetes

Dehydration can make it more likely that you will develop a serious side effect called lactic acidosis.

NSAIDs: Used for Pain

Example: Ibuprofen, Naproxen, Diclofenac, Celecoxib, Etorcoxib

If you are dehydrated, these medicines can stop your kidneys working properly.

What Can You Do to Avoid Dehydration?

1. Drink enough fluids throughout the day, especially in hot weather or during physical activity.
2. Limit alcohol and caffeine intake as they can contribute to dehydration.
3. Take precautions in hot environments by seeking shade, wearing appropriate clothing, and staying hydrated.
4. If you are vomiting, take small sips of water/fluid frequently until symptoms have settled.

When to seek further care?

Speak to your GP if:

1. You have passed much less urine than you normally pass, or if you are unable to keep fluids down or have diarrhoea or vomiting for longer than 48 hours.
2. You are unwell and feel you need to speak to a clinician

If you have any doubts or concerns please contact your pharmacist, doctor or nurse or NHS 111.