Diuretics in COPD

Diuretics may be used in patients with oedema, e.g. ankle swelling, associated with cor pulmonale.

• patients presenting with cor pulmonale should be assessed for the need for long-term oxygen therapy
• oedema associated with cor pulmonale can usually be controlled symptomatically with diuretic therapy
• the following are not recommended for the treatment of cor pulmonale caused by COPD:
  • angiotensin-converting enzyme inhibitors
  • calcium channel blockers
  • alpha-blockers
  • digoxin (unless there is atrial fibrillation)

Reference:

1. National Institute for Health and Care Excellence. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. Jul 2019 [internet publication].