How to Limit Fluids With Heart Failure

Medically Reviewed By William C. Lloyd III, MD, FACS

Nearly six million people in the United States are living with congestive heart failure (CHF). When your heart isn’t able to pump out enough blood due to heart failure, fluid builds up in your lungs and can cause shortness of breath. Doctors often recommend drinking less fluid and taking diuretic medications, or water pills, to flush more water and salt out of the body through urine. The goal of treatment is to reduce swelling, which makes it easier to breathe and helps avoid hospitalization.

What Limited Fluid Intake Looks Like

How much you should reduce your fluid intake—if at all—depends on the severity of your condition. People with severe heart failure may need to limit their fluid intake to six to nine cups of fluid a day. That’s equal to one to two and a half liters. If you’re worried about getting thirsty, these tips can help:

  • Don’t get too hot
  • Chew gum, suck on ice, or rinse your mouth with cold water
  • Reduce the amount of salt you eat—It not only makes you thirsty, it makes your body retain water

Keep track of your fluid intake by using pre-measured cups at home and writing down what you drink as you go. Make sure you account for foods that contain a lot of fluid like soup, yogurt, fruit, ice cream, pudding, and ice pops.

Types of Diuretics for Heart Failure

There are three main types of diuretics for heat failure, and each works on a different part of the kidneys. They may be taken alone or in combination.

  • Loop diuretics help the kidneys expel more urine
  • Thiazides widen the blood vessels to reduce water and salt in the body and lower blood pressure
  • Potassium-sparing agents reduce water levels in the body without reducing potassium levels

Diuretics that lower the potassium level in your body as a side effect can cause fatigue and muscle weakness. Your doctor may suggest extra potassium supplementation to make up the difference.

What to Expect With Diuretics for Heart Failure

Diuretics can cause more frequent urination and tiredness, but these side effects often get better over time. Depending on the specific diuretic medication, side effects can also include:

 Let your doctor know if you’re struggling with these side effects. Talk with your doctor immediately if you have:


Call 911 if you have difficulty breathing or swelling in your lips, tongue, throat, or face.

Monitoring Fluid Intake

To help monitor your fluid intake and treatment effectiveness, your doctor will likely ask you to commit to regular follow-up appointments. You’ll also need to plan to weigh yourself every day to check for weight gain from excess fluids. A weight gain of more than two or three pounds in one day or more than five pounds in one week can indicate a problem.  

Changing habits or starting new medications can be challenging for anyone. Remember, you’re doing it to feel better and live better with heart failure. Your healthcare team will work with you to make the adjustments easier, so don’t be afraid to ask for help.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Jan 18
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