This page gives you information about what actions to take if you develop an illness that causes dehydration (your body becomes short of fluid). These actions are called “medicine sick day rules”.
This information is for people taking the following medicine(s) – these are known as ‘SADMAN’ drugs:
| S | A | D | M | A | N |
| SGLT2 drugs | ACEinhibitors | Diuretics | Metformin | ARB’s | NSAIDs |
| e.g. canagliflozin, dapagliflozin, empagliflozin, ertugliflozin. | e.g. ramipril, captopril, enalapril, lisinopril, perindopril | e.g. furosemide, bendroflumethiazide, indapamide, spironolactone | e.g. losartan, candesartan, valsartan | e.g. ibuprofen (nurofen), naproxen, diclofenac. |
Which illnesses cause dehydration?
Dehydration is the loss of fluid from your body. Vomiting, diarrhoea and fever (high temperature, sweats, shaking) can make you dehydrated. If you are sick once or have diarrhoea once, then you are unlikely to become dehydrated. Having two or more episodes of vomiting or diarrhoea can lead to dehydration: in these cases, you should follow the advice in this leaflet.
What actions should I take?
If you develop a dehydrating illness, you should temporarily stop taking any medicine listed (SADMAN). It is very important that you restart your medicine once you have recovered from the illness. This would normally be after 24 to 48 hours of eating and drinking normally. When you restart your medicine, just take them as normal. Do not take extra for the doses you have missed.
Why do we ask you to stop them?
SGLT2 drugs – These medicines can make dehydration more likely and if you have diabetes can cause acid to build up if you are unwell.
ACE inhibitors – A medicine for high blood pressure and heart conditions. If you are dehydrated, these medicines can stop your kidneys working properly.
Diuretics – Sometimes called ‘water pills’ Used for excess fluid and high blood pressure. These medicines can make dehydration more likely.
Metformin – Dehydration can make it more likely that you will develop a serious side effect called lactic acidosis.
ARBs drugs ending in ‘sartan’ -. A medicine for high blood pressure and heart conditions. If you are dehydrated, these medicines can stop your kidneys working properly.
NSAIDs – If you are dehydrated, these medicines can stop your kidneys working properly.