Diuretic tablets are chemicals that have a different structural structure, and perform the functions of the reverse absorption of sodium ions and water.
Under their influence, an increase in the volume of fluid excreted from the body occurs. There are several varieties of diuretics that, although they have the same therapeutic properties, have a different mechanism of action.
It is for this criterion that a particular diuretic drug is chosen, and this is done exclusively by a specialist.
How to choose diuretic pills?
The choice of type of diuretics depends on the diagnosis. Let us consider this issue in more detail.
Saluretics - a group of diuretic drugs that promote the excretion of potassium and magnesium ions, having a diuretic effect. Saluretics are divided into several types:
- Loopback. This group includes Furosemide, Torasemide, Lasix, Etacrynic acid, etc.
- Sulfonamides. Clopamide and chlorthalidone are diuretics, which are often combined with beta-blockers. Indapamide - a drug that has a diuretic and hypotensive effect.
- Thiazide diuretics - Hypothiazide, Cyclomethiazide.
- Carboanhydrase inhibitors. This group includes Diakarb and Acetazolamide.
The peculiarity of such drugs lies in the impact on the discharge channels without loss of potassium by the body. This group of diuretics include:
The choice of the drug is carried out strictly individually!
The mechanism of action of such diuretics is based on preventing the reabsorption of fluid. This effect is achieved by creating different pressure in the tubules.
Features prescription drugs
Diagnosis and prescribed diuretics:
|Disease||Diuretic group / drug name|
|Hypertonic disease||Thiazides, Indapamide|
|Nephrotic syndrome, heart failure||Furosemide, Lasix in the form of a solution for injection or infusion|
|Diabetes, metabolic disorders||Indapamide|
Gradation of diuretics by action:
|Strong||Furosemide, Trifas, Uregit, Lasix|
|Average||Hypothiazide, Cyclomethiazide, Oxodolin, Hygroton|
|Weak||Veroshpiron, Triamteren, Diakarb|
For the duration of action
|Long work (up to 4 days)||Eplerenone, Veroshpiron, Hlortalidon|
|Mid-term (up to 14 hours)||Diakarb, Klopamid, Triamteren, Hypothiazide, Indapamide|
|Short acting (up to 8 hours)||Mannitol, Furosemide, Lasix, Torasemide, Etacrynic acid|
By the speed of the effect
|Fast (after 30 minutes)||Furosemide, Torasemide, Etacrynic acid, Triamteren|
|Average (after 2 hours)||Diakarb, Amilorid|
|Slow (2 days)||Veroshpiron, Eplerenone|
The best diuretics of the saluretic group
Saluretics are thiazide derivatives that have a persistent hypotensive effect. Under their influence, enhanced excretion of sodium ions and less pronounced - potassium ions occurs. The most effective and frequently prescribed thiazides are:
- Furosemide. The drug has a pronounced diuretic effect. It is used primarily to reduce blood pressure. Can only be used periodically, for long-term therapy is not suitable. The active substance is furosemide. Under his influence, the tone of blood vessels is reduced, the bcc and the volume of intercellular fluid are reduced. This is what helps to reduce pressure. The effect of intravenous administration occurs in 10 to 15 minutes, after oral administration - after 1 hour. Available in the form of granules for the preparation of oral suspension, tablets, injection solution.
- Bumetanide (Yurineks, Burineks). The drug acts quickly, because it has the property almost instantly absorbed. It is prescribed for edema and hypertension, which are symptoms of chronic renal failure.
- Indapamide. This drug has a moderate diuretic effect. Used for edema caused by CHD. The components of the drug are rapidly absorbed in the digestive tract. The active component of drugs, in addition to the diuretic, also has a hypotensive effect. After oral administration, the effect occurs within an hour and lasts for 1.5 days. Indapamide can be used to remove excess fluid for weight loss, but only as part of complex therapy.
- Torasemide The drug belongs to the group of loop diuretics. It has a rapid and pronounced diuretic effect. The effect appears already an hour after admission, and persists for half a day. The drug copes well with high blood pressure, so it is prescribed to patients with arterial hypertension. It is also advisable to use in hypertensive crises, as well as to eliminate puffiness in renal, hepatic, cardiac pathologies. But for the appointment of Torasemide must be a good reason, because it has a large list of contraindications, and can cause a number of side effects. The dosage and duration of the course of treatment is determined solely by the doctor individually for each patient.
Diuretic drugs of this group should be prescribed for:
- edema caused by impaired cardiac or renal activity;
- etiological edema of the liver (in combination with potassium-sparing diuretics);
- secondary hypertension. In particular, diuretic pills prescribed for hypertension, which arose against the background of chronic renal failure, in patients with contraindications to the appointment of thiazide diuretics. Such diuretics are especially needed in patients with creatinine clearance below 30 ml per 1 minute.
The best diuretic pills that do not wash out calcium
Drugs in this group contribute to the intensive removal of sodium from the body, but at the same time, they do not wash out calcium. The main feature of these drugs is the almost complete absence of their toxic effects on the body. Most often, this group of diuretics is used to eliminate puffiness in patients with heart failure. The best tools in this category are:
- Triamteren. The drug has a mild diuretic and a weak hypotensive effect. It can be used to eliminate edema of various etiologies, as well as an adjunct in hypertension. The effect occurs 2 hours after taking the pill, and lasts about half a day. Triamteren can be used to treat children. But it is important to strictly observe the dosage of the medicine, otherwise you can provoke the development of dyspeptic disorders and hyponatremia. A significant disadvantage of Triamteren is its poor solubility, which can cause the formation of renal calculi. In addition, there is a high risk of hyperkalemia. Due to the deposition of cadium in the tubules, the patient's urine becomes blue, which can cause serious concern.
- Amiloride. Tableted preparation containing the active substance of the same name. Used in the complex treatment of hypertension, as well as edema of the heart or kidney etiology. The effect of the drug is mild, but the effect of its administration is maintained for a long period of time. The tablet begins to act several hours after ingestion, therefore Amiloride is not suitable for use in emergency situations.
- Veroshpiron. This diuretic also has a weak therapeutic effect. In its structure, spironolactone is similar to aldosterone, and therefore has the property of blocking aldosterone receptors in the distal nephron tubules. As a result, the process of sodium reabsorption into the cells of the renal epithelium is disrupted. Due to this, along with the urine increases the excretion of sodium from the body. The effect of taking pills will have to wait about 2 - 3 days, while it is weakly expressed. However, the action Veroshpirona continues throughout the day. Under the influence of this medication, intensive removal of calcium from the body occurs. In addition, Veroshpiron has a pronounced positive inotropic effect on the heart muscle.
Veroshpiron is prescribed for Kona syndrome (adrenal tumors), secondary hyperaldosteronism, which occurs on the background of nephropathy, heart failure, liver cirrhosis. In addition, the use of drugs spironolactone is advisable when conducting complex treatment of hypertension, gout, diabetes. The drug can be combined with other diuretics, as well as with cardiac glycosides.
The best diuretic of the osmotic diuretic group
Osmotic diuretics are potent agents that are commonly used to relieve acute conditions. Under the influence of drugs in this group, an increase in osmotic pressure in the blood plasma occurs. This prevents the reabsorption of fluid.
Good diuretics for this group are:
- Mannitol It has a pronounced diuretic effect. It is advisable to use for the relief of acute edema. The active substance of the drug is mannitol, under the influence of which there is an increase in blood plasma pressure, obstruction of reabsorption, an increase in the volume of urine. Water enters the bloodstream, which causes a powerful diuretic effect. The drug is released in the form of an injection solution in ampoules.
Mannitol is prescribed to:
- Prevention or relief of cerebral edema with shocks, tumors, injuries, etc.
- Elimination of pulmonary edema or larynx of various etiologies.
- Provocation of forced diuresis in case of poisoning with aggressive medical drugs. First of all, it concerns drugs from the groups of barbiturates, salicylates, sulfonamides, PASK. Boron acid poisoning is also dangerous. The provoking of forced diuresis with the help of Manitol is also carried out during the transfusion of incompatible donor blood.
- Cupping an acute attack of glaucoma.
- Prevent or reduce damage to the renal tubules with a sharp inhibition of the filtration function of the paired organ. Such a violation is characteristic, above all, for patients who are in a state of shock. Also, the use of medications for this purpose is necessary for extensive blood infection, peritonitis, osteomyelitis, burns. The drug normalizes blood circulation in the kidneys, helps them cope with blood filtration. He is also prescribed to patients with poisoning by hemolytic poisons.
What diuretic to choose?
To achieve the expected therapeutic effect and to avoid adverse effects is possible only with the right choice of diuretic. Selection of a diuretic drug should be carried out only by a doctor. In this process it is necessary to be guided by the following criteria:
- The composition of the drug. Diuretics can be synthetic, semi-synthetic and natural, vegetable, origin. The latter have a mild diuretic effect, but the chemicals act quickly, and remove excess fluid in large volumes.
- Type of diuretic. Diuretic drugs can be potent, moderate and weak. The first contribute to the rapid elimination of water from the body and edema decline. They are used in the treatment of various diseases. Medium and weak diuretic drugs are used mainly in the swelling of the upper and lower extremities. They can be prescribed for pregnant women, children and elderly patients. Such diuretics begin to act only after 2 - 3 days from the moment of taking the pill.
- Information about the manufacturer. High-quality medical products are manufactured only by large pharmaceutical companies that have been in the market for many years. When buying a diuretic medication, it is necessary to pay attention to information about the manufacturer.
- Contraindications. If in the instructions for use of a diuretic in the column with contraindications there is at least one item that prohibits taking the pills to a specific patient, you should not risk it. It is better to abandon it in favor of another, safer, diuretic medication. It should be chosen only with the attending physician.
Below is a selection of real reviews of patients taking diuretic drugs for therapeutic purposes.
- Victor. The most popular, effective and at the same time inexpensive diuretic, which has never failed me, is Furosemide. It does not cause any side effects, and the action after taking it comes in less than an hour.
- Irina. Mom suffers from chronic heart failure. Swelling on the legs and arms is terrible, sometimes even the shoes do not fit. In such cases, the doctor advises to take diuretics. Best of all, Mom is helped by the drug Hypothiazide. He acts quickly, and she has never had any symptoms associated with side effects. But the drug has one drawback: it washes nutrients from the body, so each time the doctor recommends taking funds with potassium and magnesium.
- Catherine. Five years ago, I was diagnosed with arterial hypertension "of 3 degrees. Now I take diuretics with antihypertensives every time. I take diuretics. The drug Indapamide has proven itself. Despite the fact that it takes only 1.5 days to take it, it helps me a lot.
- Alevtina. I try to drink diuretic pills with less, as many of them wash out vitamins and minerals from the body. But sometimes you still have to resort to their use. Always saw Furosemide, but the doctor advised not to get involved in them, and appointed Diuver. He is dissatisfied with the treatment: the edema is gone, but the side effects have been tormented for another 2 days. As a result, I also had to drink painkillers to get rid of a headache.
- Oleg. Dad has diabetes, and an arrhythmia has developed on his background. Often the pressure jumps, swelling appears. The doctor said to drink Furosemide, although the list of contraindications indicated that diabetics should not use it. They believed the doctor, bought the drug. Indeed, papa has become much easier: in combination with antihypertensive drugs, Furosemide helps to relieve pressure. There were no side effects or other harm from them, but the endocrinologist warned that they should not be treated on their own.
Natural diuretics in foods
Not always patients may need pharmacy diuretic drugs. There are natural remedies that have a diuretic effect. These include:
- pharmacy chamomile;
- bird mountaineer;
- flax seeds;
- burdock roots;
- birch buds and leaves;
- rosehip berries;
- parsley roots;
Also, in order to remove excess fluid from the body, you need to replenish the menu:
Potatoes also have diuretic properties. But not raw, and not in the form of mashed potatoes. To remove excess water from the body, it is recommended from time to time to use baked potatoes. Among other things, this vegetable is also enriched with many useful substances. In particular, potassium, which is actively excreted from the body by the use of many pharmaceutical diuretics.