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What time of day is best to take diuretics. How to take diuretics (diuretics and tablets) correctly? Adverse symptoms of diuretic use

In case of obesity, drugs are taken to lose weight. To get maximum results from using diuretics, you must follow the rules for their use.

Mechanism of action of diuretics

Diuretics, or diuretics, affect the functioning of the kidneys, that is, they help increase fluid excretion. This leads to stronger urine production and frequent elimination. Due to their properties, diuretics reduce the absorption of salts in the renal tubules. As a result of this, their intensive removal occurs along with excess fluid. Thanks to this, the swelling of organs and tissues is reduced, the load on the heart is reduced and the blood pressure.

What are the basic admission rules?

Only a specialist can choose the right diuretic. Unauthorized decisions to use diuretics lead to an imbalance of substances in the body. The doctor prescribes the drug based on the results laboratory research urine and blood, as well as based on the patient’s existing complaints and illnesses. To monitor the effectiveness of the diuretic taken, the patient provides the attending physician with measured data. Based on the obtained figures, the doctor adjusts the dosage of the drug. Important among them are:

the amount of liquid drunk and that which left the body;
morning and evening pressure readings;
volumes of swelling;
patient's weight.

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In what cases should you take a diuretic?

Tissue swelling is a consequence of the disease, one of the symptoms. Therefore, diuretics are prescribed as an addition to the main therapy. Among the body conditions that require the use of diuretics are edema, blood pressure surges, pregnancy, heart muscle failure and diabetes. Using a diuretic drug for weight loss is dangerous for the body, as it leads to disruption of the level of salt and fluid in the body.

For swelling

Swelling is one of the symptoms of the disease. To correctly prescribe a diuretic, it is necessary to identify the root cause of edema. Kidney diseases, in which the organ cannot cope with the removal of fluid and sodium salts in sufficient quantities, provoke the appearance of bags under the eyes. Disturbances in the functioning of the cardiovascular system lead to swelling of the legs. Depending on the disease that led to the swelling, the doctor prescribes a certain type of diuretic and its dosage. Excessive swelling of the legs is a consequence of obesity or heavy physical work. In this case, the use of diuretics will not have any effect. All you have to do is change your lifestyle and reduce the stress on your body.

Under pressure

Diuretic tablets can normalize high blood pressure. This occurs due to increased fluid excretion through urine. By reducing water in the body, the load on the body is reduced. cardiovascular system. At the initial stages of treatment, the doctor prescribes minimal doses of a diuretic. When the blood pressure normalizes after using it, the patient continues to take the diuretic. Otherwise, the doctor adjusts the treatment.

What can you drink during pregnancy?

Swelling during pregnancy appears in the 3rd trimester. This symptom may indicate problems with the kidneys, heart or liver. However, the cause of swelling may be excessive air temperature. In any case, if they are present, it is better to monitor your health more carefully expectant mother. Neglect of such a symptom is harmful to the child. At the same time, you should not engage in self-medication and traditional medicine. Even seemingly harmless herbs and berries can harm a pregnant woman and child. Strawberries, juniper and parsley should be taken with caution. Approved diuretic tablets include Canephron, Phytolysin and Eufillin. Each of them is safe for the expectant mother and child, but it is important to follow the dosage and regimen of use.

For heart failure

In heart failure, 40–50% more blood passes through the organ. Such a volume does not have time to be sufficiently saturated with oxygen for the normal functioning of human systems. Increased fluid and nitrate retention occurs due to kidney and liver damage, which occurs as a result of poor oxygen saturation. As a result, the patient suffers from edema. The simultaneous use of diuretics and drugs for heart failure eliminates the symptoms of the disease at different stages. Long-term use of diuretics leads to addiction, so it is worth changing them gradually. The purpose of the drugs is to reduce the patient’s weight and relieve swelling.

How to take a diuretic without harm to the body?

Diuretics are classified according to their principle of action. There are thiazide, loop, potassium-sparing and natural diuretics. The rules of administration and the corresponding dosages depend specifically on the class of diuretic. The prescription of a particular type of diuretic is determined by the patient's disease.

Thiazide diuretics

Sodium and chlorine salts are removed. With prolonged use, the strength of action does not decrease, and addiction to the diuretic does not occur. The visible effect of the product occurs within 2 hours. Diuretic tablets are effective for 12 hours. Treatment rules:

After a week of use, it is recommended to take a break of at least 4 days.
Treatment begins with minimal doses to prevent adverse reactions.
Along with diuretics, a diet with a high potassium content is prescribed.

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Should loop diuretics be taken in the morning or evening?

The effect occurs after 1 hour and lasts up to 4 hours. The use of loop diuretics requires careful monitoring of potassium levels in the blood. In case of low levels, a diet high in potassium and potassium-containing drugs are prescribed. Take tablets once a day, in the morning. The course of treatment is started with minimal doses and the regimen is adjusted if necessary.

Potassium-sparing diuretics

Along with the abundant excretion of sodium salts, diuretics of this group do not reduce the potassium content in the blood. For this reason, the doctor does not prescribe additional intake of potassium-containing drugs. The effect occurs 2 hours after taking the tablet, but some diuretics of this class manifest themselves only after 2 days of use. In this case, the specialist prescribes another diuretic to the patient. Potassium-sparing medications should be taken once a day. According to the rules, it is recommended to drink the required dose on an empty stomach.

Natural (herbal) diuretics

The mechanism of action of diuretics in this group is based on the properties medicinal herbs. Experts prescribe drugs in the form of solutions or pastes. In the first case, water is used to dissolve the required dose. To reduce bad taste Juice or other liquid is added to the product. Diuretics in the form of a paste are also dissolved in water and taken after a meal. Along with the use of a herbal diuretic, marinades, spices and sauces are prohibited. You need to drink at least 2 liters of non-carbonated mineral water per day.

How often to take and how to get off a diuretic?

Stopping the use of diuretics should be gradual. This is especially true for patients with unstable blood pressure. Abrupt refusal of diuretics leads to complications of existing diseases. To properly stop using medications, you should gradually reduce the dose. The schedule for how much is better to take, how often and when to stop is drawn up by the attending physician.

Adverse symptoms of diuretic use

Self-medication and incorrect dosage of a diuretic drug can cause negative health consequences. This happens due to excessive excretion of calcium and potassium salts along with the liquid. As a result, disturbances in the functioning of the heart and kidneys occur. Against the background of a deficiency of these elements, arrhythmia, fatigue and muscle cramps are observed. Patients also report headaches, increased sweating, unreasonable anxiety, sore throat and cough. An allergy to the components of a diuretic drug causes a rash and itching. When taking a diuretic at night, insomnia may occur due to frequent urination. It is often not recommended to use a diuretic, as it will have the opposite effect - dehydration.

Why doesn't a diuretic help?

The causes of swelling are various diseases. For maximum effect from a diuretic, it is necessary to clearly determine which disease was the root cause of fluid retention in the body. Only after making a diagnosis can a specialist prescribe a diuretic that will bring the most pronounced results. One of the reasons for its ineffectiveness is the site of action of the drug. Loop diuretics are closer to the kidney and have the most effective effect. The second most effective are thiazide drugs. The effect of potassium-sparing diuretics occurs later than others. A diuretic drug that will help the patient as much as possible should be prescribed by the attending physician. Self-medication leads to complications of diseases.

During pregnancy, due to severe swelling at 7 months, the doctor prescribed Canephron to me. Of course, I didn’t want to resort to medications, but I had to. This is the only time I've taken diuretics so far. And drinking them without a doctor’s prescription is the height of human stupidity, I think. You shouldn't play with your kidneys; it could end badly.

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Diuretics (diuretics): for edema, hypertension - in products, preparations, from the pharmacy

Diuretics (diuretics) are chemical substances with different structural structures that perform the function of reabsorption of sodium and water ions and increase the excretion of fluid from the body.

The expected effect of treatment for many diseases depends on the right choice diuretics, since, although they are called diuretics, they differ in their mechanism of action, that is, they are heterogeneous: some act more at the level of the tubules, others predominantly affect renal hemodynamics, affecting the tubules to a lesser extent.

Drugs of the first group (carbonic anhydrase inhibitors, acetazolamide, osmotic diuretics) are not very common in medical practice, which cannot be said about strong loop diuretics that act at the level of the ascending limb of the loop of Henle, the main representative of which is furosemide, which is very widely used in therapeutic practice.

Close in strength and mechanism to loop diuretics are quinazalone and chlorobenzamides, which can act gently but for a long time (more than a day).

Pteridines and carboxamides are a special group of diuretics. Patients forced to frequently use similar drugs, they are known as potassium-sparing diuretics. They do not have a negative effect on glomerular filtration, act for more than a day and can be prescribed to patients with chronic renal failure (CRF).

The main classes of medicinal diuretics:

More detailed information about medicinal diuretics will be given later in the article.

Diuretics in products

Not always and not everyone necessarily needs to buy diuretics at the pharmacy. And not everyone who really needs them goes to the doctor, writes out a prescription and takes them as the doctor prescribed. Many people switch to a diet low in table salt, giving preference to foods that, due to their natural properties They remove excess fluid from the body well. In addition, diuretics are happily consumed instead of traditional tea.

Recently, monastery tea for weight loss, which contains laxative and diuretic herbs, has become especially popular. All this, of course, is possible and certainly useful if a person does not have special problems with health, and swelling on the face or legs is associated with a flagrant violation of the diet, excessive addiction to salty foods, or due to basic fatigue.

The list of diuretic herbs is made up of ubiquitous and therefore widely known representatives of the flora:

Chamomile;
Horsetail;
Lingonberry (leaves);
Bearberry;
Chicory;
Bird's knotweed;
Burdock;
Flax (seeds);
Birch leaves and buds;
Juniper;
Rosehip, which has a mild diuretic effect and is a source of vitamin C;
Parsley (roots);
Dill greens.

Some of these plants are included in the diuretic collection sold by the pharmacy chain.

The choice of diuretic plants against edema based on the patient’s health status:

Diuretic products that you can add to your diet to combat edema include the following list:

Baked potatoes can be interesting in this regard. Being a source of potassium, it also has a diuretic effect. For those who want to lose weight, you can try a three-day potato diet (or you can stretch it for a week if you have enough strength). So: consume 1 kg of potatoes, baked in their jackets, throughout the day, washed down with plain water. Result: 3 days – minus 3 kg and no swelling.

Unfortunately, there are situations when similar treatment cannot be avoided and no matter how good diuretic properties the gifts of nature have, it may be necessary to prescribe real diuretics. However, before you start using synthetic diuretics, it would be a good idea to study the characteristics of some representatives of this pharmaceutical group.

Video: natural diuretics

Loop diuretics

effect of the main types of diuretics

Action

Loop diuretics (LD) include drugs whose action begins quickly (from a quarter of an hour to half an hour) and lasts from 2 (bumetadine, furosemide) to 6 hours (torasemide). In addition to their main action (diuretic), diuretics of this group are expected to change some hemodynamic parameters, which is especially noticeable when intravenous their introduction.

This property of loop diuretics is used to reduce end-diastolic pressure (EDP) and end-diastolic volume (EDV) of the left ventricle during left ventricular failure, as well as a drop in pressure in the pulmonary circle with pulmonary hypertension. In addition, loop diuretics reduce the volume of extracellular fluid and affect breathing (help reduce signs of shortness of breath).

Considering the listed advantages of loop diuretics, they are often used in combination with other drugs to provide emergency care for cardiovascular or renal pathology.

Video: the effect of various diuretics on the human body

Representatives

Furosemide is considered the most well-known and has been used for many years, but this group also includes other diuretics:

Furosemide (Lasix). After ingestion on an empty stomach, otherwise you will have to wait longer, the drug begins to act in half an hour - an hour, intravenous administration speeds up the process and reduces the time to 5 minutes. Furosemide does not linger for a long time, half of it is excreted in the urine after 4-6 hours (when taken orally) and after a couple of hours when used intravenously.
Torasemide differs from furosemide in having a longer therapeutic effect, and less potassium is lost. It is used for renal and heart failure, and there is even an opinion that for chronic renal failure it is more effective than the famous furosemide.
Bumetanide (Yurinex, Burinex). It is characterized by rapid absorption and the onset of a diuretic effect, since within half an hour the drug makes itself felt. It is used for swelling of the face and swelling of the legs, and for hypertension caused by severe renal failure.
Piretanide is a very strong diuretic (more powerful than furosemide). In addition to the basic properties, it has other abilities. Piretanide reduces blood clotting, blocks “slow” calcium channels(peripheral vasodilator), and can be used as an antihypertensive agent (this action even precedes the diuretic effect), therefore it is often prescribed to reduce blood pressure in arterial hypertension of 1-2 degrees (monotherapy) or as part of combination treatment in more complex cases. In addition, the drug is prescribed for renal and heart failure and edema of various origins.
Ethacrynic acid is more familiar under another name – uregit. It is characterized by a strong diuretic, but short-lived effect, which depends on the method of application (from 2 to 4-6 hours). Uregit can be prescribed together with furosemide, since they have different places of application. Ethacrynic acid is used for swelling of any nature, but you should also know its contraindications: anuria, oliguria, hepatic coma, acid-base imbalance.

It should be noted that representatives of this group are by no means potassium-sparing, and, in addition, they lead to an increase in the excretion of other microelements: magnesium, sodium, chlorine, calcium.

Doctors always take this circumstance into account and prescribe drugs to compensate for the loss - panangin, potassium orotate, asparkam. By the way, it would also be very useful for patients to know about this feature of loop diuretics and not to use them uncontrollably, even if the pharmacy sells diuretic tablets without a prescription.

Thiazide diuretics and their close relatives

Double effect

Thiazide diuretics (TDs) are primarily available in tablet form and are often prescribed in combination with other antihypertensive agents to lower blood pressure and reduce edema. Diuretic tablets of this group block return transport sodium and chlorine, which leads to a decrease in the amount of plasma, extracellular fluid, as well as a drop in cardiac output and peripheral vascular resistance, and, therefore, a decrease in blood pressure. These processes are achieved through humoral and intracellular mechanisms that regulate sodium levels as fluid volume decreases.

However, long-term use of thiazide diuretics can cause multidirectional reactions in patients - some stop responding to therapy. In such patients, with a reduced plasma volume, there is a high level of humoral factors responsible for increasing TPR (total peripheral resistance), these are renin, angiotensin, aldosterone. IN similar cases in order to potentiate the effect of TD, antihypertensive drugs are prescribed, which are called ACE inhibitors(angiotensin converting enzyme). Together (TD + ACE inhibitors) they achieve the desired effect and help the patient cope with edema due to hypertension and with hypertension itself. By the way, there are also combination drugs, so to speak, “2 in 1”, which eliminates the need to buy diuretics separately from antihypertensives.

Why do hypertensive patients love them?

Thiazide diuretics differ from loop diuretics not only in that they terrible force do not remove substances necessary for the functioning of the heart muscle; they have a significant difference in the duration of their action. If the period of the diuretic effect of PD is limited to 3-6 hours, then even for the shortest-acting TD this time is extended to 18 hours; others have even greater abilities and provide a therapeutic effect for a day or more.

Patients usually like TD diuretic tablets because they have a consistent, mild diuretic effect. The bladder does not fill up every minute and does not force a person to practically leave the toilet; everything happens almost physiologically, so these products can be used at work or even while traveling.

Thiazide diuretics for hypertension can be used alone or in combination with other antihypertensive or potassium-sparing diuretics to lower blood pressure. Some patients get by with small doses of TD, which provides a good effect, although it occurs more slowly (after about a month).

The use of TD can significantly reduce the number of such adverse reactions as:

Hypokalemia (drop in serum potassium levels);
Hyperlipoproteinemia (increased lipids and lipoproteins, which contributes to the development of atherosclerosis);
Arrhythmias that occur due to a lack of potassium, sodium, magnesium, and chlorine.

In short, thiazide diuretics are recognized by both doctors and patients as good diuretics, having a hypotensive effect and not straining the patient’s psyche and bladder.

Close “relatives” of TD are non-thiazide sulfonamide diuretics that act on the cortical segment of the loop of Henle, and drugs that occupy intermediate position between sulfonamide and loop diuretics (xipamide) and prescribed for hypertension.

Diuretic tablets from the group of thiazide diuretics

Many representatives of this group are well known to patients who have long suffered from arterial hypertension. They are sold in pharmacies without a prescription and are almost always available:

Hydrochlorothiazide (esidrex, hypothiazide). It can be classified as a medium diuretic (in terms of strength and duration of action). It slightly increases the excretion of sodium, potassium and chlorine, but does not disturb the acid-base balance. It is prescribed after meals 1 or 2 times a day and exhibits its effect within 1-2 hours; the hypotensive effect lasts for hours. The drug can be used intermittently or long-term (in severe cases). Hypothiazide requires a diet enriched with potassium and a decrease in daily salt intake. If the patient has renal pathology, then combination with potassium-sparing diuretics and potassium supplements is not recommended.
Indapamide (indapamide, arifon, pamid) is a drug that combines hypotensive and diuretic effects at the same time, that is, we can say that indapamide is a diuretic for edema, reducing blood pressure. Its advantages include the fact that it does not affect the functional abilities of the kidneys, does not change indicators lipid spectrum, and, in addition, has the ability to protect the heart and blood vessels.
Chlorthalidone (hygroton, oxodoline) is a non-thiazide sulfonamide diuretic (SD), has average strength and a pronounced effect that can last up to 3 days. In its behavior, chlorthalidone is somewhat similar to hypothiazide.
Clopamide (brinaldix) is similar in strength, duration of action and pharmacodynamics to chlorthalidone and hypothiazide.

Table: comparison of selected loop and thiazide diuretics

Potassium-sparing diuretics

Potassium-sparing diuretics (KSDs) are considered mild, but have long lasting effect. True, it usually doesn’t come on the first day either. You should not expect such a manifestation of diuretic abilities as from loop diuretics or even thiazide ones. In this case, you can rely more on triamterene, which can begin to relieve swelling in the third hour after administration, but this will not be so pronounced, so patients do not always notice it.

In most cases, KSDs are prescribed as diuretics for edema, while in case of hypertension they are perceived only as an adjuvant. Excellent diuretics are obtained by combining potassium-sparing diuretics with thiazide ones: triamterene + hypothiazide. Depending on the amount of the main active ingredient (triamterene), good diuretic tablets are obtained - triampur, diazide, makzid. Likewise can be obtained complex drug a moduretic consisting of amiloride, hypothiazide and furosemide or uregit.

A little about potassium-sparing people themselves

Of course, it is not possible to list all the drugs along with their advantages and disadvantages, synonyms and the mechanism of action of any group of diuretics, therefore, as in previous cases, we will focus only on typical representatives of potassium-sparing diuretics:

Spironolactone (veroshpiron, aldactone) is a light drug with a long-lasting effect, which begins to appear from 3-5 days and lasts for another couple of days after discontinuation. As an antihypertensive rapid response is not suitable, because in this regard it begins to act only after half a month. Of course, the patient will not wait that long, but it is still prescribed in combination with other antihypertensive or diuretics for mild periodic edema or for long-term treatment of hypertension, without fear that even with a decrease in blood pressure it will have a negative effect. Veroshpiron does not exhibit its hypotensive effect at low and normal blood pressure. Due to the fact that spironolactone is a steroid drug, its side effects, in addition to hyperkalemia, are specific: gynecomastia, male pattern hair growth in females, that is, directly related to hormonal imbalance.
Triamterene (Daytek, Pterofen) is a mild diuretic, similar in behavior to spironolactone, characterized by a slight independent diuretic effect, which appears a couple of hours after administration and lasts an average of 13-15 hours. Its hypotensive effect is superior to that of spironolactone. In older patients, side effects are more common: the development of hyperkalemia can lead to kidney damage due to the fact that potassium begins to be deposited in the tubules. As a result, the urine of such people may change color and become blue or blue. This is usually very frightening for patients and their relatives..
Amiloride (midamor) is a weak diuretic that removes sodium and chlorine, but preserves potassium. Although its own diuretic effect is insignificant, amiloride can stimulate the diuretic effect of furosemide, uregitis, and thiazide diuretics. In order to reduce potassium loss, it is used in combination with hypothiazide (moduretic) for the treatment of arterial hypertension and heart failure.

When should or should not diuretics be used?

Indications, contraindications and side effects are precisely those points in the annotation for any drug on which the patient fixes his gaze, skipping the pharmacokinetics and pharmacodynamics.

Diuretics should also be treated at least in this regard, without prescribing them for weight loss:

Strong diuretics will remove several liters of water, and the scale will show a loss of a couple of kilograms. Don't flatter yourself, it won't last long.
Powerful diuretics will require fluid replenishment, everyone knows that after taking the same furosemide, thirst sets in, the body wants to get back lost water, so for weight loss it is better to use folk remedies, without fear that they will remove everything and lead to unwanted side reactions.
And finally - the author of the article, having a higher education medical education and having tried many medications on myself, I have not met a person who could overcome obesity with the help of diuretics, so to speak, I was convinced from personal experience.

Diuretics should also be used with caution if you have diabetes. Development of the syndrome diabetic foot often begins with the appearance of swelling of the legs, however, given the complexity of such a disease as diabetes, which is considered a systemic pathology, you cannot engage in amateur activities - the prescription of diuretics for diabetes is solely within the competence of the attending physician. Leg swelling of other origins (fatigue, varicose veins, heart failure) also require an individual approach. Of course, for swelling associated with fatigue of the lower extremities, traditional medicines are most likely suitable, while synthetic drugs may simply not be needed.

If there is swelling of the face, if a person has not overdone it with food and drinks, it is also better to visit a doctor; perhaps there are kidney problems and the doctor knows how to solve them. It is not necessary to rush to the use of diuretic drugs; it is likely that diuretic products will help if the pathology is not very far advanced.

And here's a special case

Another special case– pregnancy. Swelling during pregnancy, especially in the second half, is a common phenomenon and in part natural. The additional load caused by hormonal changes with an increase in the amount of progesterone and venous stasis created by the pregnant uterus will make themselves felt. The size of the legs increases by a couple of centimeters, walking becomes difficult, but, meanwhile, during pregnancy, swelling can be a sign of gestosis, which in other cases has disastrous consequences.

Regular visit antenatal clinic and following the doctor’s recommendations is intended to protect the woman, and swelling, if provoked physiological reasons, will go away after childbirth, but it is extremely undesirable to prescribe furosemide in such a situation. Pregnant women are sometimes (but not in the first months) prescribed thiazide diuretics, but again, this is done by the doctor observing the woman.

When does a doctor prescribe diuretics?

The overwhelming majority of people themselves know when diuretics are prescribed, but in other cases those with a long history of heart problems are still perplexed why they are suddenly prescribed veroshpiron and even refuse to take it, citing other age-related problems (urinary incontinence, etc.).

In this regard, I would like to provide a reasonable list of indications so that the patient does not think that this is just the doctor’s personal whim:

Arterial hypertension (AH), which has not yet been complicated by renal failure. Diuretics, by reducing BCC (circulating blood volume) and systolic ejection, lead to a decrease in systolic pressure already in the first days of treatment. It should be noted that the pressure does not fall uncontrollably, blood pressure decreases moderately, and postural hypotension does not develop. Long-term treatment leads to a decrease in the diuretic effect and normalization of systolic output due to its own compensatory mechanisms (increased renin and aldosterone levels), further unauthorized fluid loss stops, and the hypotensive effect persists regardless of the high level of renin, which is associated with a decrease in the concentration of sodium in the cells and an increase in potassium in walls of blood vessels. As a result, after 1.5-2 months, diastolic pressure also normalizes (cardiac output remains unchanged). Patients often ask their doctors a reasonable question: are diuretics used for hypertension addictive? No, it is either absent or so inconspicuous that such a circumstance can be neglected. The use of these drugs for years, as noted by the patients themselves, does not lead to impotence and decreased libido, which is considered an indisputable advantage of diuretics prescribed for arterial hypertension.
Chronic circulatory failure (CFC) with edema, as well as hypertension with impaired glomerular filtration require the use of powerful diuretics with a short or medium period of action (furosemide, uregit). The main advantages of these drugs allow them to be used in quite serious situations for emergency therapy– swelling of the brain, lungs, poisoning with potent substances that are excreted by the kidneys, for example, barbiturates.
Secondary hyperaldosteronism (consequence of hypertension and CNC) or preventionhypokalemia are an indication for the prescription of potassium-sparing diuretics, which have a mild diuretic and hypotensive effect.
Diabetes insipidus;
Glaucoma.

Video: lecture on the use of diuretics in heart failure

Undesirable effects of diuretics

Disorders associated with the excretion of microelements

Diuretics, removing ions of chemical elements that are not superfluous to the body, cannot but produce side effects. Basically, these are electrolyte imbalances that can cause heart rhythm disturbances (arrhythmia), arterial hypotension and, worst of all for the male half, impotence. Thus, the list of the main undesirable manifestations of diuretics:

Decreased potassium levels (hypokalemia) are the main drawback of diuretics;
A drop in magnesium levels (hypomagnesemia). Mostly loop diuretics are endowed with similar abilities; thiazide diuretics remove magnesium, but to a lesser extent, and potassium-sparing diuretics, on the contrary, delay its excretion.
Calcium excretion. And again, loop diuretics, which, even with a single use, can remove up to 30% of Ca 2+. Thiazide drugs have an ambiguous attitude towards this element: some increase excretion in the urine, others, which do not remove calcium, retain it in the body and thereby cause hypercalcemia. Potassium-sparing (veroshpiron, triamterene, etc.) - also belong to the non-removing calcium group, but by increasing its reabsorption in the tubules, they can lead to hypercalcemia.
A decrease in sodium concentration (hyponarthemia) is often observed with independent and uncontrolled self-prescription of diuretics, which will manifest itself muscle weakness, drowsiness, malaise, nausea.

Important: symptoms of “too much” diuretics can become mental disorders and coma (it is very advisable to keep this fact in mind for people using diuretics for weight loss).

Arrhythmic complications, metabolic disorders

Serious restrictions on the use of diuretics are arrhythmias, since diuretics cause these arrhythmias. There is an opinion that long-term therapy of arterial hypertension with diuretics (especially thiazide) can cause not only rhythm disturbances, but also sudden coronary death. Provoking factors for the development of arrhythmia are considered:

Hypokalemia, which leads to pathological changes electrocardiograms (myocardial instability, long Q-T syndrome);
Severe left ventricular (LV) hypertrophy, which itself contributes to rhythm disturbances;
Stress;
Administration of β-agonists.

Table: types of diuretics and typical side effects

Other side effects of diuretics:

Diuretics can reduce the weight of the LV myocardium within 11%, where the most active in this regard is recognized indapamide.
Treatment with strong or moderate diuretics often leads to an increase in serum uric acid levels ( hyperuricemia). This phenomenon is especially typical for people who are overweight. Gout or chronic nephropathy, although in rare cases, can be a consequence of the use of diuretics.
In some cases, a persistent increase in blood glucose may develop - hyperglycemia, capable of transforming into progressive diabetes mellitus
Initiation of the use of thiazide diuretics for hypertension is accompanied by lipid disorder (hyperlipidemia), which is manifested by an increase in serum content blood LDL and VLDL (atherogenic lipoproteins), but later everything usually returns to normal.
Powerful (furosemide, uregit) and moderate (thiazide) diuretics can affect the acid-base balance and, with prolonged use, lead to an imbalance, causing metabolic alkalosis , which is corrected with potassium chloride. Meanwhile, treatment with potassium-sparing drugs may be accompanied by an increase in potassium in the blood (hyperkalemia) and metabolic acidosis.

Contraindications to the use of diuretics

Contraindications for the use of diuretics, as for others medicines, there are general, relative and absolute, but there are not so many of them, so they can be placed in one list:

Renal and liver failure, preventing the use of many drugs in this group, except for amiloride, which is still prescribed for liver damage;
Diuretics are not used during early pregnancy;
Some contraindications for diabetes mellitus are provided for hydrochlorothiazide;
Hypovolemia and severe anemia are a strict contraindication to the use of furosemide and uregitis;
Incomplete atrioventricular block and hyperkalemia absolutely do not allow the use of potassium-sparing diuretics;
The combination of several diuretics that do not remove potassium is prohibited.

Dangerous combinations

Considering that drugs in this group often have to be prescribed together with other pharmaceuticals, it is necessary to keep in mind the possible reactions of this combination. For example:

Potassium-removing diuretics are dangerous to combine with digitalis derivatives, since there is a risk of arrhythmia;
Spironolactone and triamterene (potassium-sparing), used in conjunction with digoxin, also often lead to rhythm disturbances, therefore this combination requires constant monitoring of digoxin in the patient’s plasma.
Diuretics that do not remove potassium do not combine well with a diet rich in this element or with potassium supplements.
Medicines that themselves increase blood glucose levels further enhance the hyperglycemic effect of diuretics.
Antibiotics of the aminoglycoside and cephalosporin series in combination with loop diuretics can lead to a toxic level of these drugs in the kidneys and damage to the latter; in addition, aminoglycosides (kanamycin, streptomycin, gentamicin) with loop diuretics increase the likelihood of complications such as damage to the vestibular apparatus and hearing organs
NSAIDs (non-steroidal anti-inflammatory drugs) have the ability to reduce the diuretic effect of some diuretics.

In conclusion, I would like to remind our readers once again: although diuretics at first glance seem absolutely harmless, in reality this is not the case, so before you start taking diuretic tablets to relieve swelling, lose kilograms or for any other purpose, you should think about possible consequences such decisions.

Diuretics are substances that have different chemical structures, but have the common property of increasing the volume of fluid removed from the body. Diuretics are also called diuretics. Diuretics reduce the process of reabsorption of water and salts in the kidney tubules, due to which much more of them are excreted in the urine. In addition, diuretics increase the volume of urine and the rate at which it is formed, reducing the amount of fluid that accumulates in various tissues and cavities.

Diuretics are used in complex treatment hypertension, pathologies of the cardiovascular system, liver and kidneys, as well as any other conditions accompanied by swelling of various organs and tissues.

Currently, there is a fairly wide range of diuretic drugs, which are classified according to various criteria and combined into groups based on similar properties.

General classification of diuretics

Depending on their origin, all diuretics are divided into the following groups:

Natural diuretics (herbal infusions, certain foods, herbal teas, etc.);
Diuretic drugs (various tablets and solutions for intravenous administration).

In addition, depending on the purpose, diuretics are divided into the following categories:
1. Strong (“ceiling”) diuretics used to quickly eliminate edema, lower blood pressure, eliminate toxic substance from the body due to poisoning, etc.;
2. Diuretics used long-term as part of complex therapy for diseases of the heart, kidneys and urinary tract;
3. Diuretics used to control urination in various diseases (for example, diabetes, gout, etc.).

The above classifications reflect only two aspects of diuretics regarding their origin and purpose. In addition, there are a large number of different classifications of diuretics, taking into account their chemical structure, composition, mechanism of action, side effects and area of priority therapeutic use. All these parameters apply to both natural diuretics and tablets.

Let us consider separately the classifications and areas of application of diuretic tablets and natural remedies, so as not to cause confusion. The article will provide international names of medicines without listing commercial names. Knowing the international name, you can use the Vidal reference book to find a list of medications containing this substance as active, and their commercial names under which they are sold in pharmacies. For example, the text of the article will give the international name of the substance Spironolactone, which is active ingredient a drug with the commercial name Veroshpiron. For convenience and to avoid numerous listings of commercial names of drugs, we will use only international names of active ingredients.

Diuretic drugs (tablets, solutions for infusion) - classification

IN clinical practice To select the optimal drug in a given case, doctors use the following classification of diuretics:
1. Potent (potent, "ceiling") diuretics (Furosemide, ethacrynic acid, Bumetamide, Torsemide and Peritanide) are used to quickly eliminate edema of various origins and lowering blood pressure. The drugs are used once, as needed, they are not used in courses;
2. Medium-strength diuretics (Dichlorothiazide, Hypothiazide, Indapamide, Clopamide, Chlorthalidone) are used in long courses as part of the complex treatment of arterial hypertension, diabetes insipidus, glaucoma, edema syndrome in heart or renal failure, etc.;
3. Potassium-sparing diuretics (Triamterene, Amiloride and Spironolactone) are weak, but they do not remove potassium ions from the body. Potassium-sparing diuretics are used in combination with other diuretics that remove calcium in order to minimize the loss of ions;
4. Carbonic anhydrase inhibitors (Diacarb and Dichlorphenamide) are weak diuretics. Used to reduce intracranial and intraocular pressure in various conditions;
5. Osmotic diuretics (mannitol, urea, glycerin and potassium acetate) are very strong, so they are used in complex therapy acute conditions, such as cerebral and pulmonary edema, glaucoma attack, shock, sepsis, peritonitis, lack of urine formation, as well as for accelerated excretion various substances in case of poisoning or drug overdose.

Potent, moderate-strength, potassium-sparing diuretics and carbonic anhydrase inhibitors are also called saluretics, since all drugs of these pharmacological groups remove a large amount of salts from the body, primarily sodium and potassium, as well as chlorine, phosphates and carbonates.

Potent diuretics - names of drugs, general characteristics, indications and contraindications for use, side effects

Potent diuretics, also called loop, power, or ceiling diuretics. Currently in countries former USSR The following powerful diuretics are used - Furosemide, ethacrynic acid, Bumetamide, Torsemide and Peritanide.

Strong diuretics begin to act approximately 1 hour after oral administration, and the effect lasts for 16 to 18 hours. All medications are available in the form of tablets and solutions, so they can be taken by mouth or administered intravenously. Intravenous administration of diuretics is usually performed in severe conditions of the patient, when it is necessary to obtain quick effect. In other cases, drugs are prescribed in tablet form.

The main indication for the use of strong diuretics is the treatment of edema syndrome caused by the following pathologies:

Chronic heart failure;
Chronic renal failure;
Nephrotic syndrome;
Edema and ascites in liver cirrhosis.

The drugs are effective even for any degree of renal failure, so they can be used regardless of glomerular filtration rates. However, daily use of potent diuretics causes addiction and weakens their therapeutic effect. Therefore, to maintain the desired effect, drugs are used in short courses with breaks between them.

Strong diuretics are not used for long periods of time course therapy hypertension, since they have a very short duration, but powerful and pronounced effect. However, they are used to relieve a hypertensive crisis.

Also, potent diuretics can be used in the complex and short-term treatment of the following acute conditions:

Pulmonary edema;
Poisoning with various substances;
Overdose of drugs;
Hypercalcemia.

Contraindications to the use of potent diuretics are the presence of the following conditions in a person:

Anuria (lack of urination);
Severe dehydration of the body;
Severe sodium deficiency in the body;
Hypersensitivity to drugs.

The side effects of diuretics are caused by disturbances in water-electrolyte balance due to the excretion of water and ions.

Side effects of strong diuretics may include the following:

Arterial hypotension;
Vascular collapse;
Thromboembolism of various vessels;
Encephalopathy in people suffering from liver disease;
Arrhythmia;
Hearing impairment up to deafness (develops with intravenous administration of drugs);
Increased concentrations of glucose and uric acid in the blood;
An increase in the concentration of low-density lipoproteins (LDL) and triglycerides (TG) with a parallel decrease in the level of high-density lipoproteins (HDL);
Skin rash;
Photosensitivity;
Paresthesia (feeling of goosebumps, etc.);
Decrease in the total number of platelets in the blood;
Disorders of the digestive tract.

The most commonly used drugs currently are Torsemide, Furosemide and ethacrynic acid. The choice of a specific drug is made by the doctor, however, in principle, any drug can be used, since the differences are minor.

Medium strength diuretics - names of drugs, general characteristics, indications and contraindications for use, side effects

Medium diuretics are represented by drugs from the thiazides group. Currently, the following thiazide diuretics are used in the CIS countries - Dichlorothiazide, Hypothiazide, Indapamide, Clopamide, Chlorthalidone.

Thiazide diuretics begin to act 30–60 minutes after oral administration, and the maximum effect develops within 3–6 hours. Dichlorothiazide, Hypothiazide and Clopamide act for 6 - 15 hours, Indapamide - 24 hours, and Chlorthalidone - 1 - 3 days. All diuretics of medium strength are effective when the glomerular filtration rate in the kidneys is not lower than 30 - 40 ml/min, according to the Rehberg test.
Indications for the use of moderate-strength thiazide diuretics are the following conditions:

Comprehensive treatment of arterial hypertension;
Chronic edema due to heart failure, liver cirrhosis or nephrotic syndrome;
Glaucoma;
Diabetes insipidus;
Oxalate kidney stones;
Edema syndrome of newborns.

Thiazide drugs are most widely used for long-term treatment of hypertension outside periods of exacerbation. Typically, drugs are prescribed in small doses (no more than 25 mg per day), since this amount is sufficient to develop a pronounced antihypertensive effect. A persistent decrease in blood pressure usually develops after 2 to 4 weeks of regular use of thiazide diuretics, with the most pronounced effect observed with Indapamide. That is why Indapamide is the drug of choice for the treatment of hypertension.

Contraindications to the use of moderate-strength diuretics are the presence of the following conditions:

Hypersensitivity to sulfonamide drugs (for example, Biseptol, Groseptol, etc.);
Pregnancy.

Side effects of moderate-strength diuretics are caused by changes in the water-electrolyte balance in the human body, as well as associated disruptions in the functioning of various organs and systems. With the use of thiazide diuretics, the concentration of magnesium, potassium, sodium and chlorine ions in the blood decreases (hypomagnesemia, hyponatremia, hypokalemia, hypochloremia), but the content of calcium and uric acid increases (hypercalcemia, hyperuricemia). Side effects of thiazide diuretics caused by water and electrolyte imbalance include the following:

Reduced blood pressure;
General weakness;
Impaired sensitivity (feeling of goosebumps, etc.);
Nausea, vomiting;
Abdominal colic;
Decreased libido;
Sexual dysfunction;
Decline total number platelets in the blood;
An increase in the total number of lymphocytes and monocytes in the blood;
Skin rash;
Sensitivity to light;
Increased concentrations of glucose, total cholesterol, triglycerides and low-density lipoproteins in the blood.

The greatest danger among the side effects of thiazide diuretics is a decrease in potassium levels in the blood. That is why thiazide diuretics are not recommended for use simultaneously with antiarrhythmic drugs.

Potassium-sparing diuretics - names of drugs, general characteristics, indications and contraindications for use, side effects

Drugs in this group do not lead to the removal of potassium from the body, which was the basis for their name. It is the preservation of potassium ions that determines the positive effect of drugs of this group on the heart muscle. Currently, the following potassium-sparing diuretics are available on the market in the CIS countries - Triamterene, Amiloride and Spironolactone. These drugs have a weak and slow effect, which develops 2–3 days after the start of administration, but lasts for a very long time.
Indications for the use of potassium-sparing diuretics are the following conditions:

Primary hyperaldosteronism;
Secondary hyperaldosteronism caused by chronic heart failure, liver cirrhosis or nephropathic syndrome;
Comprehensive treatment of arterial hypertension;
In combination with other diuretics that cause increased excretion of potassium from the body (potent, medium-strength carbonic anhydrase inhibitors);
Gout;
Diabetes mellitus;
To enhance the effect of cardiac glycosides (for example, Strophanthin, Korglykon, Digoxin, etc.).

The main use of potassium-sparing diuretics is their combination with other diuretics to compensate for potassium excretion. Potassium-sparing diuretics are not used as stand-alone drugs for the treatment of edema and hypertension because their effect is too weak.

Potassium-sparing diuretics are contraindicated in the following conditions:

Hyperkalemia;
Cirrhosis;
Hyponatremia;
Acute renal failure;
Severe form of chronic renal failure.

Potassium-sparing diuretics may cause the following side effects:

Urolithiasis;
Photosensitivity;
constipation or diarrhea;
Headache;
Dizziness;
Cramps of the calf muscles;
Skin rash;
Erectile dysfunction;
Menstrual irregularities;
Changing the timbre of your voice.

Carbonic anhydrase inhibitors - names of drugs, general characteristics, indications and contraindications for use, side effects

Carbonic anhydrase inhibitors are weak diuretics. When taken orally, their effect develops after 1 – 1.5 hours and lasts for 16 hours. When administered intravenously, the effect begins within 30–60 minutes and lasts 3–4 hours. Carbonic anhydrase inhibitors can be used in the form of tablets or intravenous injections. Currently, the following carbonic anhydrase inhibitors are available on the market in the CIS countries - Diacarb and Dichlorphenamide. Since these diuretics are highly addictive, they are used in short courses with breaks between them.

Indications for the use of carbonic anhydrase inhibitors are the following conditions:

Acute attack of glaucoma;
Increased intracranial pressure;
Petite epileptic seizure;
Poisoning with barbiturates (Phenobarbital, etc.) or salicylates (Aspirin, etc.);
During chemotherapy for malignant tumors;
Prevention of mountain sickness.

The main area of use of carbonic anhydrase inhibitors is the treatment of glaucoma, reducing intraocular and intracranial pressure. Currently, carbonic anhydrase inhibitors are not used for the treatment of edema syndrome due to the availability of more effective drugs, but if necessary, the drugs can be used for this condition.

The following conditions are contraindications to the use of carbonic anhydrase inhibitors:

Uremia (increased concentration of urea in the blood);
Decompensated diabetes mellitus;
Severe respiratory failure.

Side effects of carbonic anhydrase inhibitors include the following:

Encephalopathy in patients with liver cirrhosis;
Formation of kidney stones;
Decreased concentrations of sodium and potassium in the blood (hypokalemia and hyponatremia);
Suppression of hematopoietic processes in the bone marrow;
Skin rash;
Drowsiness;
Paresthesia (feeling of goosebumps, etc.).

Osmotic diuretics - names of drugs, general characteristics, indications and contraindications for use, side effects

Osmotic diuretics include Mannitol (mannitol), urea, concentrated glucose solutions and glycerin. These diuretics are the most powerful among all currently available diuretics. Osmotic diuretics are used only as intravenous infusions to treat a variety of acute conditions. Currently, mannitol is the most widely used among osmotic diuretics, since its effect is most pronounced and the amount and risk of side effects is minimal.

Indications for the use of osmotic diuretics are the following conditions:

Brain swelling caused by any factor (shock, brain tumor, abscess, etc.);
Pulmonary edema caused by the toxic effects of gasoline, turpentine or formaldehyde;
Edema of the larynx;
Poisoning with drugs from the group of barbiturates (Phenobarbital, etc.), salicylates (Aspirin, etc.), sulfonamides (Biseptol, etc.) or boric acid;
Transfusion of incompatible blood;
Acute attack of glaucoma;
Acute conditions that can lead to death, such as shock, burns, sepsis, peritonitis or osteomyelitis;
Poisoning with hemolytic poisons (for example, paints, solvents, etc.).

Osmotic diuretics are used only during acute conditions. When a person’s condition normalizes and stabilizes, diuretics are discontinued.

There are no contraindications to the use of osmotic diuretics, since these drugs are used in very severe cases when we're talking about about human survival.

Side effects of osmotic diuretics may include nausea, vomiting, headache, or allergic reactions.

Side effects of diuretics - video

Diuretics for edema

To treat chronic edema in various parts of the body (legs, arms, abdomen, face, etc.), the following potent diuretics can be used:

Torasemide;
Furosemide;
Bumetanide;
Piretanide;
Xipamide.

The above drugs must be taken intermittently, that is, in short courses with intervals between them. An intermittent regimen of administration is necessary in order to avoid addiction and a strong decrease in the severity of the therapeutic effect. Usually the drugs are taken at a dose of 5–20 mg once a day, until the swelling subsides. Then they take a break for 2–4 weeks, after which the course is repeated again.

In addition to the above drugs, the following moderate-strength diuretics can be used to treat chronic edema:

Hydrochlorothiazide (Hypothiazide);
Polythiazide;
Chlorthalidone;
Klopamide;
Indapamide;
Metal shop.

Medium strength diuretics (thiazide diuretics) to eliminate edema should be taken 25 mg once a day. The course of treatment should be continuous and long-term, no breaks are required.

For mild edema caused by mild illnesses or functional disorders, potassium-sparing diuretics Spironolactone, Triamterene or Amiloride can be used for treatment. These diuretics are used at a dose of 200 mg per day, divided into 2 to 3 doses. The duration of the course of treatment is 2 – 3 weeks. If necessary, the course of treatment for edema with potassium-sparing diuretics can be repeated at intervals of 10 to 14 days.

Diuretics for blood pressure (hypertension)

All medications, including diuretics, used for hypertension, are conventionally divided into two large groups depending on the situations in which they are used:
1. Drugs to relieve hypertensive crisis, that is, to quickly lower excessively high blood pressure;
2. Drugs for the ongoing treatment of hypertension, necessary to maintain blood pressure within normal limits.

In fact, drugs for relieving hypertensive crisis are emergency means used when it is necessary to very quickly reduce too much high blood pressure, life-threatening. And drugs for the long-term treatment of hypertension are drugs that are continuously used during periods of remission (outside of hypertensive crises) to control and maintain blood pressure at a constant, normal level.

To relieve a hypertensive crisis, potent diuretics are used, such as ethacrynic acid, Torasemide, Furosemide, Bumetanide, Xipamide and Piretanide. The best remedy among diuretics for reducing blood pressure during a hypertensive crisis is ethacrynic acid and Torsemide. However, in practice, all of the listed drugs are used and have a pronounced effect. Typically, drugs are administered intravenously to ensure the fastest possible effect. The duration of use of potent diuretics is 1–3 days. After the hypertensive crisis has stopped, potent diuretics are discontinued and drugs of another group are prescribed, the action of which is slow, not so powerful and aimed at maintaining pressure at a constant, relatively normal level.

To maintain blood pressure at a constant, normal level, medium-strength diuretics (thiazide diuretics) are used, which include Hydrochlorothiazide (Hypothiazide), Polythiazide, Chlorthalidone, Clopamide, Indapamide and Metozalone. The drug of choice for hypertension is Indapamide, since its blood pressure lowering effect is much stronger than other thiazide diuretics. Indapamide uniformly reduces blood pressure, maintaining it at a constant level throughout the day, and preventing it from increasing in the morning. Indapamide should be taken 1 tablet per day for a long time. The specific duration of the course of therapy is determined by the attending physician.

Diuretics during pregnancy

Diuretics should not be used during pregnancy. Moreover, this ban applies to both medications (tablets) and various natural remedies (for example, herbal decoctions, juices, etc.). The prohibition of the use of diuretics during pregnancy is due to the fact that they remove water and salts from the body, changing or disrupting normal water-electrolyte balance, which will negatively affect both the condition of the child and the mother.

Unfortunately, at present, many women are trying to use diuretics during pregnancy to eliminate edema, completely not understanding that the mechanism of their formation does not allow diuretics to eliminate the problem. Against the background of edema during pregnancy, diuretics will only worsen the situation.

If a woman with edema begins to drink any diuretic drugs (tablets, teas, infusions, decoctions, juices, etc.) to eliminate them, a large amount of water will leave the vascular bed. And swelling, that is, water will remain in the tissues. This will lead to the blood becoming excessively thick due to lack of water, which can provoke thrombosis, placental abruption, fetal death and other adverse consequences for the woman and child. Thus, the problem of edema during pregnancy is too serious and cannot be solved by simply taking diuretics at home. Let's consider the mechanism of the formation of edema in pregnant women, as well as situations when the use of diuretics is necessary to eliminate them.

During pregnancy under the influence various factors water from the vascular bed goes into the tissues, forming edema. In order for a normal amount of water to be in the vascular bed, a woman needs to drink. Then part of the incoming water is excreted from the body with urine, and the remaining is distributed between the tissues and the vascular bed. Unfortunately, it is impossible to suppress the formation of edema, since this is due to the action of hormones and biologically active substances, produced by the mother's body to continue pregnancy. If their effect is stopped, the pregnancy will be terminated. Therefore, while pregnancy continues, it is almost impossible to remove water from tissues, that is, to relieve swelling, since at present there are no means that could “overpower” the influence of pregnancy hormones. This means that the only way to eliminate swelling during pregnancy is to terminate the pregnancy. However, this is not an acceptable option for a woman who wants a child.

Therefore, gynecologists do not treat edema during pregnancy, but in fact simply monitor them. If the swelling is small and does not pose a threat to the woman’s life, then she will have to put up with it, since it is impossible to eliminate it. After childbirth, all swelling will go away very quickly. If the swelling becomes excessively severe, is combined with hypertension, and significantly worsens the woman’s well-being, then she is hospitalized in a hospital, where treatment is carried out aimed at removing fluid from the body. Since this situation usually threatens a woman’s life, doctors use a wide range of drugs, including diuretics.

Furosemide is usually used for 1–2 days to “pull” water out of the tissues, and then Spironolactone or Triampur is used to remove excess fluid from the vessels for 7–10 days. This treatment is enough to eliminate swelling for a while, but it will form again, and this will happen until the end of pregnancy. If edema cannot be treated or develops too quickly, threatening the woman’s life, then the pregnancy is terminated for medical reasons.

The best diuretics

Unfortunately, at present there are no ideal medications, so it is simply impossible to choose the “best” diuretic that is ideal for all people, has a pronounced effect and does not cause side effects. After all, each diuretic has its own characteristics, which are optimal for a particular situation. And if the drugs are used specifically taking into account a specific situation, then they will truly be “the best” for this person.

Therefore, doctors do not say the “best” drug, preferring to use the concept “optimal”, that is, best suited to this person in his specific situation. For example, with cerebral edema the best drug, that is, Mannitol will be optimal in this situation, and in case of hypertensive crisis - ethacrynic acid, etc. That is, in order to choose the “best” diuretic drug, you need to consult a doctor who will select the drug that is optimal in a particular situation, and it will be the “best”.

Effective diuretics

All modern diuretics are effective, but the maximum severity and usefulness of the action of each drug is possible only when used in certain situations. In other words, each diuretic has indications for use for which it will be very effective. Therefore, in order to understand which diuretic will be effective in this particular case, it is necessary to formulate the purpose of its use, for example, “eliminating hangover syndrome,” “reducing blood pressure,” etc. Then find out which drugs are effective for the stated purpose and choose one of them. It is this diuretic drug that will be effective in this particular case.

Strong diuretic

Strong diuretics include the following drugs:

Torasemide;
Furosemide;
Bumetanide;
Piretanide;
Xipamide;
Ethacrynic acid;
Mannitol;
Urea.

Mild diuretics

Mild diuretics include the following:

Spironolactone;
Triamterene;
Amiloride;
Diacarb.

Safe diuretics

There are no safe diuretics, like any other medicines. Each medicine can cause side effects or have a negative impact if used off-label or against the background of existing contraindications. Also, any medicine can become dangerous if the dosage is exceeded, the duration of the course of treatment and other rules for using the drug are not followed. Therefore, the same diuretic drug in one case will be completely safe, but in another, on the contrary, very dangerous.

In principle, all diuretics (tablets, herbs, teas, decoctions, etc.) are potentially dangerous because they remove fluid and ions from the body, which can lead to water-electrolyte imbalance. And severe pathologies of water and electrolyte balance without timely treatment can lead to death. However, even among these potentially very dangerous drugs, there are relatively safe ones, which include Spironolactone and Triamterene. These diuretics are the safest available.

Natural (natural, folk) diuretics

Natural diuretics include various decoctions of medicinal plants, as well as food products that have the property of increasing the removal of water from the human body. The most effective natural diuretics are various decoctions, infusions and teas made from medicinal herbs. Food products have a less pronounced diuretic effect. However, both herbs and products have a relatively weak diuretic effect compared to modern specialized drugs. Therefore, natural remedies serious illnesses can only be used as part of complex therapy as auxiliary components. But for the treatment of functional disorders, herbal diuretics may well be used as the only and main remedy.

The selection of an herbal natural diuretic should be made by a doctor, since different herbs and products are used to treat different diseases. For example, in case of heart failure, leaves containing vitamins and microelements are used as a diuretic, due to which the severe side effects characteristic of tablets will be completely eliminated. To obtain a diuretic effect, you can consume the above products both in their natural form and in the form of juices. However, in order for the diuretic effect to develop, products cannot be subjected to heat treatment; they can only be consumed fresh.

Tea as a diuretic can have a general or targeted effect. For example, rose hip or cat whisker tea has a targeted effect and is used for certain diseases. And tea made from dill, mint, nettle, horsetail and other herbs that have a diuretic effect, have a general effect, and therefore can be used as a diuretic for any condition.

Most often, diuretic teas made from herbs that have a general effect are positioned as weight loss products and are sold in pharmacies or other stores. In principle, they can be used for their intended purpose (as a diuretic), if there are no serious diseases and contraindications to the use of diuretics in principle. These ready-made diuretic teas are convenient because you just need to put the bag in boiling water, steep for a couple of minutes, and the drink is ready. According to doctors, diuretic teas for weight loss are optimal for the complex treatment of edema in various diseases of the kidneys, heart, liver and other organs.

Targeted diuretic teas usually fall into the category of decoctions and infusions of medicinal herbs, since they are used only for certain conditions. The most effective and safe diuretic herbs currently are the following:

Rose hip tea , used to eliminate swelling after surgery or antibiotic therapy. To prepare, chop 2 – 3 teaspoons of rose hips and brew in a glass of boiling water. Ready tea to drink throughout the day. You can drink rosehip tea for 10 days, after which you take a break for 7–10 days, after which the course can be repeated;
Cat's whisker tea used for kidney diseases. Take for 4 – 6 months with 5-day breaks every month;
A decoction of flax seeds. Pour a teaspoon of flax seeds into a liter of boiling water, boil for 15 minutes, then leave for 1 hour. Drink the finished infusion half a glass every 2 hours;
Infusion of birch leaves used to treat edema in heart and kidney diseases. Grind 100 g fresh leaves birch and pour 0.5 liters of warm water, leave for 6 - 7 hours. Strain and squeeze the mixture, place on a flat surface until sediment appears, which is filtered through several layers of gauze. Drink a tablespoon of pure infusion 3 times a day;
Bearberry leaf tea used for inflammatory diseases bladder, ureters and urethra. For one serving, take 0.5 - 1 g of bearberry leaves and pour a glass of water, leave for 5 - 10 minutes, and then drink. They drink tea 3–5 times a day;
Infusion of lingonberry leaves used for inflammation of the urinary tract. To prepare the infusion, pour 1 - 2 g of leaves into a glass of water, infuse and drink 3 - 4 times a day.

Homemade diuretics

There is a recipe for a mild diuretic that can be prepared at home and is used only for the treatment of functional conditions, for example, to speed up the elimination of alcohol after a stormy party, increase the effectiveness of the diet, etc.

To prepare homemade diuretic tea, you need to mix 20 g of parsley, hay, dandelion and nettle, as well as 10 g of dill and mint. Pour a teaspoon of the resulting green mixture with a glass of boiling water, leave for 10 minutes, strain and drink in small sips. Tea should be drunk 30 minutes after meals, 1 glass per day.

Diuretics for weight loss

Diuretic tea for weight loss is sold in pharmacies and, when used correctly, can be beneficial by enhancing the effectiveness of the diet. It should be remembered that diuretic tea for the purpose of losing weight can only be used against the background of a diet. The diet leads to the breakdown of adipose tissue, resulting in the release of quite a large amount of water. It is this water that the diuretic tea will remove, preventing its reabsorption and, thereby, enhancing the effectiveness of the diet, the final result of which will be much better than expected. To enhance the effectiveness of the diet, you can use any diuretic tea sold in a pharmacy.

However, drinking diuretic tea for weight loss without simultaneously following a diet is strictly prohibited, since this will lead to weight loss due to dehydration of the body, which is fraught with serious problems.

Losing weight with diuretics - video

Before use, you should consult a specialist.

In case of obesity, drugs are taken to lose weight. To get maximum results from using diuretics, you must follow the rules for their use.

Mechanism of action of diuretics

Diuretics, or diuretics, affect the functioning of the kidneys, that is, they help increase fluid excretion. This leads to stronger urine production and frequent elimination. Due to their properties, diuretics reduce the absorption of salts in the renal tubules. As a result of this, their intensive removal occurs along with excess fluid. Thanks to this, swelling of organs and tissues is reduced, the load on the heart is reduced and blood pressure is normalized.

What are the basic admission rules?

Only a specialist can choose the right diuretic. Unauthorized decisions to use diuretics lead to an imbalance of substances in the body. The doctor prescribes the drug based on the results of laboratory tests of urine and blood, as well as based on the patient’s existing complaints and illnesses. To monitor the effectiveness of the diuretic taken, the patient provides the attending physician with measured data. Based on the obtained figures, the doctor adjusts the dosage of the drug. Important among them are:

the amount of liquid drunk and that which left the body;
morning and evening pressure readings;
volumes of swelling;
patient's weight.

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In what cases should you take a diuretic?

For swelling

Under pressure

Diuretic tablets can normalize high blood pressure. This occurs due to increased fluid excretion through urine. By reducing water in the body, the load on the cardiovascular system is reduced. At the initial stages of treatment, the doctor prescribes minimal doses of a diuretic. When the blood pressure normalizes after using it, the patient continues to take the diuretic. Otherwise, the doctor adjusts the treatment.

What can you drink during pregnancy?

Swelling during pregnancy appears in the 3rd trimester. This symptom may indicate problems with the kidneys, heart or liver. However, the cause of swelling may be excessive air temperature. In any case, if they are present, it is better to more carefully monitor the health of the expectant mother. Neglect of such a symptom is harmful to the child. At the same time, you should not engage in self-medication and traditional medicine. Even seemingly harmless herbs and berries can harm a pregnant woman and child. Strawberries, juniper and parsley should be taken with caution. Approved diuretic tablets include Canephron, Phytolysin and Eufillin. Each of them is safe for the expectant mother and child, but it is important to follow the dosage and regimen of use.

For heart failure

How to take a diuretic without harm to the body?

Thiazide diuretics

After a week of use, it is recommended to take a break of at least 4 days.
Treatment begins with minimal doses to prevent adverse reactions.
Along with diuretics, a diet with a high potassium content is prescribed.

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Should loop diuretics be taken in the morning or evening?

Potassium-sparing diuretics

Natural (herbal) diuretics

The mechanism of action of diuretic drugs in this group is based on the properties of medicinal herbs. Experts prescribe drugs in the form of solutions or pastes. In the first case, water is used to dissolve the required dose. To reduce the unpleasant taste, juice or other liquid is added to the product. Diuretics in the form of a paste are also dissolved in water and taken after a meal. Along with the use of a herbal diuretic, marinades, spices and sauces are prohibited. You need to drink at least 2 liters of non-carbonated mineral water per day.

How often to take and how to get off a diuretic?

Stopping the use of diuretics should be gradual. This is especially true for patients with unstable blood pressure. Abrupt refusal of diuretics leads to complications of existing diseases. To properly stop using medications, you should gradually reduce the dose. The schedule for how much is better to take, how often and when to stop is drawn up by the attending physician.

Adverse symptoms of diuretic use

Why doesn't a diuretic help?

The causes of swelling are various diseases. To maximize the effect of a diuretic, it is necessary to clearly determine which disease was the root cause of fluid retention in the body. Only after making a diagnosis can a specialist prescribe a diuretic that will bring the most pronounced results. One of the reasons for its ineffectiveness is the site of action of the drug. Loop diuretics are closer to the kidney and have the most effective effect. The second most effective are thiazide drugs. The effect of potassium-sparing diuretics occurs later than others. A diuretic drug that will help the patient as much as possible should be prescribed by the attending physician. Self-medication leads to complications of diseases.

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Diuretics for weight loss

The method of losing excess weight with the help of diuretics has gained great popularity. There is an opinion that this is much safer than being on a strict diet for a painfully long time. Diuretics do help you lose weight, but they are far from harmless. They should be used wisely, otherwise you can undermine your health.

Diuretics for weight loss

The cells of the body function, as is known, only in liquid medium Therefore, the human body consists of 65-75% water. Excessive amounts can lead to edema, high blood pressure, and excess weight gain. Diuretics have the remarkable ability to remove fluid from the body. This is why diuretics are so attractive to those who want to get a slim body quickly and easily.

However, initially diuretics are not diuretic diet pills at all, but drugs created to treat serious illnesses genitourinary, cardiovascular, endocrine, respiratory systems. The use of such medications is associated with a number of contraindications, restrictions, and side effects. They must definitely be taken into account, otherwise, instead of benefit, you can cause harm to the body.

When using diuretics for weight loss, it should be understood that body weight is reduced due to the fluid removed from the tissues. The stronger the diuretic effect of the tablets, the more urine is produced and the less body weight becomes. However, as soon as you drink a bottle of soft drink in the heat, your water balance is restored, and with it your weight inevitably increases.

In addition, you need to know: in the process of losing weight, diuretics have no effect on subcutaneous fats! They are not broken down either with excess or deficiency of water in the body. You can get rid of fat reserves if you actively spend energy. This does not require diuretics, but thorough physical activity. At the same time, weight loss results should be consolidated with a balanced diet.

In addition to synthesized medications, diuretics are also dietary supplements (biological active additives to food). Turboslim, Tienshi, Hoodia Gordonia, Fitomucil, Chitosan, XLS Medical are considered effective. Leaves of bearberry, sage, fennel, mint, chicory, and yarrow have a pronounced diuretic effect. Famous products include watermelon, cranberries, viburnum, lingonberries, melon, blackberries, and gooseberries. Such safe gifts of nature are especially useful on fasting days.

Benefit

In severe hypertension, the heart, forced to work under high pressure literally to the point of wear and tear, cannot cope with the increasing load of pumping blood. Fluid reserves increase in the tissues, and swelling occurs. Diuretics are prescribed for weight loss. Main goal taking them reduces high blood pressure and eases the load on the heart muscle.

Diuretic medications taken to help you lose extra pounds can be helpful because they enhance the effectiveness of weight loss diets. Diuretics often replace grueling physical training and eliminate strict dietary restrictions. In addition, such drugs cleanse the body. The effect of these drugs on the kidneys, stomach, intestines, liver, and skin is especially beneficial.

The disadvantage of diuretics is that, along with excess fluid and waste, medications remove valuable substances. First of all, it is potassium, which is so necessary for the heart muscle. To prevent a deficiency, experts advise replenishing the reserves of this element simultaneously with the use of diuretics. There is a lot of potassium in bananas, legumes, potatoes, honey, milk, fish.

In addition, if you often use diuretics for weight loss at home, the body may experience an imbalance in water balance and dehydration may occur due to fluid loss. This dangerous condition! Rapid heartbeat, ringing in the ears, convulsions, loss of consciousness, and blood clots may occur. Diuretics should not be taken for weight loss by nursing mothers or pregnant women.

Types of diuretics

The classification of diuretic drugs for weight loss is as follows:

very powerful: Mannitol, Glycerin, urea, potassium acetate (removes large amounts of potassium and sodium, so they are prescribed only for critical conditions);
potent: Furosemide (Lasix), Bumetamide, ethacrynic acid, Peritanide, Torasemide (they cannot be used in courses - only once);
diuretics of medium potency: Indapamide, Hypothiazide, Dichlorothiazide, Chlorthalidone, Clopamide (can be used in long courses);
weak: Spironolactone (Veroshpiron), Triamterene, Amiloride (potassium-sparing drugs prescribed in combination with stronger diuretics);
even weaker: Diacarb, Dichlorphenamide (used mainly for increased intracranial and intraocular pressure).

How to take diuretic pills for weight loss

Before using diuretics, you should consult your doctor. This is especially true for people with kidney disease, diabetes, gout, and skin tuberculosis. Diuretics often disrupt water balance, and for this reason dangerous complications can occur. It is also necessary to check whether regularly taken medications, which can neutralize their effect, are compatible with them.

It is necessary to adhere to mandatory rules when taking diuretics for weight loss. You should:

exclude all salty dishes from the menu;
drink a lot of water (7-8 glasses daily) to prevent dehydration;
Use natural diuretics for weight loss whenever possible: parsley, tea, coffee, watermelon, melon;
measure your body weight every morning, preferably with a fat analyzer.

Furosemide

The first urge after taking the medicine occurs within minutes. The effect of the drug lasts about 17 hours. It is important to realize that arbitrary use of Furosemide for weight loss is fraught with irreversible complications. The dosage should be agreed with your doctor! Strong diuretics have the following contraindications and limitations:

chronic kidney and liver diseases;
severe heart and vascular diseases (especially heart attack);
diabetes;
pancreatitis;
prostate adenoma;
allergies;
gout;
lupus erythematosus;
neurological or mental pathologies;
pregnancy, breastfeeding.

The medicine significantly suppresses the immune system, so it often appears colds. Potency problems can occur in men. You must be prepared for the side effects that strong diuretics have. Among them:

pressure drop;
drowsiness, apathy;
fainting states;
change in taste preferences in food, nausea;
swelling;
yellowness of the skin, rashes;
increase in temperature;
constipation;
muscle pain;
lack of coordination;
hearing loss.

Asparkam

Diuretics of this type contain potassium and magnesium and are intended primarily for patients suffering from cardiovascular diseases. Asparkam activates metabolic processes and accelerates blood circulation, making it a safer way to lose weight than taking Furosemide. It is recommended to take 1 tablet 3 times a day after meals for a month.

However, this drug also has contraindications:

severe renal failure;
atrioventricular block (obstruction of impulses from the atrium to the ventricle of the heart);
conditions after injuries, operations;
recent burns;
hemolytic anemia (premature destruction of red blood cells);
myasthenia gravis (muscle weakness).

Video

Reviews

Anya, 28 years old: On major holidays I want to look like a queen. I take diuretics for weight loss, most often Furosemide, and my favorite dress feels like a glove again. My legs are swelling. After Furosemide I feel comfortable wearing stiletto heels. You just can’t take diuretics often.

Svetlana, 35 years old: I took Furosemide to lose weight and really regretted it. Terrible swelling appeared, the eyes turned into slits. Then the skin was “decorated” with a rash. She was in the hospital on IV drips. After this, sometimes I take only Hypothiazide - it is much safer.

Olga, 29 years old: The best thing for losing weight is to brew linden blossom and mint as tea and drink a little throughout the day. I also love it when watermelon season comes. Natural herbs and berries are much healthier. Besides, this yummy food is much nicer than chemicals!

The information presented on the site is for informational purposes only. The site materials do not call for self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on individual characteristics specific patient.

How to take diuretics (diuretics and tablets) correctly?

Before taking diuretics for edema, you need to consult a doctor about the problem and find out the cause of fluid retention. You should not use diuretics yourself, as they change the salt balance, thereby causing adverse reactions. It should also be noted that swelling is only a symptom of a disease. It is impossible to manage with diuretics alone. Therefore, how to take diuretic tablets correctly should be consulted with a specialist who, taking into account the interaction of drugs, the patient’s condition and his concomitant diseases, will select correct dosage and appointment time.

What should the patient consider?

To take diuretics correctly, you must adhere to the basic principles. Every day you need to measure the following parameters and write them down in a notebook:

Monitoring fluid intake and excretion throughout the day.
Blood pressure measurement (morning, evening).
Measure body weight.
Measure the volume of the abdomen and legs (depending on the location of the edema).

All this data must be provided to your doctor so that in the future he can adjust the dosage of the drug, replace it with another, or add another medicine. If there is feeling unwell(dizziness, nausea or other negative sensations) you should immediately notify your doctor.

Not all diuretics have the same mechanism of action. Among them there are: potassium-sparing (Vershpiron, Triamterene), loop (Furosemide), thiazide (Hypothiazide), herbal. To understand how to take diuretics correctly, you need to know the pharmacodynamics of each group.

Thiazide diuretics

The action of thiazide diuretics is based on the removal of sodium, chlorine and, to a lesser extent, potassium. The advantage of the drugs is that they are not addictive. Even long-term use does not weaken the diuretic effect. But despite this, it is not recommended to take it for more than 7 days in a row. If necessary, take a break of 4 days and resume treatment.

Thiazide drugs are rapidly absorbed and begin to act within 2 hours. A single dose of the tablet prolongs the diuretic effect for up to 12 hours. Thiazides are usually prescribed in small doses to reduce side effects. To prevent the leaching of potassium salts, it is recommended to follow a diet that includes dried apricots (peach or apricot), bananas, baked potatoes, prunes and other foods high in potassium.

Loop diuretics

The diuretic effect after taking loop diuretics occurs very quickly. After taking the tablets, fluid removal begins within an hour and lasts about four hours. But such an effect on the body increases the risk of disrupting the ion balance. To avoid complications, it is recommended to use potassium supplements (Asparkam, Kalinor, Panangin). Long-term use of loop diuretics requires correction of potassium metabolism.

Take diuretic tablets correctly fast acting once in the morning. It is not recommended to exceed the prescribed dose. There are active and maintenance phases of treatment with loop diuretics. Begin therapy with a moderate dose, which is gradually increased if necessary. The maintenance phase consists of continuously taking medications.

Potassium-sparing diuretics

Potassium-sparing diuretics remove sodium along with urine and completely retain potassium content. Therefore, when taking diuretics of this group, drugs that replenish potassium are not prescribed. The diuretic effect may occur within 2 hours. It is usually recommended to take diuretics once a day during the day. If the level of urea in the blood increases, the drug is taken every other day.

Some diuretics of this group (Spironolactone, Veroshpiron) exhibit a diuretic effect only on day 2. Typically, such drugs are combined with other diuretics when potassium loss is undesirable. If you need to take the medicine 2 times a day, then take the first dose in the morning and the second in the afternoon. Herbal diuretics

For kidney disease and the appearance of edema, diuretics based on medicinal herbal extracts (Canephron N, Cyston, Fitolysin, Urolesan) are prescribed. The dosage and frequency of administration should be prescribed by the doctor depending on the patient’s problem. If a diuretic is prescribed in solution, then the required dose must be diluted with water before taking. To soften the unpleasant taste, you can dilute it with other liquids (juice, compote).

If diuretics in the form of a paste (Phytolysin) are prescribed, take them correctly after dissolving them in warm water. The resulting suspension is drunk after meals. During therapy with herbal diuretics, irritating foods (spices, smoked meats, marinades) are excluded from the diet and the volume of liquid is increased to 2 liters. If allergic reactions occur, the drugs are discontinued.

Diuretics for edema, presented today in huge quantities by various pharmaceutical companies, help to quickly remove it.

A diuretic collection is an excellent means of helping those who want to speed up the excretion of urine to eliminate swelling in any area.

The kidneys perform the function of the body’s natural filters, which are involved in the process of cleansing the body and regulating the water-salt balance. As soon as.

Excessive accumulation of fluid in the body is a problem that is solved in modern medicine by prescribing diuretics. Enough.

In the minds of many, edema is initially associated with diuretic drugs. Is it possible to take diuretics if there is a delay?

Fluid retention in the body occurs due to various reasons. Inflammatory diseases urinary system, heart failure, disorder.

Reviews and comments

I have heart failure, I take a lot of diuretics, which causes terrible constipation, apparently all the water leaves the gastrointestinal tract, I no longer have the strength! What to do, but you can’t give up diuretics.

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How to take diuretic tablets for edema

Diuretics (tablets, solutions) have become quite firmly established in our lives. They are used to correct acid-base balance in the body. After all, they perfectly remove excess acid and alkali from it. Diuretic tablets, the list of which is quite impressive, are used in the treatment of poisoning, some injuries (especially when it comes to head injuries), and to combat hypertension. But, unfortunately, not everyone knows not only the mechanism of action of these drugs, but also the side effects that they can cause. And improper use of diuretics can lead to serious complications.

Diuretic tablets are used to treat many ailments. The list of effective drugs continues to grow today. Diuretics are also called diuretics.

Their main goal is to remove excess water, chemicals, and salts from the body, which tend to accumulate in the walls of blood vessels and tissues. In addition, diuretics have a positive effect on water-salt balance.

If the body accumulates large number sodium ions, then subcutaneous tissue begins to be deposited. It has a very negative effect on the functioning of the kidneys, heart, and hematopoietic system. As a result, the patient develops a variety of diseases and disorders.

In addition, diuretics are in great demand in sports medicine. They are often used for weight loss. Very often, diuretics (tablets) are included in complex therapy to combat various ailments.

Based on their effect on the body, modern diuretics are divided into two main forms. The first category of drugs affects the process of urine formation directly in the kidneys. The second form of diuretics is responsible for the hormonal regulation of urine production.

There is a lot of information that diuretic tablets, the list of which is given below, also easily solve cosmetic problems. However, many people believe that such drugs are completely safe. Some women take these medications on their own for weight loss purposes. Athletes widely use drugs before competitions in order to lose weight. Even bodybuilders use them, trying to create artificial dehydration so that the muscles look more prominent.

However, people who take diuretics without a doctor's prescription are at great risk. After all, treatment with diuretics can lead to unpleasant consequences. You should know that diuretics can:

Remove potassium from the body, thereby increasing human fatigue.
Provoke salt deposition.
Increase the risk of diabetes because they increase levels of “bad” cholesterol.
Increase urination, causing sleep disturbance.
Create problems for men with potency.

Quite often, even those patients who understand the risk believe that the newest drugs “Indapamide”, “Torasemide”, “Arifon” do not have a detrimental effect on metabolism. Such medications are indeed much better tolerated than older generation medications. However, they are also harmful to health. But negative impact these funds are revealed much later. It is enough to understand the mechanism of their action. Medicines of the new and old generation are aimed at one thing - to stimulate the kidneys to work more intensively. Consequently, they excrete more salt and water.

It is important to understand that fluid retention in the body is a symptom of a serious illness. Swelling cannot occur on its own. It is provoked by serious disruptions in the functioning of the kidneys, heart, and sometimes other reasons. Consequently, diuretics are drugs (their list is very extensive) with exclusively symptomatic action. Unfortunately, they do not get rid of the cause of the disease. Thus, medications only delay the unpleasant ending for patients. Therefore, people who want to improve their health and fight real disease, should not make do with diuretics alone, much less use them independently.

To this day, there is no single system according to which all diuretics are divided, since all drugs have different chemical structures and have different effects on the body systems. Therefore, it is impossible to create an ideal classification.

Often the division occurs according to the mechanism of action. According to this classification, there are:

Thiazide drugs. They are excellent for treating hypertension and are excellent for lowering blood pressure. It is recommended to use them in parallel with other medications. Thiazides can negatively affect metabolism, so such diuretics are prescribed in small quantities. Drugs (a list of only the most popular ones is given in the article) from this group are “Ezidrex”, “Hydrochlorothiazide”, “Chlorthalidone”, “Indapamide”, “Hypothiazide”, “Arifon”.
Loop means. They remove salt and fluid from the body due to their effect on kidney filtration. These medications have a rapid diuretic effect. Loop diuretics do not affect cholesterol levels and do not create preconditions for the occurrence of diabetes mellitus. However, their biggest drawback is the many side effects. The most common drugs are Torasemide, Furosemide, Ethacrynic acid, Bumetanide.
Potassium-sparing agents. Quite an extensive group of drugs. Such medications help increase the excretion of chloride and sodium from the body. At the same time, the removal of potassium is minimized by such diuretic tablets. List of the most popular drugs: Amiloride, Triamterene, Spironolactone.
Aldosterone antagonists. These diuretics block the natural hormone that retains salt and moisture in the body. Drugs that neutralize aldosterone promote fluid removal. At the same time, the potassium content in the body does not decrease. The most popular representative is “Veroshpiron”.

For good effect, potent agents can be used. The following diuretic tablets are used for edema:

Medium-strength diuretic tablets can also be used for edema:

Such drugs are used for a long time and continuously. The recommended dose is determined by the attending physician. As a rule, it is about 25 mg per day.

For minor edema, potassium-sparing diuretics, such as Spironolactone, Amiloride, and Triamterene, are more suitable. They are taken in courses (2-3 weeks) at daily intervals.

Diuretic medications that are used for high blood pressure fall into two categories:

Remedies that have a quick effect. Such drugs are used during a hypertensive crisis, when there is a need to quickly reduce blood pressure.
Products for daily use. Medicines help maintain optimal blood pressure levels.

Potent medications can stop a hypertensive crisis. The most popular drug is Furosemide. Its price is low. The following remedies are no less effective during a crisis:

The duration of taking the above medications can be 1-3 days. After stopping the crisis from such potent drugs switch to medications that can maintain blood pressure at the required level every day.

These medications are taken daily as prescribed by your doctor. They perfectly maintain the optimal pressure level.

Drugs for heart failure

As a result of this pathology, fluid retention in the body often occurs. This phenomenon creates stagnation of blood in the lungs. The patient exhibits many unpleasant symptoms, such as shortness of breath, swelling, enlarged liver, and wheezing in the heart.

For people with heart failure, the doctor must introduce a diuretic into therapy. It perfectly prevents severe consequences such as pulmonary edema and cardiogenic shock. At the same time, diuretics increase patients' tolerance to physical activity.

For patients with the first and second degrees of the disease, a good diuretic is a thiazide drug. In case of more serious pathology, the patient is transferred to a strong drug - a loop diuretic. In some cases, the drug Spironolactone is additionally prescribed. It is especially important to take such a remedy if the patient has developed hypokalemia.

If the effect of using the drug Furosemide weakens, cardiologists recommend replacing it with the drug Torasemide. It has been noticed that the latter remedy has a more beneficial effect on the body when severe forms heart failure.

The medicine is a fast-acting diuretic. Its effect occurs after taking it for 20 minutes. The duration of the drug's effect is about 4-5 hours.

This remedy is effective not only for stopping a hypertensive crisis. According to the instructions, the medicine helps with heart failure, swelling of the brain and lungs, and chemical poisoning. It is often prescribed for late toxicosis during pregnancy.

However, the product also has strict contraindications. The drug is not used in the first trimester of pregnancy. It should not be used in patients with renal failure, people who have hypoglycemia, obstruction urinary tract.

The cost of the drug "Furosemide" is low. The price is approximately 19 rubles.

The medicine is a fast-acting remedy. The drug "Furosemide" undergoes biotransformation in the kidneys, so it is not suitable for all patients. A more effective medicine for people suffering from kidney diseases is the drug "Torasemide", since it undergoes biotransformation in the liver. But with pathologies of this organ, the medicine can cause serious harm.

After just 15 minutes, the effect on the body begins (as stated in the instructions for use attached to the drug "Torasemide"). The price of the product varies from 205 to 655 rubles.

Long-term studies have confirmed the high effectiveness of the drug in heart failure. In addition, the drug perfectly removes salts and liquid. At the same time, the loss of potassium by the body is insignificant, since effective remedy blocks the hormone aldosterone.

The medicine is very effective for hypertension (severe and moderate). The product perfectly reduces blood pressure and maintains its optimal level throughout the day. In addition, it prevents an increase this indicator in the morning.

You need to take the medicine once a day, 1 tablet, as evidenced by the instructions included in the drug “Indapamide”. The price of the product varies on average from 22 to 110 rubles.

Before taking it, you should familiarize yourself with the contraindications, since this excellent remedy is not suitable for all patients suffering from hypertension. The drug is not intended for people who have problems with the kidneys or liver. Pregnant and nursing mothers are prohibited from taking the medicine. In case of cerebral circulation failure, anuria, hypokalemia, the drug is contraindicated.

The medicine is mild diuretic. It is recommended to use it in combination with another diuretic drug, Hydrochlorothiazide. Thanks to this combination, it is possible to reduce the loss of potassium by the body. The drug Triamterene has a beneficial effect. The instructions position it as a potassium-sparing agent.

The medicine should be used strictly according to the prescribed dosage. People with impaired kidney function may experience an unpleasant side effect: increased potassium levels. Sometimes the product can lead to dehydration. When interacting with folic acid, the medicine helps increase red blood cells.

The cost of the product is 316 rubles.

The medicine is a potassium- and magnesium-sparing agent. At the same time, it effectively removes sodium and chlorine from the body. After starting to take the drug, the diuretic effect occurs approximately 2-5 days.

The medicine can be prescribed for hypertension, chronic heart failure, liver cirrhosis, nephrotic syndrome. The use of Spironolactone is effective for swelling in the 2nd and 3rd trimester of pregnancy.

The drug is not intended for people diagnosed with diabetes mellitus, renal or liver failure, or anuria. It is forbidden to use the product in the first trimester of pregnancy. In case of hyponatremia, hyperkalemia, hypercalcemia, the drug is contraindicated. It should not be administered to people with Addison's disease.

Side effects may also occur when taking the medicine. In some cases, the drug provokes urticaria, itching, drowsiness, headache, diarrhea or constipation.

The cost of the product is about 54 rubles.

Many patients are interested in the opinions of those people who are already taking diuretic pills. Reviews usually contain information about effectiveness and side effects.

People facing a hypertensive crisis confirm that the drug Furosemide can help very quickly and effectively. However, at the same time, they emphasize that the drug should be used only as prescribed by a doctor and in recommended doses.

The effectiveness of the product is also confirmed by pregnant women who use the drug in the last months of pregnancy. Patients claim that it perfectly relieved swelling.

However, abusing the drug is strictly prohibited. After all, the drug "Furosemide" is quite easily addictive. In addition, the product removes potassium from the body. After long-term use, patients may experience seizures.

The drug “Indapamide” is in high demand. Hypertensive patients are often prescribed this remedy. There is an opinion among patients that the medicine is well tolerated by the body. In this case, the diuretic effect is favorable. There are no negative opinions about the drug.

The drug Torasemide has a good effect on the body. Patients who take the drug strictly as prescribed by a doctor and under his supervision say that the drug is very effective. It perfectly relieves puffiness. At the same time, patients do not experience any problems in the form of side effects.

Other diuretic tablets also bring favorable results to the body. Reviews of the drug Spironolactone indicate a strong diuretic effect. However, patients claim that the drug should be used only as prescribed by a doctor and in appropriate doses.

Before taking a diuretic, be sure to tell your doctor about all the medications you are taking. In addition, an important factor in selecting the necessary medication is the presence of chronic ailments. You should not take such medications without permission. It is necessary to strictly follow the doctor's instructions. Take the drug at the appointed time (this will avoid unpleasant awakenings at night) and only in the dosage that was prescribed to you. Such simple truths will allow you not to feel severe consequences taking diuretics.

Why are diuretics needed? Mainly to relieve generalized edema syndrome, which accompanies serious diseases of the heart, kidneys and lungs. It is pointless to treat local edema with diuretics, since medications only muffle the symptoms. It is necessary to look for the causes of edema, which can be very serious (lymphostasis, blockage of lymph nodes, etc.). Then why do they take diuretics and why are they needed? Diuretics are not usually prescribed as a separate medication. Doctors prescribe them in combination with other drugs.

When you drink a diuretic, the reabsorption of potassium, sodium and chlorine in the kidneys is inhibited. These electrolytes begin to be intensively excreted along with the liquid. The body's blood volume decreases and blood pressure decreases. This leads to a decrease in the load on the heart. Diuretics are also used for other diseases of the cardiovascular system, liver, kidneys, eyes (glaucoma).

Indications for the use of diuretics (diuretics) are:

Only a doctor should tell you what diuretics to take and when to take them. Different types of these medications are indicated for each condition. In low doses, thiazide diuretics (Hypothiazide, Hydrochlorothiazide) have a hypotensive effect in patients with moderate arterial hypertension. In order to prevent the loss of potassium that occurs when taking diuretics, potassium-sparing drugs (Triamterene, Veroshpiron) are prescribed. In order to reduce cerebral edema, Manit is prescribed. In cases where a quick effect is needed, Torasemide, Trifas, Furosemide are prescribed.

It is impossible to replace diuretics where nothing can replace them. However, you should not get carried away with diuretics, as they have serious consequences:

Mostly side effects appear due to electrolyte imbalances and a shift in urine acidity and the appearance of acidosis. To reduce the risk of side effects, patients should inform their doctor about the medications they are taking and any chronic medical conditions they have.

Swelling can be either temporary or permanent. Puffiness of the face, swollen legs and arms spoil a person’s appearance. And often the patient himself, trying to get rid of the problem, prescribes a diuretic for swelling. Unfortunately, diuretics not only do not relieve a person of the problem, but can also aggravate the course of the underlying disease that caused the edema. Therefore, in order to properly treat this symptom, it is important to identify the cause.

If kidney function is impaired or the head is positioned incorrectly during sleep, swelling appears mainly on the face. Another reason is excessive use liquids in the evening. U healthy person The swelling goes away on its own within a couple of hours. Patients with chronic renal failure should not use potassium-sparing and osmotic diuretics, as life-threatening complications may occur.

A dangerous cause of edema is a disruption of the heart and the formation of CHF. In this case, a diuretic for edema is prescribed to relieve the myocardium. To reduce severe edema, drugs with a rapid diuretic effect are prescribed (Torasemide, Furosemide, Trifas). For prevention, potassium-sparing agents are prescribed (Veroshpiron, Triamterene, Spironolactone). In case of violations venous outflow Diuretics for edema are prescribed with great caution, since their improper use can lead to impaired microcirculation and thrombosis.

If you regularly use diuretics for weight loss, you can get rid of extra pounds. However, weight loss will only occur due to the removal of fluid from the body. In addition, important microelements involved in metabolism will be released along with water. At the same time, fat cells deprived of fluid are not destroyed. As soon as a person stops taking diuretics, fat cells will again replenish the lack of fluid, and the weight will return to the same.

There is another factor that indicates that you should not take diuretics for weight loss. Medicine describes a syndrome called “idiopathic edema.” They occur with prolonged use of diuretics, which leads to adaptation to their action. As a result, instead of losing weight, it begins to gain.

In order to minimize the risk of side effects, doctors recommend consulting with nutritionists and taking medications strictly as prescribed. It is recommended to take diuretics for weight loss instead of synthetic drugs and include foods with a mild diuretic effect (artichoke, asparagus, juniper, celery, watermelon).

Expectant mothers need to know that it is prohibited to drink diuretics without permission during pregnancy! Prescribing yourself even “harmless” drugs plant origin can lead to electrolyte imbalance and cause significant harm to mother and baby. Diuretics lead to disruption of the uteroplacental circulation, thrombosis of placental vessels, disruption of fetal development, etc. Synthetic drugs can be prescribed in extreme cases in recent months. For example, to relieve a hypertensive crisis at risk of pulmonary edema.

If necessary, doctors prescribe Canephron to pregnant women, which is made from medicinal herbs (rosemary, lovage, centaury). Phytolysin is also used, but only if the pregnant woman does not have inflammation in the kidneys. Under the supervision of a doctor, for edema, take the bronchodilator drug Eufillin, which has a diuretic effect.

Pregnant women should also take herbal decoctions with caution. It is forbidden to drink juniper tea, which can cause uterine contractions. Plants such as parsley and strawberry leaves are contraindicated. It is allowed to take tea from lingonberry leaves, horsetail, birch leaves and buds.

To prevent and treat arterial hypertension, cardiologists prescribe diuretics to patients. Thiazide-like diuretics for blood pressure have a sufficient effect with moderate increases in blood pressure. In small doses, Indapamide retard and Hydrochlorothiazide reduce left ventricular hypertrophy. Since thiazides remove potassium, potassium-sparing drugs (Veroshpiron, Amiloride) are prescribed in combination.

Prescribing thiazides in combination with potassium-sparing diuretics significantly improves the prognosis of the disease and reduces the risk of coronary complications (heart attack, stroke). One of the requirements of therapy to normalize blood pressure is the selection of the most effective drug and its dosage.

Thiazides are not effective for the treatment of patients with arterial hypertension and renal failure. Such patients are shown loop diuretics for blood pressure (Furosemide, Trifas, Lasix). They are prescribed in small doses to prevent heart attacks. In emergency cases of hypertensive crisis, loop diuretics, when administered intravenously, can quickly reduce blood pressure.

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I liked the article, the only thing I didn’t find was a more detailed answer to traditional treatment diuretics, how can they harm a child? Does fennel leach calcium? Can I drink them for a long time? Do they cause allergic reactions and seizures?

I have been taking indapamide for 5 months and my blood pressure was normal. Now it has gone up again to 15090, what should I do?

Thank you. Wonderful site!

Is it possible to take 10 mg of Trigrim and 100 mg of Veroshpiron at the same time in the morning?

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One of the common symptoms of disease is swelling. To remove excess fluid from organs and tissues, you can take a diuretic. Diuretics help clear the kidneys of accumulated sodium and chlorine salts. In case of obesity, drugs are taken to lose weight. To get maximum results from using diuretics, you must follow the rules for their use.

Diuretics, or diuretics, affect the functioning of the kidneys, that is, they help increase fluid excretion. This leads to stronger urine production and frequent elimination. Due to their properties, diuretics reduce the absorption of salts in the renal tubules. As a result of this, their intensive removal occurs along with excess fluid. Thanks to this, swelling of organs and tissues is reduced, the load on the heart is reduced and blood pressure is normalized.

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Only a specialist can choose the right diuretic. Unauthorized decisions to use diuretics lead to an imbalance of substances in the body. The doctor prescribes the drug based on the results of laboratory tests of urine and blood, as well as based on the patient’s existing complaints and illnesses. To monitor the effectiveness of the diuretic taken, the patient provides the attending physician with measured data. Based on the obtained figures, the doctor adjusts the dosage of the drug. Important among them are:

the amount of liquid drunk and that which left the body;
morning and evening pressure readings;
volumes of swelling;
patient's weight.

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Swelling during pregnancy appears in the 3rd trimester. This symptom may indicate problems with the kidneys, heart or liver. However, the cause of swelling may be excessive air temperature. In any case, if they are present, it is better to more carefully monitor the health of the expectant mother. Neglect of such a symptom is harmful to the child. At the same time, you should not engage in self-medication and traditional medicine. Even seemingly harmless herbs and berries can harm a pregnant woman and child. Strawberries, juniper and parsley should be taken with caution. Approved diuretic tablets include Canephron, Phytolysin and Eufillin. Each of them is safe for the expectant mother and child, but it is important to follow the dosage and regimen of use.

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After a week of use, it is recommended to take a break of at least 4 days.
Treatment begins with minimal doses to prevent adverse reactions.
Along with diuretics, a diet with a high potassium content is prescribed.

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Diuretics (tablets, solutions) have become quite firmly established in our lives. They are used to correct the acid-base balance in the body. After all, they perfectly remove excess acid and alkali from it. Diuretic tablets, the list of which is quite impressive, are used in the treatment of poisoning, some injuries (especially when it comes to head injuries), and to combat hypertension. But, unfortunately, not everyone knows not only the mechanism of action of these drugs, but also the side effects that they can cause. And improper use of diuretics can lead to serious complications.

Diuretic tablets are used to treat many ailments. The list of effective drugs continues to grow today. Diuretics are also called diuretics.

If a large number of sodium ions accumulate in the body, then subcutaneous tissue begins to be deposited. It has a very negative effect on the functioning of the kidneys, heart, and hematopoietic system. As a result, the patient develops a variety of diseases and disorders.

In addition, diuretics are in great demand in sports medicine. They are often used for weight loss. Very often, diuretics (tablets) are included in complex therapy to combat various ailments.

However, people who take diuretics without a doctor's prescription are at great risk. After all, treatment with diuretics can result in unpleasant consequences. You should know that diuretics can:

Remove potassium from the body, thereby increasing human fatigue.
Provoke salt deposition.
Increase the risk of diabetes because they increase levels of “bad” cholesterol.
Increase urination, causing sleep disturbance.
Create problems for men with potency.

Quite often, even those patients who understand the risk believe that the newest drugs “Indapamide”, “Torasemide”, “Arifon” do not have a detrimental effect on metabolism. Such medications are indeed much better tolerated than older generation medications. However, they are also harmful to health. But the negative impact of these funds is revealed much later. It is enough to understand the mechanism of their action. Medicines of the new and old generation are aimed at one thing - to stimulate the kidneys to work more intensively. Consequently, they excrete more salt and water.

It is important to understand that fluid retention in the body is a symptom of a serious illness. Swelling cannot occur on its own. It is provoked by serious disruptions in the functioning of the kidneys, heart, and sometimes other reasons. Consequently, diuretics are drugs (their list is very extensive) with exclusively symptomatic action. Unfortunately, they do not get rid of the cause of the disease. Thus, medications only delay the unpleasant ending for patients. Therefore, people who want to improve their health and fight a real disease should not make do with diuretics alone, much less use them themselves.

Often the division occurs according to the mechanism of action. According to this classification, there are:

Thiazide drugs. They are excellent for treating hypertension and are excellent for lowering blood pressure. It is recommended to use them in parallel with other medications. Thiazides can negatively affect metabolism, so such diuretics are prescribed in small quantities. Drugs (a list of only the most popular ones is given in the article) from this group are “Ezidrex”, “Hydrochlorothiazide”, “Chlorthalidone”, “Indapamide”, “Hypothiazide”, “Arifon”.
Loop means. They remove salt and fluid from the body due to their effect on kidney filtration. These medications have a rapid diuretic effect. Loop diuretics do not affect cholesterol levels and do not create preconditions for the occurrence of diabetes mellitus. However, their biggest drawback is the many side effects. The most common drugs are Torasemide, Furosemide, Ethacrynic acid, Bumetanide.
Potassium-sparing agents. Quite an extensive group of drugs. Such medications help increase the excretion of chloride and sodium from the body. At the same time, the removal of potassium is minimized by such diuretic tablets. List of the most popular drugs: Amiloride, Triamterene, Spironolactone.
Aldosterone antagonists. These diuretics block the natural hormone that retains salt and moisture in the body. Drugs that neutralize aldosterone promote fluid removal. At the same time, the potassium content in the body does not decrease. The most popular representative is “Veroshpiron”.

For good effect, potent agents can be used. The following diuretic tablets are used for edema:

"Torasemide";
"Furosemide";
"Piretanide";
"Xipamide";
"Bumetanide".

Medium-strength diuretic tablets can also be used for edema:

"Hydrochlorothiazide";
"Hypothiazide";
"Chlorthalidone";
"Klopamide";
"Polythiazide";
"Indapamide";
"Met hall."

Such drugs are used for a long time and continuously. The recommended dose is determined by the attending physician. As a rule, it is about 25 mg per day.

For minor edema, potassium-sparing diuretics, such as Spironolactone, Amiloride, and Triamterene, are more suitable. They are taken in courses (2-3 weeks) at intervals of 10-14 days.

Diuretic medications that are used for high blood pressure fall into two categories:

Remedies that have a quick effect. Such drugs are used during a hypertensive crisis, when there is a need to quickly reduce blood pressure.
Products for daily use. Medicines help maintain optimal blood pressure levels.

Potent medications can stop a hypertensive crisis. The most popular drug is Furosemide. Its price is low. The following remedies are no less effective during a crisis:

"Torasemide";
"Bumetanide";
"Ethacrynic acid";
"Piretanide";
"Xipamide."

The duration of taking the above medications can be 1-3 days. After the crisis has stopped, they switch from such potent drugs to medications that can maintain blood pressure at the required level every day.

"Indapamide";
"Hydrochlorothiazide";
"Hypothiazide";
"Klopamide";
"Metro salon";
"Polythiazide";
"Chlorthalidone."

These medications are taken daily as prescribed by your doctor. They perfectly maintain the optimal pressure level.

If the effect of using the drug Furosemide weakens, cardiologists recommend replacing it with the drug Torasemide. It has been noted that the latter remedy has a more beneficial effect on the body in severe forms of heart failure.

The medicine is a fast-acting diuretic. Its effect occurs after taking it for 20 minutes. The duration of the drug's effect is about 4-5 hours.

This remedy is effective not only for stopping a hypertensive crisis. According to the instructions, the medicine helps with heart failure, swelling of the brain and lungs, and chemical poisoning. It is often prescribed for late toxicosis during pregnancy.

However, the product also has strict contraindications. The drug is not used in the first trimester of pregnancy. It should not be used by patients with renal failure, people who have hypoglycemia, or urinary tract obstruction.

The cost of the drug "Furosemide" is low. The price is approximately 19 rubles.

After just 15 minutes, the effect on the body begins (as stated in the instructions for use attached to the drug "Torasemide"). The price of the product varies from 205 to 655 rubles.

You need to take the medicine once a day, 1 tablet, as evidenced by the instructions included in the drug “Indapamide”. The price of the product varies on average from 22 to 110 rubles.

The medicine is a mild diuretic. It is recommended to use it in combination with another diuretic drug, Hydrochlorothiazide. Thanks to this combination, it is possible to reduce the loss of potassium by the body. The drug Triamterene has a beneficial effect. The instructions position it as a potassium-sparing agent.

The cost of the product is 316 rubles.

Side effects may also occur when taking the medicine. In some cases, the drug provokes urticaria, itching, drowsiness, headache, diarrhea or constipation.

The cost of the product is about 54 rubles.

Many patients are interested in the opinions of those people who are already taking diuretic pills. Reviews usually contain information about effectiveness and side effects.

The effectiveness of the product is also confirmed by pregnant women who use the drug in the last months of pregnancy. Patients claim that it perfectly relieved swelling.

Before taking a diuretic, be sure to tell your doctor about all the medications you are taking. In addition, an important factor in selecting the necessary medicine is the presence of chronic ailments. You should not take such medications without permission. It is necessary to strictly follow the doctor's instructions. Take the drug at the appointed time (this will avoid unpleasant awakenings at night) and only in the dosage that was prescribed to you. Such simple truths will allow you not to experience the severe consequences of taking diuretics.

The expected effect of treating many diseases depends on the correct choice of diuretics, since, although they are called diuretics, they differ in their mechanism of action, that is, they are heterogeneous: some act more at the level of the tubules, others predominantly affect renal hemodynamics, affecting the tubules to a lesser extent.

Close in strength and mechanism to loop diuretics are quinazalone and chlorobenzamides, which can act gently but for a long time (more than a day).

Pteridines and carboxamides are a special group of diuretics. To patients forced to frequently use such drugs, they are known as potassium-sparing diuretics. They do not have a negative effect on glomerular filtration, act for more than a day and can be prescribed to patients with chronic renal failure (CRF).

The main classes of medicinal diuretics:

More detailed information about medicinal diuretics will be provided later in the article.

Not always and not everyone necessarily needs to buy diuretics at the pharmacy. And not everyone who really needs them goes to the doctor, writes out a prescription and takes them as the doctor prescribed. Many people switch to a diet low in table salt, giving preference to products that, due to their natural properties, are good at removing excess fluid from the body. In addition, diuretics are happily consumed instead of traditional tea.

Recently, monastery tea for weight loss, which contains laxative and diuretic herbs, has become especially popular. All this, of course, is possible and certainly useful if a person does not have any special health problems, and swelling on the face or legs is associated with a flagrant violation of the diet, excessive addiction to salty foods, or due to basic fatigue.

The list of diuretic herbs is made up of ubiquitous and therefore widely known representatives of the flora:

Chamomile;
Horsetail;
Lingonberry (leaves);
Bearberry;
Chicory;
Bird's knotweed;
Burdock;
Flax (seeds);
Birch leaves and buds;
Juniper;
Rosehip, which has a mild diuretic effect and is a source of vitamin C;
Parsley (roots);
Dill greens.

Some of these plants are included in the diuretic collection sold by the pharmacy chain.

Diuretic products that you can add to your diet to combat edema include the following list:

Watermelon;
Melon;
Cranberry;
Cucumbers;
Pineapple;
Parsley, celery, dill.

Unfortunately, there are situations when such treatment is not possible and no matter how good diuretic properties the gifts of nature have, it may be necessary to prescribe real diuretics. However, before you start using synthetic diuretics, it would be a good idea to study the characteristics of some representatives of this pharmaceutical group.

effect of the main types of diuretics

Action

Considering the listed advantages of loop diuretics, they are often used in combination with other drugs to provide emergency care for cardiovascular or renal pathology.

Furosemide is considered the most well-known and has been used for many years, but this group also includes other diuretics:

Furosemide (Lasix). After ingestion on an empty stomach, otherwise you will have to wait longer, the drug begins to act in half an hour - an hour, intravenous administration speeds up the process and reduces the time to 5 minutes. Furosemide does not linger for a long time, half of it is excreted in the urine after 4-6 hours (when taken orally) and after a couple of hours when used intravenously.
Torasemide differs from furosemide in its longer-lasting therapeutic effect, and less potassium is lost. It is used for renal and heart failure, and there is even an opinion that for chronic renal failure it is more effective than the famous furosemide.
Bumetanide(jurinex, burinex). It is characterized by rapid absorption and the onset of a diuretic effect, since within half an hour the drug makes itself felt. It is used for swelling of the face and swelling of the legs, and for hypertension caused by severe renal failure.
Piretanide– a very strong diuretic (more powerful than furosemide). In addition to the basic properties, it has other abilities. Piretanide reduces blood clotting, blocks “slow” calcium channels (peripheral vasodilator), and can be used as an antihypertensive agent (this action even precedes the diuretic effect), therefore it is often prescribed to reduce blood pressure in arterial hypertension of 1-2 degrees (monotherapy) or as part of combination treatment in more complex cases. In addition, the drug is prescribed for renal and heart failure and edema of various origins.
Ethacrynic acid, more familiar under a different name - uregitis. It is characterized by a strong diuretic, but short-lived effect, which depends on the method of application (from 2 to 4-6 hours). Uregit can be prescribed together with furosemide, since they have different places of application. Ethacrynic acid is used for swelling of any nature, but you should also know its contraindications: anuria, oliguria, hepatic coma, acid-base imbalance.

It should be noted that representatives of this group are by no means potassium-sparing, and, in addition, they lead to an increase in the excretion of other microelements: magnesium, sodium, chlorine, calcium.

Double effect

Thiazide diuretics (TDs) are primarily available in tablet form and are often prescribed in combination with other antihypertensive agents to lower blood pressure and reduce edema. Diuretic tablets of this group block the reverse transport of sodium and chlorine, which leads to a decrease in the amount of plasma, extracellular fluid, as well as a drop in cardiac output and peripheral vascular resistance, and, therefore, a decrease in blood pressure. These processes are achieved through humoral and intracellular mechanisms that regulate sodium levels as fluid volume decreases.

However, long-term use of thiazide diuretics can cause multidirectional reactions in patients - some stop responding to therapy. In such patients, with a reduced plasma volume, there is a high level of humoral factors responsible for increasing TPR (total peripheral resistance), these are renin, angiotensin, aldosterone. In such cases, in order to potentiate the effect of TD, antihypertensive drugs called ACE inhibitors (angiotensin-converting enzyme) are prescribed. Together (TD + ACE inhibitors) they achieve the desired effect and help the patient cope with edema due to hypertension and with hypertension itself. By the way, there are also combination drugs, so to speak, “2 in 1”, which eliminates the need to buy diuretics separately from antihypertensives.

Thiazide diuretics differ from loop diuretics not only in that they do not remove substances necessary for the functioning of the heart muscle with terrible force, they have a significant difference in the duration of their action. If the period of the diuretic effect of PD is limited to 3-6 hours, then even for the shortest-acting TD this time is extended to 18 hours, others have even greater abilities and provide a therapeutic effect for a day or more.

Thiazide diuretics for hypertension can be used alone or in combination with other antihypertensive or potassium-sparing diuretics to lower blood pressure. Some patients get by with small doses of TD, which provides a good effect, although it occurs more slowly (after about a month).

The use of TD can significantly reduce the number of such adverse reactions as:

Hypokalemia (drop in serum potassium levels);
Hyperlipoproteinemia (increased lipids and lipoproteins, which contributes to the development of atherosclerosis);
Arrhythmias that occur due to a lack of potassium, sodium, magnesium, and chlorine.

In short, thiazide diuretics are recognized by both doctors and patients as good diuretics, having a hypotensive effect and not straining the patient’s psyche and bladder.

Close “relatives” of TD are non-thiazide sulfonamide diuretics, acting on the cortical segment of the loop of Henle, and drugs that occupy an intermediate position between sulfonamide and loop diuretics (xipamide) and are prescribed for hypertension.

Many representatives of this group are well known to patients who have long suffered from arterial hypertension. They are sold in pharmacies without a prescription and are almost always available:

Hydrochlorothiazide(esidrex, hypothiazide). It can be classified as a medium diuretic (in terms of strength and duration of action). It slightly increases the excretion of sodium, potassium and chlorine, but does not disturb the acid-base balance. It is prescribed after meals 1 or 2 times a day and exhibits its effect after 1-2 hours, the hypotensive effect lasts 12-18 hours. The drug can be used intermittently or long-term (in severe cases). Hypothiazide requires a diet enriched with potassium and a decrease in daily salt intake. If the patient has renal pathology, then combination with potassium-sparing diuretics and potassium supplements is not recommended.
Indapamide(indapafone, arifon, pamid) is a drug that combines hypotensive and diuretic effects at the same time, that is, we can say that indapamide is a diuretic for edema, reducing blood pressure. Its advantages include the fact that it does not affect the functional abilities of the kidneys, does not change the lipid spectrum, and, in addition, has the ability to protect the heart and blood vessels.
Chlorthalidone(hygroton, oxodoline) belongs to non-thiazide sulfonamide diuretics (SD), has medium strength and a pronounced effect, which can last up to 3 days. In its behavior, chlorthalidone is somewhat similar to hypothiazide.
Klopamide(brinaldix) - similar in strength, duration of action and pharmacodynamics to chlorthalidone and hypothiazide.

Potassium-sparing diuretics (KSDs) are considered mild but have long-lasting effects. True, it usually doesn’t come on the first day either. You should not expect such a manifestation of diuretic abilities as from loop diuretics or even thiazide ones. In this case, you can rely more on triamterene, which can begin to relieve swelling in the third hour after administration, but this will not be so pronounced, so patients do not always notice it.

In most cases, KSDs are prescribed as diuretics for edema, while in hypertension they are perceived only as an adjuvant. Excellent diuretics are obtained by combining potassium-sparing diuretics with thiazide ones: triamterene + hypothiazide. Depending on the amount of the main active ingredient (triamterene), good diuretic tablets are obtained - triampur, diazide, makzid. In a similar way, you can obtain a complex moduretic drug consisting of amiloride, hypothiazide and furosemide or uregit.

Spironolactone(veroshpiron, aldactone) is a light drug with a long-lasting effect, which begins to appear from 3-5 days and lasts for another couple of days after discontinuation. It is not suitable as a rapid response antihypertensive drug, since in this regard it begins to act only after half a month. Of course, the patient will not wait that long, but it is still prescribed in combination with other antihypertensive or diuretics for mild periodic edema or for long-term treatment of hypertension, without fear that even with a decrease in blood pressure it will have a negative effect. Veroshpiron does not exhibit its hypotensive effect at low and normal blood pressure. Due to the fact that spironolactone is a steroid drug, its side effects, in addition to hyperkalemia, are specific: gynecomastia, male pattern hair growth in females, that is, directly related to hormonal imbalance.
Triamterene(daitek, pterofen) - a mild diuretic, similar in behavior to spironolactone, characterized by a slight independent diuretic effect, which appears a couple of hours after administration and lasts an average of 13-15 hours. Its hypotensive effect is superior to that of spironolactone. In older patients, side effects are more common: the development of hyperkalemia can lead to kidney damage due to the fact that potassium begins to be deposited in the tubules. As a result, the urine of such people may change color and become blue or blue. This is usually very frightening for patients and their relatives..
Amiloride(midamor) is a weak diuretic that removes sodium and chlorine, but preserves potassium. Although its own diuretic effect is insignificant, amiloride can stimulate the diuretic effect of furosemide, uregitis, and thiazide diuretics. In order to reduce potassium loss, it is used in combination with hypothiazide (moduretic) for the treatment of arterial hypertension and heart failure.

Indications, contraindications and side effects are precisely those points in the annotation for any drug on which the patient fixes his gaze, skipping the pharmacokinetics and pharmacodynamics.

Diuretics should also be treated at least in this regard, without prescribing them to yourself for weight loss:

Strong diuretics will remove several liters of water, and the scale will show a loss of a couple of kilograms. Don't flatter yourself, it won't last long.
Powerful diuretics will require fluid replenishment, everyone knows that after taking the same furosemide, thirst sets in, the body wants to get back lost water, so for weight loss it is better to use folk remedies, without fear that they will remove everything and lead to unwanted side reactions.
And finally, the author of the article, having a higher medical education and having tried many medications on himself, has not met a person who could overcome obesity with the help of diuretics, so to speak, he was convinced from personal experience.

Diuretics should also be used with caution if you have diabetes.. The development of diabetic foot syndrome often begins with the appearance of swelling of the legs, however, given the complexity of such a disease as diabetes mellitus, which is considered a systemic pathology, you cannot engage in amateur activities - the prescription of diuretics for diabetes is solely within the competence of the attending physician. Leg swelling of other origins (fatigue, varicose veins, heart failure) also require an individual approach. Of course, for swelling associated with fatigue of the lower extremities, traditional medicines are most likely suitable, while synthetic drugs may simply not be needed.

Another special case is pregnancy. Swelling during pregnancy, especially in the second half, is a common phenomenon and in part natural. The additional load caused by hormonal changes with an increase in the amount of progesterone and venous stasis created by the pregnant uterus will make themselves felt. The size of the legs increases by a couple of centimeters, walking becomes difficult, but, meanwhile, during pregnancy, swelling can be a sign of gestosis, which in other cases has disastrous consequences.

Regular visits to the antenatal clinic and following the doctor’s recommendations are designed to protect the woman, and swelling, if caused by physiological reasons, will go away after childbirth, but prescribing furosemide to yourself in such a situation is extremely undesirable. Pregnant women are sometimes (but not in the first months) prescribed thiazide diuretics, but again, this is done by the doctor observing the woman.

In this regard, I would like to provide a reasonable list of indications so that the patient does not think that this is just the doctor’s personal whim:

Arterial hypertension(AH), which has not yet been complicated by renal failure. Diuretics, by reducing BCC (circulating blood volume) and systolic ejection, lead to a decrease in systolic pressure already in the first days of treatment. It should be noted that the pressure does not fall uncontrollably, blood pressure decreases moderately, and postural hypotension does not develop. Long-term treatment leads to a decrease in the diuretic effect and normalization of systolic output due to its own compensatory mechanisms (increased renin and aldosterone levels), further unauthorized fluid loss stops, and the hypotensive effect persists regardless of the high level of renin, which is associated with a decrease in the concentration of sodium in the cells and an increase potassium in the walls of blood vessels. As a result, after 1.5-2 months, diastolic pressure also normalizes (cardiac output remains unchanged). Patients often ask their doctors a reasonable question: are diuretics used for hypertension addictive? No, it is either absent or so inconspicuous that such a circumstance can be neglected. The use of these drugs for years, as noted by the patients themselves, does not lead to impotence and decreased libido, which is considered an indisputable advantage of diuretics prescribed for arterial hypertension.
Chronic circulatory failure(CNC) with edema, as well as hypertension with impaired glomerular filtration require the use of powerful diuretics with a short or medium period of action (furosemide, uregitis). The main advantages of these drugs allow them to be used in quite serious situations for emergency treatment - cerebral edema, pulmonary edema, poisoning with potent substances that are excreted by the kidneys, for example, barbiturates.
Secondary hyperaldosteronism(a consequence of hypertension and CNC) or prevention hypokalemia are an indication for the prescription of potassium-sparing diuretics, which have a mild diuretic and hypotensive effect.
Diabetes insipidus;
Glaucoma.

Disorders associated with the excretion of microelements

Decreased potassium levels (hypokalemia) – the main disadvantage of diuretics;
Falling magnesium levels (hypomagnesemia). Mostly loop diuretics are endowed with similar abilities; thiazide diuretics remove magnesium, but to a lesser extent, and potassium-sparing diuretics, on the contrary, delay its excretion.
Calcium excretion. And again, loop diuretics, which, even with a single use, can remove up to 30% of Ca2+. Thiazide drugs have an ambiguous attitude towards this element: some increase excretion in the urine, others, which do not remove calcium, retain it in the body and thereby cause hypercalcemia. Potassium-sparing (veroshpiron, triamterene, etc.) - also belong to the non-removing calcium group, but by increasing its reabsorption in the tubules, they can lead to hypercalcemia.
Decreased sodium concentration (hyponarthemia) is often observed with independent and uncontrolled self-prescription of diuretics, which will manifest itself as muscle weakness, drowsiness, malaise, and nausea.

Important: symptoms of “too much” of diuretics can include mental disorders and coma (it is very advisable to keep this fact in mind for people using diuretics for weight loss).

Hypokalemia, which leads to pathological changes in the electrocardiogram (myocardial instability, long QT syndrome);
Severe left ventricular (LV) hypertrophy, which itself contributes to rhythm disturbances;
Stress;
Administration of β-agonists.

Contraindications to the use of diuretics

Contraindications for the use of diuretics, as for other medications, are general, relative and absolute, but there are not so many of them, so they can be placed in one list:

Renal and liver failure, which prevent the use of many drugs in this group, except for amiloride, which is still prescribed for liver damage;
Diuretics are not used during early pregnancy;
Some contraindications for diabetes mellitus are provided for hydrochlorothiazide;
Hypovolemia and severe anemia are a strict contraindication to the use of furosemide and uregitis;
Incomplete atrioventricular block and hyperkalemia absolutely do not allow the use of potassium-sparing diuretics;
The combination of several diuretics that do not remove potassium is prohibited.

Considering that drugs in this group often have to be prescribed together with other pharmaceuticals, it is necessary to keep in mind the possible reactions of this combination. For example:

Potassium-removing diuretics are dangerous to combine with digitalis derivatives, since there is a risk of arrhythmia;
Spironolactone and triamterene (potassium-sparing), used in conjunction with digoxin, also often lead to rhythm disturbances, therefore this combination requires constant monitoring of digoxin in the patient’s plasma.
Diuretics that do not remove potassium do not combine well with a diet rich in this element or with potassium supplements.
Medicines that themselves increase blood glucose levels further enhance the hyperglycemic effect of diuretics.
Antibiotics of the aminoglycoside and cephalosporin series in combination with loop diuretics can lead to a toxic level of these drugs in the kidneys and damage to the latter; in addition, aminoglycosides (kanamycin, streptomycin, gentamicin) with loop diuretics increase the likelihood of complications such as damage to the vestibular apparatus and hearing organs
NSAIDs (non-steroidal anti-inflammatory drugs) have the ability to reduce the diuretic effect of some diuretics.

In conclusion, I would like to remind our readers once again: although diuretics at first glance seem absolutely harmless, in reality this is not the case, so before you start taking diuretic tablets to relieve swelling, lose kilograms or for another purpose, you should think about the possible consequences of such decisions.

Diuretics have been used to treat hypertension and cardiovascular disease for more than 50 years. These remedies help lower blood pressure by forcing the body to get rid of excess salt and water. Purification is carried out by the kidneys through urine. For heart failure, diuretics are also widely prescribed. They improve the condition of patients by reducing the stress on the heart that excess fluid in the body creates. If a patient has swelling due to problems with the heart, kidneys or liver, then diuretics help reduce them.

Different groups of drugs have different effects on the kidneys, removing more or less water and salt from the body. You will learn more about this in the “Classification of diuretics” section. We tried to provide readers up-to-date information about diuretics that are currently most often used, written accessible language. This material will help doctors who need to understand the classification of diuretics and the features of their use. It is also advisable for patients to read this article to understand the principles and mechanisms of treatment. If you have to take diuretic pills, you can choose an effective drug with moderate or minimal side effects. It’s even better if you can abandon “chemical” diuretics in favor of natural substances that have a diuretic effect.

Diuretics: Important Caution for Patients

First of all, we want warn patients against “infatuation” with diuretics. You can find a lot of information online that these medications make it easy to solve not only therapeutic, but also “cosmetic” problems, and at the same time they are quite safe. Women often voluntarily take diuretics to lose weight. Athletes use them to quickly lose weight before competitions. Even bodybuilders artificially dehydrate their bodies to make their muscles look more defined.

But let's figure out what the risks are for those who take diuretic medications without a doctor's prescription.

These drugs remove potassium from the body, increasing fatigue.
At the same time, they retain calcium, which can lead to salt deposits.
Diuretics also increase the risk of diabetes, and because of them, the level of “bad” cholesterol in the blood increases.
Frequent urination may cause sleep disturbances.
Men more often experience problems with potency when taking diuretics.

You can easily find out that the newest diuretics indapamide (arifon, arifon retard) and torasemide do not affect metabolism and are tolerated by patients much better than the drugs of the previous generation. But they can also be harmful to human health. It’s just that their negative effects do not appear immediately, but later. After all, if you try to understand the mechanism of action of diuretic drugs, you will find that all these drugs, both new and older, do the same thing. They “stimulate” the kidneys to work more intensively and remove more water and salt from the body.

But fluid retention in the body is only a symptom of a serious illness, and not its cause! Edema does not occur on its own, but due to serious problems in the functioning of the heart or kidneys, or less often for other reasons. Thus, diuretics are drugs with only symptomatic action that do not relieve the causes of the disease. In practice, this leads to the fact that diuretics only allow the patient to postpone the sad ending for some time. This could be several weeks, months or, if you are very lucky, years. It turns out that if you want to influence the cause of the disease in order to really prolong life and improve health, then you can’t do it with diuretics alone.

Thus, you have received “information for thought,” and we move directly to the use of diuretic drugs for hypertension and heart failure.

Order taurine - a natural diuretic - from the USA, the best quality in the world:

How to order taurine from the USA- . Get the diuretic effect without the harm of chemical diuretics. Get rid of edema, bring your blood pressure back to normal, improve your heart function. Read more about the methodology in the article ““. Taurine is a powerful natural diuretic, so safe that it is even prescribed to pregnant women (check with your doctor!).

Diuretics for hypertension

When it comes to treating hypertension with diuretics, doctors discovered in the 1990s that these drugs worked well for patients, even when given in low doses. A reduced dose is the equivalent of no more than 25 mg of dichlorothiazide (a “basic” diuretic drug, see below) per day. Before this, patients often took medications in high doses - 50 mg of dichlorothiazide per day. However, patients suffered greatly from its side effects. It turned out that Reducing the dosage of diuretics for hypertension reduced their side effects several times, and the therapeutic effect decreased slightly. Studies conducted in Europe in 1999, 2000 and 2003 showed that low-dose diuretics were as effective as the newer classes of antihypertensive (blood pressure-lowering) drugs - ACE inhibitors and calcium antagonists. This has led to a “surge” in the use of kidney-stimulating drugs to treat hypertension. Previously, this was observed only in the 1960-1970s, because there were simply no other drugs that lowered blood pressure.

Diuretic drugs for hypertension: pros and cons

Diuretics are the drugs of choice for hypertension in the following situations:

in elderly patients (for more details, see the note “ “);
with isolated systolic hypertension, i.e. when only the “upper” blood pressure is increased (read about this type of hypertension);
in the presence of concomitant heart failure (see below);
for osteoporosis.

Numerous studies have proven that diuretic tablets reduce the incidence of complications in hypertensive patients:

myocardial infarction - by 14-16%;
stroke - by 38-42%.

Classification of diuretics. Groups of diuretic drugs and their use in hypertension

An ideal classification of diuretics would take into account all aspects of their action. But today it does not exist, because diuretic drugs have a fundamentally different chemical structure. Because of this, they differ too much from each other in the mechanism and duration of action on the patient’s body.

There have been attempts to classify diuretics according to which part of the nephron of the kidney they affect. But some diuretics not only stimulate the kidneys, but also have an effect on other body systems. Selected drugs, having penetrated the blood into the kidneys, they exhibit activity throughout the nephron. Therefore, it is not possible to create a harmonious system that would unite all the medications that rid the body of excess fluid and sodium.

The most appropriate classification of diuretics according to their mechanism of action seems to be. In practice, the following groups of diuretic drugs are used: thiazide, loop (this includes furosemide) and potassium-sparing (aldosterone antagonists). Below is detailed information about each of them below. The history of diuretics began with mercury-based drugs, as well as osmotic drugs that removed only water from the body, but not salt. These groups have long been supplanted by new classes of diuretic drugs, which are more effective and safe.

Diuretic drugs: what are they?

Thiazide and thiazide-like diuretics	For hypertension, they are prescribed more often than any other diuretic drugs. These tablets act slowly and relatively weakly, but the side effects from taking them are moderate. This group includes the drugs dichlorothiazide (Hypothiazide) and indapamide (Arifon Retard). The remaining thiazide and thiazide-like diuretics are considered obsolete today. Indapamide for hypertension is used not as a diuretic, but as a vasodilator. It stands out because it does not impair metabolism, unlike most other diuretic drugs. It can be taken by patients with diabetes, gout, and the elderly.
Loop diuretics	These are powerful medications that stimulate the kidneys to produce more urine and get rid of water and salt. Unfortunately, along with excess fluid and salt, the body loses valuable minerals - potassium and magnesium. Loop diuretics are more potent than thiazide diuretics, but cause more serious side effects. They are rarely prescribed for high blood pressure. As a rule, they are taken for edema caused by heart failure, kidney or liver disease. This group includes the drugs torasemide (Diuver, Britomar, Trigrim) and furosemide (Lasix). Bumetanide and ethacrynic acid are obsolete drugs.
Potassium-sparing diuretics	They have a weak diuretic effect, but improve the results of treatment with basic diuretics. Reduce the risk of potassium deficiency in the body - a common side effect of loop and thiazide diuretics. Many patients are helped for severe hypertension that cannot be treated with standard medications. They also reduce mortality in heart failure. The main potassium-sparing diuretic is Veroshpiron (spironolactone). Unfortunately, this medicine can cause impotence and gynecomastia - breast growth - in men. But for severe illnesses it is worth taking, despite the risk of side effects.

Read about diuretics (diuretics):

Diuretic medications prescribed for hypertension

Popular diuretic tablets:

If therapy with thiazide diuretics does not bring results, then loop diuretics can be used for emergency treatment of a hypertensive crisis due to renal or heart failure.

Treatment of hypertension with diuretics - useful information

Diuretics (especially in high doses) contribute to the development of diabetes and increase blood cholesterol levels. Therefore, they try not to prescribe them to young patients, as well as to hypertensive patients with obesity and diabetes. However, the thiazide-like diuretic indapamide (Arifon, Arifon Retard) and the loop diuretic drug torasemide are devoid of these adverse metabolic effects.

What are the disadvantages of treating hypertension with diuretics:

“Quick” side effects: increased urination, sleep disturbances, fatigue, decreased potency in men, increased blood cholesterol and others.
Possible dangerous long-term side effects in the form of accelerated “wear and tear” of the kidneys and heart.
After some time, the body “gets used” to diuretics, and therefore their effectiveness often decreases over time.
And most importantly: diuretics do not affect the cause of hypertension, but only “mute” its symptoms.

We would like to offer you a treatment method that allows most patients to normalize blood pressure and get rid of edema without taking diuretics.

The amino acid taurine is excellent replacement“traditional” diuretics. It not only removes excess fluid from the body and relieves swelling, but also relaxes blood vessels. Taurine is no less effective than “chemical” diuretic drugs. But it is a natural substance that is naturally found in the human body and therefore does not cause any harm. On the contrary, taurine strengthens the kidneys and heart. In addition to normalizing blood pressure, it improves immunity and helps with visual impairment. Read more.
If you have hypertension, it will be very useful for you to take magnesium supplements, which are sold in pharmacies (by the way, high-quality taurine is also there, so no dubious dietary supplements are needed). Magnesium does not have a direct diuretic effect, but it relaxes blood vessels and improves heart and kidney function. Magnesium is an important part of an effective drug-free hypertension treatment program
Vitamin B6, which you'll likely take in the same tablet as magnesium, is itself a diuretic. It complements the action of taurine and also has a beneficial effect on many other processes in the body.

Remember the formula “taurine + magnesium + vitamin B6”. For you it means victory over hypertension, abandonment of “chemical” diuretics and prolongation of life. These natural substances act quickly, effectively and have no harmful side effects. They normalize blood pressure and remove excess fluid, affecting the cause of diseases. Read more at the links below.

Diuretics for heart failure

The consequence of heart failure is usually fluid retention in the body. It often leads to stagnation of blood in the lungs. Symptoms of moderate heart failure: swelling, shortness of breath, cyanosis (bluish skin color), enlarged liver, wheezing in the heart. In more severe stages, pulmonary edema, cardiogenic shock, and hypotension may occur (“upper” blood pressure below 90 mm Hg).

Diuretics are recommended to be prescribed to all patients in whom heart failure has caused edema, as well as shortness of breath due to fluid stagnation in the lungs. With the help of diuretics, doctors stimulate the removal of excess fluid and salt from the body, and thus improve the patient's condition. In case of heart failure, adequate diuretic therapy relieves swelling, increases exercise tolerance and, possibly, improves the prognosis for the patient - prolongs his life.

Watch also the video.

Diuretic medications are only a symptomatic treatment for heart failure; they do not address its causes. Therefore, they are prescribed only in combination with ACE inhibitors and/or beta blockers. Questions about the use of the last two groups of drugs for the treatment of heart failure are beyond the scope of our site.

Alternative Treatment Options for Heart Failure

If the cause of the disease is not addressed, it quickly leads to death or the need for a heart transplant. Even official medicine admits that Diuretics are nothing more than symptomatic treatment heart failure. Beta blockers and ARF inhibitors also only “mute” the symptoms.

Advanced Western cardiologists have concluded that the causes of heart failure are:

Long-term deficiency in the body nutrients, important for the heart
Chronic “smoldering” inflammatory processes. For example, the proliferation of infection in carious teeth can cause excessive activity of the immune system, which “at the same time” attacks the heart muscle.

What natural substances strengthen the heart and eliminate the causes of heart failure?

Coenzyme (coenzyme) Q10	A substance that takes part in energy production in cells. Probably, Q10 deficiency is one of the most important causes of heart problems. Improves rehabilitation after coronary artery bypass surgery. For many patients, taking Q10 even allows them to avoid a heart transplant.
L-carnitine	Regulates the metabolism of fatty acids, which provide 2/3 of the heart with energy. Improves the condition of patients and the prognosis for cardiovascular diseases, as well as during rehabilitation after surgery, heart attack or stroke.
Magnesium	An essential mineral for heart health. Stabilizes heart rate. Improves potassium balance. Increases the endurance of the heart muscle. Relieves spasm of blood vessels. Reduces blood clotting to prevent blood clots. Improves the balance of cholesterol in the blood.
Taurine	Natural amino acid is a useful substitute for “chemical” diuretic drugs for the body. In addition to a powerful diuretic effect, it normalizes blood pressure and strengthens the heart muscle. Recommended for congestive heart failure.
D-ribose	It is a precursor for the synthesis of “fuel” that nourishes heart cells. Facilitates the patient's condition, increases energy and tolerance physical activity. However, it does not have a direct effect on the causes of heart disease. This is an auxiliary nutritional supplement.

A detailed discussion of heart failure therapy is beyond the scope of this site. Therefore, we give you links to two useful books for heart patients.

These books are easily available in electronic form. If you know English language- read them both. If not, then at least study “Dietary Supplements” by Dr. Atkins.

Edema is a problem for many people. This is an early symptom of unfavorable processes occurring in the body. Edema signals that it is time for a person to take care of his health, and there is no place to put it off any longer. And important diagnostic value has localized edema.

If swelling is caused by kidney disease (nephritis, etc.), then they can appear all over the body, but are most clearly noticeable on the face, especially around the eyes. They are usually too visible in the morning, after a night's sleep. “Renal” edema is usually soft to the touch, and the skin around it is pale. They are formed because unhealthy kidneys remove salt and water worse. The concentration of proteins in the blood plasma decreases, and the permeability of the vessel walls increases. A more rare cause of swelling on the face can be various allergies, as well as endocrine disorders.

If you experience swelling in your legs and mainly in the evenings after a hard day's work, then it is probably caused by heart failure. The cause may also be problems with the blood vessels of the legs, if the heart is healthy.

Diuretics for edema are prescribed only by a doctor. He also makes recommendations on dietary nutrition, identifies and treats the disease that is the root cause of edema. Please do not take diuretics for edema without permission, consult a doctor. Self-medication with diuretics is extremely dangerous. Edema is a serious symptom that requires immediate examination to determine its cause. Treatment should only be prescribed by a qualified doctor.

Diuretic medications for leg swelling: do you always need to take them?

For swollen legs, as with other problems, do not take diuretic tablets on your own initiative. See your doctor. He will probably send you for a thorough medical examination. But sometimes the diagnosis can be determined immediately by appearance swelling of the legs. If the cause of the disease is inflammation of the joint or damage to the ligaments, then swelling forms in the place where the inflammatory process occurs under the skin. In kidney disease, swelling is usually visible on the back side legs

Do you always need to take diuretics for swelling of the legs? Of course not. If the cause of edema is not an internal pathology, then sometimes you can get rid of the problem without medications. After all, swelling of the legs often occurs due to difficulties at work and at home. Representatives of many professions (teachers, salespeople, etc.) spend the whole day on their feet, and they have to stand a lot rather than walk. Swelling of the legs can also occur due to a sedentary lifestyle, flat feet, and even due to the fact that a person has been sitting for a long time with his legs crossed. To get rid of edema in all these situations, it is necessary not to swallow diuretic tablets, but to decisively change working and resting conditions.

Unfortunately, every third woman experiences edema during pregnancy. As a rule, the problem of edema occurs in the third trimester of pregnancy. If a diet with limited or complete exclusion of salt is not enough to eliminate it, then you have to take one or another diuretic. Diuretics for pregnant women can be synthetic (medicines) and natural - various herbs, fruits and berries. Swelling during pregnancy cannot be ignored. They can be symptoms of serious problems with the kidneys or heart, as well as gestosis (toxicosis) in pregnant women. When a woman informs the doctor about the appearance of edema, he immediately begins intensive treatment or, at least, strengthens his control over the course of the pregnancy.

Unfortunately, the options for treating edema during pregnancy are very limited. Most women nowadays, without unnecessary reminders, realize that diuretics should not be taken without permission during pregnancy. All groups of diuretics (thiazide, loop, potassium-sparing and others), which we discussed above in this article, are strictly prohibited in the first half of pregnancy. In the second half, they are prescribed only in the most extreme cases, in a hospital setting. At the same time, doctors realize that they are putting a pregnant woman and her fetus at great risk. Possible complications for a child: hearing impairment, kidney problems, jaundice, deterioration of blood composition and others.

As for herbal diuretics, i.e. folk diuretics, not everything is so simple with them either. Many pregnant women frivolously believe that diuretic teas are completely safe. Therefore, they voluntarily brew and drink diuretic herbal infusions. Often the doctor doesn’t even know about it. In fact, Diuretic teas during pregnancy are by no means harmless. If only because they remove potassium, magnesium, and other macro- and microelements from the body, change the acidity of the blood and the water-salt balance.

The doctor prescribes kidney tea during pregnancy if there are serious reasons for it. And mild swelling without internal pathology can be tolerated without treatment. In addition, it is useful for pregnant women to know list of herbal diuretics that are prohibited for them. It includes:

strawberries
juniper fruits
parsley root

What diuretics are acceptable during pregnancy ( only by doctor's prescription!):

Canephron is a combination medicine of herbal origin. It is prescribed for problems with the kidneys and urinary tract. It has not only a diuretic, but also an antiseptic, antispasmodic and anti-inflammatory effect. Allowed (with caution!) for use at any stage of pregnancy. Canephron comes in drops and pill form. Pregnant women are prescribed the tablet form, because the drops contain ethanol(alcohol).
Phytolysin is another complex phytochemical drug for diseases of the kidneys and urinary tract. The experience of using it during pregnancy is positive, but before prescribing it, the doctor should make sure that the woman does not have an acute inflammatory process in her kidneys.
Eufillin is a bronchodilator that additionally has a diuretic effect. When prescribing it during pregnancy and breastfeeding, it is necessary to compare the possible risks and potential benefits for the woman and the fetus. It is not recommended to take it on an empty stomach, as this increases the risk of bowel dysfunction, as well as headaches and dizziness. This drug is not suitable if you have low blood pressure, heart problems, or may have seizures.

Diuretics of plant origin. Diuretic teas and mixtures

Herbal diuretics have been used in folk medicine since time immemorial. They are weaker than modern synthetic diuretics, but are much less toxic. If you choose the right herbal folk diuretic, it can be used for a long time without side effects. Only a qualified specialist should prescribe diuretic tea or herbal tea: a doctor or a trusted traditional healer. He will be able to do this taking into account the cause of fluid retention in the patient’s body, which causes edema. For example, for heart failure, birch leaves are used, as well as berries and strawberry leaves. For inflammation of the urinary tract (cystitis, pyelonephritis) - other folk remedies. Namely, tansy flowers, leaves and grass of shepherd's purse, berries and leaves of lingonberry.

Popular folk diuretics for edema

Flax seeds	One teaspoon of ground flax seeds is poured into 1 liter of boiling water and heated for 15 minutes. After this, let it brew for 1 hour in a closed pan. The finished infusion is drunk warm every 1.5-2 hours. glasses.
Birch leaves for compresses	Helps with swelling of the hands and feet. Finely chop 1 cup of birch leaves. Pour boiling water (1 liter) over them and stir with table salt (1 tablespoon). Leave for 30-40 minutes. Compresses from the infusion can be made 5-6 times a day.
Infusion of birch leaves for oral administration	Recommended for edema of renal and cardiac origin. The infusion is prepared as follows: young spring birch leaves (100 g) are poured with warm water (0.5 l). The mixture is infused for 6-7 hours, then it should be strained and squeezed. After this, the infusion should stand until a precipitate appears, which must be carefully filtered. Pure, sediment-free liquid is taken 3 times a day.
Rose hip tea	General strengthening and diuretic. Recommended for swelling after surgery or taking a long course of antibiotics. To brew a glass of boiling water you need 2-3 teaspoons of rose hips. For the best effect, rose hips must first be crushed or ground. It is advisable to brew for a long time in a thermos. A glass of the prepared infusion is drunk throughout the day. The course of treatment with rose hips can be carried out for 10 days, then take a break for 7-10 days and repeat again.
Bearberry Leaves (Bear's Ear)	A herbal diuretic used to treat inflammatory diseases bladder and urinary tract. Diuretic tea from bear's ear leaves is brewed at the rate of 0.5-1 g of leaves per dose, 3-5 times a day. This remedy is contraindicated for any kidney disease.
Lingonberry leaves	They have a weak diuretic and anti-inflammatory effect, suppress the development of pathogenic bacteria. A decoction of lingonberry leaves is taken 3-4 times a day. It is brewed at the rate of 1-2 g of medicinal plant material per dose.
Leaves of Orthosiphon staminate (cat's whisker)	This is a traditional kidney tea. It is usually prescribed for diseases of the kidneys and urinary tract. It has a weak diuretic, antispasmodic and anti-inflammatory effect. Strengthens the secretion of gastric juice. They drink it for a long time, for 4-6 months, taking monthly breaks of 5-6 days. No contraindications or side effects were found over a long period of use. Can be used during pregnancy and breastfeeding, as prescribed by a doctor.

Diuretic nutrition. What foods replace “chemical” diuretics.

Many foods have a diuretic effect. As a rule, these products also saturate the body with vitamins and help maintain normal weight. These include:

watermelon
pumpkin
celery
parsley
dandelion leaf salad

A wonderful natural diuretic are... fresh cucumbers. Try drinking cucumber juice instead of regular water. It contains huge amount potassium mineral, and therefore has a pronounced diuretic effect (and laxative too).

Medicinal diuretics and kidneys: what are the dangers?

Let's say a patient has heart failure. This means that the heart, for some reason, has weakened, and its power is not enough to properly pump blood. Therefore, fluid retention, swelling, shortness of breath and other symptoms occur. But with hypertension there is another problem: the lumen in the blood vessels has narrowed too much. Although the heart muscle contracts with normal power, this force is still not enough to pump enough blood through the vessels. In both of these situations, the load on the kidneys increases, and their nutrition (blood supply) worsens.

Imagine a horse that is carrying too much load and is forced to climb a mountain. And then the owner begins to whip her with a whip to make her walk faster. In pain, the horse will try to speed up the pace, but the owner is at great risk that due to the unbearable load, he will fall and die right on the road. So, the horse is the patient's kidneys, and diuretics are the same whip. Sometimes kidney disease can be a direct cause of hypertension. In this case, the “horse” is not only overloaded, but also sick. It will be all the more dangerous to push her with a “whip”.

From life experience we know that the heavier the load, the faster any mechanism wears out. Therefore, it would be logical to assume that diuretics accelerate the “wear and tear” of the kidneys. If this is true, then people who take diuretics for weight loss or athletic success are paying a heavy price for their “achievements” in the form of reduced life expectancy. It should be pointed out here that no one has conducted studies of the possible long-term consequences of taking diuretic drugs, and it is unlikely that they will do so. After all, if such research were organized, it would require significant funding and a period of several decades. Neither drug manufacturers nor doctors, who do not want changes in their practice, are interested in this.

Of course, before new drugs enter the market, studies are carried out on their possible side effects. But these studies are not carried out as thoroughly as they should be. This also applies to diuretics. For example, doctors used to prescribe a diuretic drug called ethacrynic acid. And only recently it was finally anathematized, because in the West they noticed that in many patients this drug causes irreversible hearing loss. Before this, ethacrynic acid was used for decades.

Alina
Good afternoon
I need information about blood pressure pills that do not harm the kidneys. On the contrary, they contain fermets that have a beneficial effect on the kidneys. Irina
Good health to everyone! I am 43 years old. After surgery on the carotid artery (pathological tortuosity, December 2012), I developed stage 2 hypertension. Before the operation I was hypotensive. I take enalapril 5, indapamide (in the morning), Tombo Ass (in the morning), Atoris (in the evening), pumpan and egilok 1/4 (in the morning). My heart and blood tests are in perfect order. Those. my hypertension is most likely related to the postoperative period. But this is general. The question is this. For 2-3 days my blood pressure does not exceed 118-120/80. Those. returns to his usual pre-operative level. These days I do not take enalapril or indapamide. Why if there is nothing to downgrade? But my doctor recommends taking at least indapamide. I can't understand the meaning of this. After all, indapamide also lowers blood pressure. And sometimes I even have 112/80... How much lower? Or do I not understand the mechanism of action of indapamide? Thank you!
Irina
Hello dears! I am 52g, height 163, weight 72. Arterial hypertension Stage II, risk III (pressure up to 190/115); vascular atherosclerosis; vegetative-vascular dystonia; chronic pyelonephritis; arthritis; Gastrodoudenitis; chronic cholecystitis; high myopia; fibroids and bilateral adnexitis (the uterus was removed in 2005). There is heaviness, swelling (morning and evening) and cramps in the legs below the knees; numbness and cramps of the toes (especially the little and ring fingers); bags under the eyes always. I have suffered from all these diseases since childhood...;(((. In at the moment I take: Enalapril 10 mg in the morning, I relieve high blood pressure with nifidipine 10 mg sublingually; For multiple sclerosis I take vitamin E; Menopause-1 caps/d (Dopelhertz; Omega-3 1 caps/d. Latest examination results from 02/04/2013: Blood OA Hb 107 g/l Lake.6.9; E.3; P/I-2; C \I-68; M-6; ESR-14 mmol; RW-negative sinus rhythm, 73 per minute; ventricle Bilirubin - 13.8 µmol/l; FLT - 12.3 u/l: Amylase - 45.3 u/l; k-ta - 194.3 µmol/l; Urea - 5.55 mlmol/l; Cholestyrin - 5.43 units. I sleep poorly, weakness, fatigue, apathy... Tell me, please. , how and with what can I help myself. I read that you can do without medications, but can I??? And where to start?
Yuri Anatolyevich
A week ago, severe swelling began, especially right leg. 2000 - stroke, 2009 - heart attack, 2010 - bypass surgery of the coronary vessels of the heart, stenting of the right carotid artery, bypass surgery of the patellofemoral artery of the right leg. In the morning I take VALZ 160x12, Egilok 1 tablet 25 mg, ThromboASS 100 mg, nitrosorbitol 10 mg. In the evening - warfarin 2 tablets. 2.5 mg, Atoris 10 mg, Egilok 1/2 tablet (12.5 mg), Nitrosorbitol 10 mg. Working. Sedentary work. 65 years old. Head of production. How to treat swelling of the legs?

Very informative, competent site. Friendly and qualified recommendations. Many thanks to the Author!

Nata
Good afternoon! The site is very informative. Thank you for your work. Please tell me what magnesium preparations can be taken for urolithiasis? In the annotation for the drugs Magne-B6, Magnerot - contraindications for this disease. Magnelis B6 has no contraindications. I have urolithiasis - phosphates 85%, oxalates 15%. I am hypertensive, stage 2, risk 3, I want to try your method.
Noel
Hello, I am 28 years old, weight 55 kg, height 168 cm. I have been suffering from swelling in my legs for several years. The calves and thighs swell evenly. In a horizontal position (lying down) everything goes away. As soon as I get up, when walking or lying down, my legs become heavy and gradually become fuller. I went to see a therapist. He told me to take urine and blood tests, do an ultrasound of all organs - I did it, everything was within normal limits. As a result, the doctor told me to rub my legs with anti-swelling cream and do exercises - nothing helps. Which doctor still needs to be visited and what could it be? Apart from swelling, there is nothing to worry about. There is no predisposition to varicose veins. Thank you.
Alexander
Hello!
I would like to clarify on the use of taurine. I was prescribed Noliprel-A for hypertension. I read everything on your site - it’s well written, but I have a question. I bought taurine and arginine. I carefully read the instructions for taurine - it says, and I quote, “Taurine stimulates the functions of cell membranes, retains potassium and magnesium, and eliminates excess sodium. Taurine prevents the removal of potassium from the heart muscle and therefore helps prevent blood clots and heart rhythm disturbances, improves blood circulation, and dilates blood vessels.” A question arises when I read about Noliprel A. I will quote again from the instructions for use: “Combined use with potassium-sparing diuretics or medications containing potassium can lead to an increase in the concentration of potassium in the blood (even to death). Co-administration of the drug noliprel with potassium-sparing diuretics and potassium supplements is recommended only in case of hypokalemia (while monitoring the level of potassium in the blood and ECG)"

How can this be? What to do with taurine? Should I accept it or not? The issue with arginine is also open. In Noliprel tablets And it is also contained in a small dose, it is not written exactly in what dose. So is it possible to take these dietary supplements?

There is no hope of giving up chemicals. I'm worried that I'll have to drink this chemical for the rest of my life! I bought everything you recommended: Omega-3, Magnesium Citrate, Quenzyme-Q10, L-Carnitine Fumarate. I take these drugs, but what about taurine and arginine? Ask the doctor to prescribe me a different drug? But I had to give up Lozap-Plus; it stopped helping. Noliprel A is a good medicine and I don’t want to change it to another one yet. Please advise whether to take these dietary supplements or not?

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