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The best diuretics. Taking diuretics during pregnancy and lactation

Many people suffer from high blood pressure, swelling, and stagnation of urine. Some people prefer to fight these phenomena with folk remedies, others completely give themselves into their own hands. traditional medicine. Doctors offer to correct such disturbances in the functioning of the body with various medications, including assistance with diuretic tablets. What is their classification? How to use drugs correctly? Who are diuretics suitable for?

Diuretics in tablets

Many still do not know why diuretics are prescribed and often refuse to take them, even after a direct recommendation from a doctor, citing normal bowel movements and frequent urge to go to the toilet. Diuretics can be prescribed not only to people with urinary problems, but also for head injuries, severe swelling of soft tissues, to normalize the acid-base balance, and this is not the entire list of indications.

If you open the instructions for any of the diuretic drugs, you will see that the tablets are recommended to be taken if you have the following health complications:

  • high blood pressure, which is not complicated by renal failure;
  • circulatory disorders with subsequent formation of edema;
  • arterial hypertension with impaired glomerular filtration;
  • glaucoma;
  • pulmonary or cerebral edema;
  • liver cirrhosis with portal hypertension;
  • secondary hyperaldosteronism;
  • diabetes insipidus.

For swelling

Diuretic tablets for edema are prescribed only when the area of ​​soft tissue damage is large, grows over time, or does not go away for a long time after taking less aggressive drugs. Diuretics - serious medical supplies, which affect the entire functionality of the body, and therefore can only be prescribed by a doctor. They can be taken in a strictly designated dosage, in long courses - 2 or 3 weeks at intervals.

Depending on the affected area and the degree of swelling of the soft or serous tissues, all prescribed drugs can be divided into several groups:

  • agents with a weak degree of severity: Spironolactone, Triamterene, Midamor;
  • drugs medium strength effects on the body: Chlorthalidone, Metozalone, Hypothiazide, Veroshpiron;
  • potent diuretics: Furosemide, Xipamide, Torasemide.

Under pressure

If there is excessive blood pressure on the brain, heart and eyes, diuretics are prescribed, which are divided into two main groups:

  • Tablets used for hypertensive crisis. Their goal is to quickly lower blood pressure. These are drugs under trade names: Furosemide, Xipamide, Ethacrynic acid, Torasemide, Metozalone.
  • Diuretics that help maintain normal blood pressure: Metozalone, Indapamide, Hypothiazide, Clopamide.

Diuretic drugs aimed at sharp decline Blood pressure is, in fact, first aid. They are never prescribed for no reason and are used only in emergency cases. If long-term therapy and remission monitoring are necessary, it is more advisable to choose products with a milder effect on the body. All diuretic tablets should not be taken for more than 3-4 days.

For heart failure

In the presence of such a pathology, the patient often experiences stagnation of fluid in the soft and serous tissues. The patient begins to complain of severe shortness of breath, pain in the liver, laryngeal wheezing after the slightest physical activity. To relieve symptoms and prevent severe consequences in the form of pulmonary edema or cardiac shock, the doctor prescribes diuretic therapy. In this case, the choice of diuretics is based on the diagnosis:

  • For patients with mild and average degree heart failure, thiazide drugs are prescribed: Hypothiazide, Hydrochlorothiazide.
  • At chronic failure the patient is transferred to stronger tablets - loop diuretics. These include: Furosemide, Trigrim, Diuver, Lasix.
  • In some especially dangerous cases Spironolactone is additionally prescribed. The use of this diuretic drug is justified in the development of hypokalemia.

For weight loss

For unknown reasons, many women find that diuretics are effective in helping them lose weight. extra pounds and burn subcutaneous fat. However, in practice this statement is a deep misconception. Yes, a diuretic for weight loss will have an effect, but only temporary. All the fluid will leave the body, the blood vessels will be cleared of cholesterol plaques, but you will not be able to lose weight, and the kilograms will return after drinking a bottle of water.

Diuretics are prescribed fat people only as an effective means for the prevention of atherosclerosis, prevention of stroke or the development of heart failure. In all other cases, these drugs will disrupt the level and ratio of electrolytes to the blood plasma, wash out potassium ions, cause weakness, dizziness, hypertension and can become a serious threat to life.

Classification of diuretics

Based on what part of the kidneys is affected by diuretics, what composition and concentration active substances in tablets, how the drug affects the body - all diuretics are divided into several groups: saluretics, potassium-sparing tablets and osmotic agents. You must always remember that taking such medications should only be done under the supervision of a doctor, if there are reasonable indications.

Saluretics

The mechanism of action of saluretic tablets is based on rapid elimination from the body of potassium and sodium ions. Thanks to this effect, the maximum possible volume of fluid leaves the soft tissues and normalizes acid-base balance fabrics. A serious disadvantage of such diuretics is the fact that along with the fluid, they are washed out of the body. large number salt.

As a rule, saluretics are used to treat vision problems, chronic circulatory failure, hypertensive crisis, and liver cirrhosis. The duration of use for each tablet is different: from several hours to a couple of days. Conventionally, all sauretics can be divided into the following groups:

  • Thiazide diuretics – drugs Hypothiazide and Oxodolin. They have a minimum of side effects, are well tolerated by patients and are not addictive. The main disadvantage of thiazide diuretics is the possibility of hypokalemia, so they are used for no more than 7 days.
  • Loop diuretics are powerful, rapid-acting diuretics. They are classified as first aid medications and are used only in cases of hypertensive crisis. At correct use loop diuretics negative reactions doesn't happen.
  • Carbonic anhydrase inhibitors are the most gentle diuretics. The tablets act gradually, but tend to accumulate in the body and become addictive.

Potassium-sparing diuretics

Diuretics, which help preserve potassium in the body, are considered the most gentle. However, you should not expect instant results after taking such a pill. These diuretics have a cumulative effect and begin to act only after completing a course of treatment. Potassium-sparing diuretics are prescribed for edema, as an adjuvant during the treatment of hypertension.

Characteristic representatives Diuretic potassium-sparing drugs are:

  • Spironolactone and its analogues - appears after taking the tablets for 3-5 days, remains effective for about a week. The medicine is prescribed for mild swelling, in combination with other antihypertensive tablets and diuretics. Due to the fact that Spironolactone contains steroids, with long-term use, women may develop hair on their face, back, chest, and there is a risk hormonal imbalance.
  • Daytek, Triamterene – easy drug The mechanism of action is similar to Spironolactone, but has a faster diuretic effect. After taking the tablet, the effect of the drug begins after 3-4 hours and lasts up to half a day. The drug is not recommended for older people due to the possibility of developing kidney disorders and the appearance of hyperkalemia.
  • Midamor or Amiloride is the weakest diuretic. These tablets help remove chlorine, but retain potassium and calcium. Often a diuretic is used as an addition to other local therapy.

Osmotic

Diuretics of this group reduce plasma pressure, remove water from tissues, and increase blood circulation. The disadvantage of such tablets is that with poor reabsorption by the kidneys, the concentration of active substances in the urine increases, and the loss of sodium and potassium increases. The tablets are prescribed as a diuretic for swelling of the brain, larynx, glaucoma, sepsis, osteomyelitis, and burns. Osmotic diuretics include:

  • Mannitol with sulfacyl;
  • Urea;
  • Theobromine;
  • Eufillin;
  • Theophylline.

Herbal diuretics in tablets

Means plant origin are considered the safest, therefore they can be prescribed during pregnancy, breastfeeding, children and the elderly. Of the contraindications, it is worth highlighting only minor ones allergic reactions and individual intolerance to the composition of certain herbs. Use herbal diuretics for edema during pregnancy, kidney failure, inflammatory diseases urinary system. These are pills.

Diuretics (diuretics) help remove fluid from tissues and correct the body’s water-salt balance. The list of names of diuretic tablets used for edema is impressive, but it should be borne in mind that for various diseases it is recommended to use diuretics of a certain class. The same diuretic medicine is practically safe for some ailments, but in other cases it can be dangerous. serious threat for health.

List of diuretic tablets for hypertension

Diuretics help reduce blood pressure in hypertension by ridding the body of excess liquid and salt. Medical statistics shows that the use of diuretics reduces the incidence of complications in people suffering from hypertension:

  • in form – from 14% to 16%;
  • in the form of a stroke - from 38% to 42%.

The list of diuretic tablets used for treatment includes drugs belonging to different groups.

Thiazide and thiazide-like diuretics

These drugs, although not considered the most effective in terms of removing salt and water, do significantly reduce blood pressure. This group of drugs includes:

  • Benzthiazide;
  • Indapamide (Arifon);
  • Klopamide;
  • Dichlorothiazide (Hypothiazide).

Most often, thiazide and thiazide-like diuretics are indicated for hypertensive patients.

Loop diuretics

The group of so-called loop diuretics includes drugs that affect the filtration process of the kidneys. These drugs significantly enhance the excretion of salt and fluid, but at the same time have serious side effects. As a rule, loop diuretics prescribed in a critical situation - during a hypertensive crisis. This group includes:

  • Bumetanide;
  • Furosemide;
  • Ethacrynic acid.

Potassium-sparing diuretics

These agents reduce the release of potassium and slightly increase the release of sodium and chloride. Belonging to the group of potassium-sparing tablets in the treatment of hypertension, they are used only in combination with other diuretics to enhance their effect and to prevent excessive leaching of potassium from the body. Potassium-sparing drugs include:

  • Amiloride;
  • Triamterene;
  • Spironolactone.

Aldosterone antagonists

This group includes medications that block the action of aldosterone, a hormone that retains fluid and salt in tissues. When the designated hormone is neutralized, more salt and water are released in the urine, but the potassium content in the body is not reduced. Veroshpiron belongs to the group.

Drugs that speed up the excretion of urine from the body are called diuretics. These drugs reduce the ability of the kidneys to reabsorb electrolytes, against the background of increasing concentrations of which fluid is released.

The first diuretic used by man was mercury. In the 19th century, this substance was used in the treatment of syphilis. It turned out to be practically powerless against this disease, but the diuretic effect of mercury did not escape the attention of doctors. Later, safer compounds appeared, the improvement of which made it possible to obtain effective and non-toxic diuretics.

Taking diuretics helps:

  • elimination of swelling in cardiac and vascular failure;
  • lowering blood pressure with hypertension;
  • alleviating the symptoms of kidney disease;
  • removal of toxins during intoxication.

Swelling is a frequent companion to urinary and vascular systems, hearts. Pathology develops as a result of sodium retention in the body. Diuretics help remove its excess. Thanks to this, swelling is noticeably reduced.

Hypotension (high blood pressure) against the background of increased sodium negatively affects blood vessels. They contract and narrow. Diuretics, used as blood pressure-lowering drugs, not only flush out sodium, but also dilate the walls of blood vessels. This effect of the drug leads to a decrease in blood pressure.

Removing toxins through the use of diuretics in clinical medicine called "forced diuresis". This method is that after intravenous administration A certain dose of a highly effective diuretic drug is administered to the patient in a similar way. This leads to the fact that at the same time toxic substances are washed out of the body.

There are several types of diuretic drugs, differing in their mechanism of action, used in the treatment of various pathologies.

There are three types of diuretics:

  1. Affecting work epithelial tissue renal tubules. The group of these drugs includes the following: Triamterene, Hydrochlorothiazide, Bumetanide, Cyclomethiazide, Chlorthalidone, Bendroflumethiazide, Ethacrynic acid, Clopamide, Methyclothiazide, Amiloride, Metolazone, Furosemide, Indapamide, Torsemide.
  2. Calcium-sparing, aldosterone (mineralocorticoid) receptor antagonists. Diuretics of this type include Spironolactone, which is known under the trade name Veroshpiron.
  3. Osmotic, for example, Mannitol (Monitol).

Diuretics are classified not only by their mechanism of action, but also by the degree of sodium leaching:

  • highly effective (washing out over 15%);
  • average efficiency (10%);
  • ineffective (5%).

The principle of action of diuretics

The effectiveness of diuretics for hypotension is directly related to the fact that they reduce sodium levels, dilate blood vessels. Maintaining vascular tone and reducing fluid concentration allows you to relieve arterial hypertension.

Taking diuretics relaxes myocardial cells, reduces platelet aggregation, improves microcirculation occurring in the kidneys, and reduces the load exerted on the left ventricle of the heart muscle. This mechanism of action leads to the fact that the myocardium needs much less oxygen. Osmotic diuretics, in addition to their direct purpose, increase the level of osmolar pressure of the nutrient medium of cellular elements - interstitial fluid.

The antispasmodic effect of the drugs is based on the ability to relax the smooth muscles of the arteries, biliary tract, bronchi.

The desire to get rid of hated kilograms pushes people to rather dubious experiments. Diuretic drugs also suffered this fate. Many people mistakenly believe that these drugs help you lose weight. This misconception is caused by the fact that ninety percent of adipose tissue consists of water.

Diuretics have an antiatherogenic effect. It lies in the ability to destroy cholesterol plaques. A drug such as Indapamide lowers the level of bad cholesterol in the blood. This in no way means that taking diuretics will help you lose fat. It stays in place, only the liquid leaves. The positive effect of the drug is that it reduces the risks of stroke, atherosclerosis, and heart failure.

Diuretics have an effect on various systems, but to a greater extent on the urinary system. If medications are taken exclusively as directed, they normalize the balance of water and electrolytes. Uncontrolled use of diuretics, on the contrary, leads to numerous health problems, even death is possible.

It is impossible to remove fluid from the body without loss of ions. The latter regulate the functioning of each internal organ. Consequently, weight loss does not occur as a result of a decrease in body fat, but due to dehydration, which is accompanied by an ionic imbalance. Against this background, cardiac arrhythmia, hypotension develops, vision decreases, and general condition weakness, attacks of dizziness occur. With a severe overdose, hallucinations and collapse are possible.

Those wishing to use diuretics for the purpose of losing weight should remember that these drugs are included in the category prohibited for athletes. The reason for this was the death of an athlete who abused diuretics in order to get sculpted muscles. Only people far from medicine can recommend these drugs for weight loss.

Indications for the use of diuretics

Diuretics are prescribed to those suffering arterial hypertension, especially acute in old age, with an excess of sodium caused by the retention and accumulation of this substance in the body. The latter condition is observed in chronic heart and kidney failure, ascites. For those suffering from osteoporosis, it is recommended to take thiazides; for people with congenital Liddle syndrome, potassium-sparing diuretics are recommended for cardiac edema, glaucoma, intraocular pressure, cirrhosis - drugs affecting kidney function.

Diuretic thiazide-like drugs are indicated for therapy and as a prophylaxis for arterial hypotension. For moderately high blood pressure, take small doses. Taking these drugs prophylactically reduces the risk of stroke. Taking large doses of these drugs unless necessary is not recommended. This may cause the development of hypokalemia. To prevent a drop in potassium levels in the blood, thiazide diuretics are combined with potassium-sparing diuretics.

Therapy with diuretics can be active or supportive. At active treatment Patients are prescribed moderate dosages of diuretics potent drugs, for example, Furosemide, and with maintenance - regular use of medications with a diuretic effect.

Contraindications to taking diuretics

Contraindications to the use of diuretics are:

  • hypokalemia;
  • diabetes mellitus;
  • renal and respiratory failure;
  • decompensated cirrhosis.

These drugs should not be taken by patients who have an individual intolerance to sulfonamide derivatives. Thiazide group drugs, for example, Methyclothiazide, Bendroflumethiazide, Cyclomethiazide, Hydrochlorothiazide, can cause a sharp increase in blood sugar levels.

In patients suffering from ventricular arrhythmia, taking diuretics can cause a worsening of the condition and is strictly under medical supervision. Combining diuretic therapy with the use of lithium salts and cardiac glycosides requires maximum caution. Patients with heart failure are not prescribed osmotic diuretics.

Side effects and health risks

Thiazide drugs can increase uric acid in the blood. This side effect of using drugs in this group must be taken into account by patients with gout. The use of thiazides for this pathology can lead to an exacerbation of the disease and worsen the patient’s condition.

Moderately effective diuretics, for example, Hydrochlorothiazide or Hypothiazide, require strict dosage. If the dose is calculated incorrectly, the patient may feel nausea, weakness, increased drowsiness, headache, dry mouth. An overdose may be accompanied by diarrhea. Similar symptoms are observed in case of individual intolerance to the medication. Against the background of ion imbalance, muscle weakness, skeletal muscle spasms, arrhythmia, allergies develop, an increase in sugar and a decrease in male libido may occur.

Furosemide may have the following side effects: reduce magnesium, calcium, potassium, cause nausea, frequent urination, dizziness, dry the oral mucosa. Disturbances in ion exchange provoke an increase in glucose, uric acid, and calcium. High content These substances have a detrimental effect on hearing, manifested by paresthesia and skin rashes.

Uregit- a drug that has an increased irritant effect. Taking it may have a negative effect on hearing.

Aldosterone antagonists can cause cramps, diarrhea, vomiting, rashes on skin, gynecomastia. Incorrect purpose of these medications causes problems in women menstrual cycle, and for men it threatens impotence.

Osmotic With the wrong approach to the treatment of heart failure, medications can increase the load on the heart muscle by increasing plasma volumes. This side effect results in pulmonary edema.

Popular diuretics: how they affect the body

Drugs, pharmacological action which are directed to the renal tubules, sodium is excreted along with urine.

Thiazide-like diuretics, for example, Methyclothiazide, reduce the degree of absorption of not only sodium, but also chlorine. These drugs can often be found under the general name "saluretics", which they received from English word"salt" meaning "salt".

Moderately effective diuretics, promoting the removal of sodium, are prescribed, as a rule, for swelling and kidney disease, for patients with heart failure. Hypothiazide is most often used as antihypertensive. This is due to the fact that this medication flushes out excess sodium and stabilizes high blood pressure. These drugs enhance the effect of hypertensive drugs.

To avoid effects on blood pressure, these diuretics are taken in large rather than moderate doses. The active substances present in Hypothiazide lower the level of calcium ions and prevent the accumulation of salts in the kidneys. It is often prescribed during therapy diabetes insipidus, urolithiasis.

Indapamide(known under the trade name as Arifon) is a drug that differs from other diuretics in its ability to dilate blood vessels and relieve spasms.

Furosemide(trade name Lasix) is the most effective diuretic, beginning to act within ten minutes after intravenous administration. It is prescribed to patients with arterial hypotension, peripheral edema, left ventricular acute insufficiency with pulmonary edema, in order to remove toxins from the body. A diuretic such as Uregit also has similar pharmacological properties. The difference is that it lasts longer.

Competitive aldosterone antagonists, known under the trade names Aldactone or Veroshpiron, are diuretics whose action is based on reducing potassium and magnesium ions and preventing the absorption of sodium ions. Indications for the prescription of diuretics from this group are: hypertension, edema, congestive processes against the background of acute or chronic disorders work of the heart muscle.

Osmotic diuretics have low permeability through membranes. The most common and effective drug This group of diuretics is Monitol, administered intravenously. It reduces intracranial and intraocular pressure, but increases plasma osmotic pressure. It is prescribed to patients with oliguria, which causes severe blood loss, trauma, burns, cerebral edema, glaucoma, including during the rehabilitation period after glaucoma surgery.

Diuretics of natural origin

There are many natural diuretics that are inferior in action to artificial analogues, but were used by humans long before the advent of synthetic diuretics. The lower effectiveness of traditional methods is compensated by its harmlessness and gentleness. Correctly selected dosage allows you to use decoctions for quite a long time without any side effects or harm. You should take natural diuretics, as well as synthetic drugs, only after finding out the real reason why fluid is retained in the body.

If fluid retention is caused by swelling and heart failure, drink a decoction made from birch leaves or strawberries. Birch leaves are used as compresses for swelling of the upper and lower limbs. Inflammations of the bladder and kidneys are treated with tansy, lingonberry, and shepherd's purse. Flaxseeds, bearberry, rose hips, and orthosiphon are most often used in the treatment of swelling. Rosehip tea is taken during long-term antibacterial treatment and recovery after surgery.

Orthosiphon is a traditional kidney tea that has both a diuretic and antispasmodic, anti-inflammatory effect. Natural diuretics are not only herbs, but also other vegetable crops. The removal of fluid is facilitated by the use of pumpkin, melons, celery, and parsley. Instead of fresh herbs, you can use cucumber and dandelion leaves to make a salad that reduces swelling.

Taking diuretics during pregnancy and lactation

Many expectant mothers, especially in the last months of pregnancy, suffer from swelling. They appear as a result of the expanding uterus compressing the vena cava. Puffiness cannot be ignored. It may signal the development of such pathological conditions, such as renal failure and gestosis. When following a diet does not bring visible results, the pregnant woman is prescribed synthetic or natural diuretics.

Most diuretics are contraindicated for use at any stage of pregnancy. You should take diuretics only as prescribed by a doctor and with extreme caution. On early stages Almost all drugs are prohibited, and in later years only a few are allowed, which are prescribed by a specialist. An incorrectly selected diuretic or dosage can change the composition of the blood, causing problems with the kidneys, hearing, vision, and even lead to a disease such as jaundice.

They can even harm a pregnant woman and the fetus folk remedies. Regular use herbal infusions violates electrolyte balance, has a negative impact on future pregnancies. You should not take juniper, strawberries, or parsley root. Most safe means is orthosiphon. It can be used both during pregnancy and lactation.

If it is impossible to do without taking diuretics, the attending physician prescribes Canephron tablets. This medicine can be taken at almost any stage of pregnancy. Drops of this drug are not prescribed because they contain alcohol. If swelling occurs without acute inflammatory processes in the kidneys, a herbal medicine such as Fitolysin may be prescribed.

An alternative to diuretics can be the bronchodilator Eufillin, which has a diuretic effect. It is contraindicated for women suffering from hypotension, epileptic seizures, and heart disease. When prescribing it during lactation, the specialist assesses the risk and the real need for taking this drug.

(diuretics) - medications that are required by most people with pathologies of the bladder and kidneys. Improper activity of the urinary organs contributes to the accumulation of excessive amounts of fluid in the body, severe stress on the heart, edema, high blood pressure. It is not difficult to find synthetic and herbal diuretics in pharmacy chains. Their list includes different types diuretics. The list of diuretic drugs is quite extensive.

Which remedy is best for the patient? What's the difference different types diuretics? Which ones are the strongest? Do complications arise when self-medicating with diuretics?

What diuretics are most effective for hypertension and heart failure? Let's try to figure it out in the article below.

The essence of diuretics

Medications of this type remove excess fluid with urine, cleanse the patient’s body, and wash the bladder and kidneys. Diuretics are prescribed not only for kidney pathologies: herbal and synthetic compounds are required to eliminate swelling in diseases of the liver and cardiovascular system.

The mechanism of action of diuretics is as follows:

  • reduce the absorption of salts and water in the renal tubules;
  • remove excessive amounts of fluid, thereby reducing tissue swelling;
  • increase the production and rate of urine excretion;
  • prevent increased stress on the urinary organs and heart;
  • lower blood pressure.

The positive effect of the ingredients in diuretics is:

  • normalizing fundus pressure;
  • risk reduction epileptic seizures;
  • stabilization of blood pressure in hypertensive patients;
  • normalization intracranial pressure;
  • faster removal of toxins from the body during certain types of intoxication;
  • reducing the concentration of calcium in the blood while maintaining the required level of magnesium.

As a result, the load on the heart is reduced, and microcirculation of the kidneys and tissues improves.

The mechanism of action of diuretics is described in detail in the instructions.

It is worth noting that, in addition to removing fluid accumulated in tissues, diuretics affect many processes, removing both urine and magnesium, sodium and potassium. Misuse chemical compositions often causes serious health pathologies. Because of this, it is prohibited to purchase and take diuretics before consulting a specialist. Depending on the type of disease, advice from a urologist, cardiologist, nephrologist or gastroenterologist will be required. Often the patient may need comprehensive examination.

Features of the classification of diuretics

Ideally, the classification should take into account all aspects of their impact. However, at present it does not exist, since diuretics differ fundamentally in their chemical structure. That is why they are too different from each other in terms of duration of influence on the human body and mechanism.

It is not without reason that experts forbid patients to choose diuretics on their own: each type of diuretic has specific effects, its own side effects and contraindications. The use of powerful compounds can cause active removal of potassium from the body or accumulation of the element, severe headaches, dehydration, and hypertensive crisis. An overdose of strong loop diuretics when self-medicated can end very sadly.

So, let's move on to the classification of diuretics.

Diuretics functioning at the glomerular level

"Eufillin" allows you to dilate blood vessels in the kidneys and increase blood flow in the kidney tissues. Due to this, diuresis and glomerular filtration increase. These drugs are most often used to enhance the effect of other diuretics. In addition, cardiac glycosides increase glomerular filtration and inhibit the reabsorption of sodium in the proximal canals.

Potassium-sparing

Potassium-sparing diuretics reduce upper (systolic) blood pressure, reduce swelling, enhance the effect of other drugs and retain potassium in the body. Undesirable effects often appear, as with the use of hormonal drugs. Excessive potassium levels can cause cardiac arrest or muscle paralysis. For kidney failure and diabetes mellitus, this group of drugs is not suitable. It is necessary to adjust the dosage individually, and also observe a nephrologist and cardiologist. Effective medicines- “Veroshpiron”, “Aldakton”.

The first is a potassium-sparing diuretic; it has a pronounced and long-lasting diuretic effect. Active active ingredient This medicine is spironolactone (adrenal hormone). This substance prevents the retention of water and sodium in the renal tubules. The drug "Veroshpiron" does not significantly affect blood circulation in the kidneys, reduces the acidity of urine and reduces the excretion of potassium from the body. The diuretic effect helps normalize blood pressure.

Thiazide

Prescribed for kidney pathologies, heart failure, glaucoma and hypertension.

Thiazide diuretics act on the distal renal tubules, reduce the reabsorption of magnesium and sodium salts, reduce the production of uric acid, and also activate the excretion of potassium and magnesium. To reduce the frequency of undesirable manifestations, it is combined with loop diuretics. Thiuzide drugs are as follows: “Indapamide”, “Clopamide”, “Chlorthalidone”, “Indap”.

Diuretics for hypertension and heart failure are absolutely irreplaceable.

Osmotic

In this group, the mechanism of action is to reduce pressure in the blood plasma, active passage of fluid through the glomeruli of the kidneys, and improve the degree of filtration. As a result, swelling is eliminated and excessive amounts of water are removed. Osmotic diuretics are weak agents that last up to 6-8 hours. It is advisable to administer them intravenously. Indications are as follows: cerebral and pulmonary edema, glaucoma, drug overdose, blood poisoning, severe burns. The most effective are Sorbitol, Urea and Mannitol.

What drugs are also included in the list of diuretics?

Loop

Especially powerful drugs with a diuretic effect. The components of the drugs affect the loop of Hengle - the kidney tubule, which is directed to the center of the organ. This loop-shaped formation sucks back liquid from various kinds substances. Medicines in this group help relax the walls of blood vessels, activate renal blood flow, gradually reduce the volume of fluid between cells, and accelerate glomerular filtration. Loop diuretics reduce the reabsorption of potassium, sodium, chlorine and magnesium salts.

The advantages of these drugs:

  • fast effectiveness (up to half an hour after use);
  • powerful influence;
  • suitable for emergency use;
  • work up to six hours.

The most effective formulations: “Ethacrynic acid”, “Piretanide”, “Furosemide” tablets.

The latter is a loop diuretic, causing rapid, strong and short-term diuresis. Reabsorption of sodium and chloride ions is blocked in both the proximal and distal portions of the renal tubules, as well as in the thick segment of the ascending limb of Hentle's loop. Furosemide in tablets has a pronounced diuretic, natriuretic and chloruretic effect.

It is worth noting that such drugs are used only in critical situations. Taking diuretics often leads to serious complications: pulmonary and cerebral edema, hypertensive crisis, severe liver inflammation, excessive potassium levels, heart and kidney failure.

Vegetable

Consider light diuretics of plant origin. Advantages:

  • obvious diuretic effect;
  • gentle effect on blood vessels, heart and kidneys;
  • remove excess fluid from the body;
  • exhibit a slight laxative effect;
  • wash the kidneys and bladder;
  • saturate the body with useful components: vitamins, mineral salts, biologically active substances, and can be used for a long time (in courses).

Natural herbal diuretics ( medicinal plants) are as follows:

  • cranberries;
  • lungwort;
  • lingonberry leaves;
  • bearberry;
  • peppermint;
  • birch buds and leaves;
  • horsetail;
  • chicory root;
  • creeping wheatgrass;
  • yarrow;
  • fennel;
  • strawberry berries.

What else applies to diuretics?

Melons, vegetables and fruits: watermelon, mango, cucumbers, tomatoes, persimmons, pears, rosehip infusion, pumpkin juice.

Aquaretics

This group of drugs increases the release of water. These medications interfere with antidiuretic hormone. They are used for congestive heart failure, liver cirrhosis, and psychogenic polydipsia. The main representative is Demeclocycline. Side effects include photosensitivity, nail changes, fever, and eosinophilia. The drug can damage kidney tissue with a decrease in glomerular filtration. Aquaretics include vasopressin antagonists and lithium salts.

What else is included in the list of diuretic drugs?

Uricosuric diuretics

From this group, Indacrinone is most often used. Compared to Furosemide, it activates diuresis more strongly. This drug is used for overt arterial hypertension and nephrotic syndrome. It is also possible that it can be used in the treatment of chronic heart failure.

The effect of using diuretics

Active excretion of urine occurs after a certain period of time:

  • fast diuretics - thirty minutes (“Torasemide”, “Furosemide”, “Triamterene”);
  • average - two hours (“Diacarb”, “Amiloride”).

Each type of diuretic drug differs in its duration of beneficial effect.

Eplerenone and Veroshpiron work for a long time (up to four days).

The middle period - “Indapamide”, “Triamterene”, “Diacarb”, diuretic “Hypothiazide”. (Fourteen hours).

Up to eight hours - diuretic "Lasix", "Mannitol", "Furosemide", "Torasemide". The compositions differ in their diuretic effect.

Weak: “Veroshpiron”, “Diakarb”. Medium: “Hypothiazide”, “Oxodolin”. Powerful: “Bumetanide”, “Ethacrynic acid”, “Furosemide”, “Trifas” tablets.

"Trifas" is a strong diuretic that relieves swelling in kidney pathologies, heart and vascular diseases. This drug copes with its functions even when other drugs are not effective. Trifas tablets are recommended to be taken at a dose of 5 mg per day.

Indications for use

Diuretics are prescribed for diseases and conditions that are accompanied by fluid retention. This:

  • osteoporosis;
  • tissue swelling;
  • nephrotic syndrome;
  • congestive heart failure;
  • pronounced swelling of the legs in heart failure;
  • glaucoma;
  • arterial hypertension (high blood pressure);
  • excessive secretion aldosterone hormone.

Contraindications

When choosing diuretic drugs, specialists take into account all restrictions. Any drug has certain contraindications, which are indicated in the instructions. During pregnancy, not all synthetic diuretics can be prescribed: if blood pressure increases, urination problems, or pronounced edema, diuretics with extracts of medicinal plants and herbal decoctions are prescribed.

Main restrictions: breast-feeding, childhood, pregnancy, excessive sensitivity to elements of synthetic diuretics or phytoextracts, severe kidney failure, diabetes mellitus.

Are diuretics always safe?

Side effects

Before starting treatment, the patient needs to be aware that diuretics in some cases cause undesirable effects. Problems arise when choosing drugs independently, especially the most powerful loop diuretics, as well as when independently extending the treatment course and increasing the dosage. The duration and strength of undesirable effects are determined by the type of diuretic drug.

The most commonly reported side effects are:

  • excessive potassium loss;
  • nausea;
  • hypertensive crisis;
  • headaches;
  • increased nitrogen content in the blood;
  • cerebral and pulmonary edema (loop diuretics);
  • chest pain;
  • kidney failure;
  • convulsions;
  • cirrhosis.

Diuretics for diseases of the urinary tract and kidneys

A urologist or neurologist will select the optimal remedy. A consultation with a cardiologist is often necessary: ​​patients with renal pathologies suffer from vascular and heart problems, arterial hypertension. For the prevention of edema and long-term use, decoctions based on medicinal herbs or weak diuretics are suitable. Choose a diuretic chemical agent You cannot do it on your own or on the advice of neighbors and relatives.

Drugs with a diuretic effect are prescribed only individually. Violation of the rules often causes serious consequences for the patient, causing a hypertensive crisis. The most effective diuretic drugs from the list are:

  • "Cyston". An effective and safe drug for nephrolithiasis, urolithiasis and pyelonephritis. Tablets are prescribed even to pregnant women and children.
  • "Furosemide". A strong loop diuretic with good effectiveness that quickly relieves swelling. Use only under medical supervision.
  • "Phytolysin". A preparation with natural oils and phytoextracts for oral use. Anti-inflammatory, diuretic and bactericidal effects. Strengthens the immune system, prevents the likelihood of relapses in pyelonephritis and cystitis.
  • "Monurel". A drug with antimicrobial, anti-inflammatory and diuretic effects. The tablets contain a lot of dry cranberry extract and ascorbic acid.

For pathologies of the bladder and kidneys, herbal decoctions are used. Experts advise brewing fennel, bearberry herb, birch buds and leaves, lingonberry leaves, peppermint. Good help cranberry juice and rosehip decoction.

It is not easy for the average buyer to choose the optimal diuretic when pharmacy shelves are filled with them: injection solutions, tablets, capsules, teas and mixtures. We bring to our readers a review of the most popular and affordable diuretics for edema.

What should be the ideal diuretic?

The best diuretic should answer the largest number requirements for such means. These include:

    Efficiency in the shortest possible time.

    Long lasting effect.

    Absence or minimum quantity side effects.

    Optimal interaction with other drugs (should not inhibit each other’s effects or form toxic compounds).

    The minimum number of restrictions on use.

    Affordable price.

Attention! At the moment, not a single diuretic has been developed that is ideally suited to the listed parameters. Each drug has a number of side effects and has its own contraindications, so before using this or that product, we recommend consulting with your doctor.

Review of diuretics with their brief description and cost

Below will be indicated the name of the drug, the pharmacotherapeutic group to which they belong, the characteristics of the drug’s effect on the body, and possible side effects from its use. It will also indicate groups of people who should use certain diuretics with caution or whose use is prohibited.

Refers to loop diuretics, produced in the form of injection solutions and tablets. Furosemide is a strong short-acting diuretic, therefore it is used in severe cases to lower blood pressure. Actively removes sodium from the body - not recommended for long-term use. Patients with kidney or liver pathology should prescribe the drug with caution. Price – 70-150 rub.

The drug is a highly active loop diuretic, the action of which is associated with inhibition of the absorption of sodium and chlorine in the renal loops of Henle. The drug is an analogue of Furosemide - the characteristics of the action of drugs on the human body are similar. Produced in the form of tablets and solutions for injection use. Cost – 200-400 rub.

The diuretic activity of the drug is pronounced, but weaker than that of Furosemide, so the medicine is used much more widely. They belong to the same pharmacological group (loop diuretics) - the mechanism of action on the renal loop apparatus is the same. Side effects are similar, as with all loop diuretics. Cost – 250-1100 rub.

Is foreign analogue Torasemide - acts on the kidneys in the same way. Available in tablet form for oral administration. Distinctive feature– tablets have a prolonged (long-lasting) effect due to the slow release of the active substance – tablets are recommended for eliminating edema. Side effects from use are the same for the entire diuretic group. Price – 350-500 rub.

Diuretic tablets are used for edema caused by congestive heart failure. The active substance of the drug is Torasemide, which is a loop diuretic. The drug removes sodium and chloride ions from the body, which, with prolonged use, leads to the development of hyperkalemia, a potentially life-threatening condition. Costs - 380-560 rubles.

It is a tablet preparation based on Torasemide, which has long-term action– long-acting diuretics for swelling of the legs are in the best possible way solving the problem. Particular caution should be used in persons with liver and kidney diseases, as well as in concomitant use of cardiac medications. Price – 500-700 rub.

Ukrainian diuretic medicinal product, available in tablet form and in the form injection solution, main active agent which is Torasemide. In this regard, the effect on the kidneys is the same for all drugs based on Torasemide. It has side effects characteristic of the entire group of drugs. It costs 380-530 rubles.

The main active ingredient of the drug is Torasemide. The best diuretic effect from the use of Toraren occurs within the first 2-3 hours after use and remains at a constant level up to 12 hours from the moment of entry into the body. Toraren is indicated for use to eliminate and prevent the development of edema and effusions in heart failure. Cost – 190-270 rub.

Trifas

A safe diuretic whose active ingredient is Torasemide, available in the form of tablets and solutions. To eliminate swelling in the extremities, the drug is used in tablet form; Trifas solution is used to remove swelling from internal organs or to lower blood pressure in heart failure. In addition to the contraindications characteristic of the entire group of drugs, the drug is prohibited for use during lactation. Price – 400-1200r.

Is the main drug from pharmaceutical group thiazide diuretics ( active substance many of them) having a moderate diuretic effect. The action of the drug differs from the action of loop diuretics, so drugs based on it are safe for long-term use. A special feature of the product is the need for long-term use (at least a month) for the therapeutic effect to occur. Cost – 60-100r.

Hydrosaluretil

The Spanish analogue of Hydrochlorothiazide is a harmless drug for long-term use (unlike loop diuretics). It is prescribed to eliminate swelling and effusions in chronic cardiac, hepatic or renal failure, arterial hypertension, as well as other diseases (diabetes insipidus, urolithiasis, obesity). Hydrosaluretil is also indicated for subcompensated glaucoma. Cost – 300-600r.

Hungarian diuretic drug with the main active substance hydrochlorothiazide. Good remedy for long-term use to eliminate edema that develops in diseases of the cardiovascular system, liver and kidneys, menstruation, after taking glucocorticosteroid drugs. Also used in the treatment of diabetes insipidus, hypercalciuria (excessive excretion of calcium in the urine) and arterial hypertension. It costs 200-370 rubles.

Belongs to sulfonamide diuretics (is the main representative of the group) - a class of non-thiazide diuretics with a moderate diuretic effect. Due to the structural features of the molecules, drugs based on Indapamide are better suited for patients with a combination of heart failure and arterial hypertension. Does not have central effects, suitable for disorders renal function, but to develop a lasting effect, it is necessary to take it for at least 2 months in a row. Price – 150-370r.

Akuter-Sanovel

Tablet diuretic based on Indapamide (1 tablet 1.5 mg), prescribed for high blood pressure and chronic heart failure. As the dose increases, the diuretic effect increases, but the effect on blood pressure does not change (typical for drugs based on Indapamide). The development of side effects is directly related to the dose used. Cost – 290-450 rub.

Arifon Retard

A diuretic that contains Indapamide, which has a long-term (prolonged) effect - it acts during the day. The main effect of use is antihypertensive (lowering blood pressure), the diuretic effect develops with increasing dosage, due to the reabsorption of sodium ions in the renal cortex. The maximum accumulation of the drug in plasma is 12 hours after administration. Price – 300-600r.

Indapamide is in the form of tablets with a prolonged effect (the antihypertensive effect lasts up to a day from the moment of use, the diuretic effect is noticeably weakened). The use of the drug is contraindicated in patients with severe renal failure, severe liver damage, including hepatic encephalopathy (damage to the nuclei of the brain), and insufficient potassium in the blood. The risk of side effects increases with increasing dosage. Cost – 200-320 rub.

Indabru

A diuretic drug based on Indapamide, which has a moderate diuretic effect. The drug acts on the cardiovascular system and kidneys, resulting in a good antihypertensive and less pronounced diuretic effect. The drug is indicated for long-term use in patients with damage to the cardiovascular system. Cost – 300-500r.

Tablet medicinal product available in dosages of 1.25 and 2.5 mg with Indapamide, containing 1.25 or 2.5 mg of the active substance. The advantage of the drug is the possibility of its use in patients on hemodialysis. Indapam must be used for a long time, due to its accumulation in the body, to develop a lasting therapeutic effect. Price – 250-400 rub.

A Polish drug, the main substance of which is Indapamide, produced in the form of regular and extended-release tablets (valid for up to a day and called Indapen SR). For a pronounced therapeutic effect to occur, it is necessary to take the tablets regularly for a week; with further use, the drug does not accumulate in the body. A special feature is the risk of developing unwanted effects when the average dosage is exceeded. Cost – 220-500 rub.

Indatence

Also belongs to the group of drugs based on Indapamide. At the recommended dosage of 2.5 mg, it has a pronounced effect on blood pressure and a slight diuretic effect, therefore, first of all, it is recommended for patients with damage to the cardiovascular system, and only then for those with kidney disease, liver disease or glaucoma. Long-term and regular use is required. Price – 340-520 rub.

Indapress

Tablets for internal use, containing Indapamide at a dosage of 2.5 mg. It is a derivative of benzamides, which has a pronounced effect on the cardiovascular system and less pronounced on the renal cortex. To develop the maximum effect, the drug must be used regularly for at least 2-3 weeks, after which pronounced persistent antihypertensive and diuretic activity develops within 12 hours after use. It is forbidden to use by pregnant and lactating women, as well as persons under 16 years of age. Cost – 190-340 rub.

Triamterene

It is a representative of potassium-sparing (does not remove potassium from the body with urine) diuretics, due to which potassium-sparing drugs are free of a number of side effects and are the safest pharmaceutical diuretics. The medicine reduces the exchange of hydrogen for potassium and sodium, which is why potassium is not excreted from the body. Contraindicated for use in severe renal impairment, acute glomerulonephritis, severe liver damage, gout. Costs - 1000-2000 rubles.

A diuretic, which is a competitive aldosterone antagonist, affects the distal renal tubules, as a result of which the retention of sodium, potassium and water is suppressed - in addition to the diuretic, a hypotensive effect also develops. In addition to eliminating edema in heart failure, it is used for primary hyperaldosteronism, liver cirrhosis, and hypokalemia. Cost – 200-530 rub.

It is an analogue of Spironolactone, produced in tablets or capsules containing the active substance from 25 to 100 mg. The maximum activity of the drug is observed 6-7 hours after use, the effect lasts for a day or more. The drug is contraindicated in increased content potassium and sodium, Addison's disease, pregnancy and lactation, acute renal failure. Price – 140-380 rub.

Also refers to potassium-sparing diuretics, inhibits aldosterone, Eplerenone acts as the active substance. Mainly used by patients with cardiovascular failure who have suffered a myocardial infarction, in order to influence the heart muscle and improve coronary blood flow. Do not use in severe renal failure or in combination with certain heart medications. Costs - 1200-2400 rubles.

Important! When using the drug, you must adhere to a diet that excludes foods with a significant potassium content. To clarify the list of products, consult your doctor.

Epplepres

Ukrainian drug, the active component of which is Eplerenone. The medicine has a selective effect on receptors for certain adrenal hormones, thereby affecting their metabolism, blood pressure and urinary excretion. Used in combination with other drugs to treat cardiovascular pathology. Cost – 550-1000 rub.

Amiloride

The drug is active in the distal tubular apparatus (located in the peripheral parts of the kidneys), leads to increased secretion of chlorine and sodium, and reduces potassium secretion. The severity of the diuretic effect is weaker than diuretics from the thiazide group. It begins to act 2 hours after application, the duration of the effect is up to a day. Costs - 240-410 rubles.

Natural Diuretics

Medicinal herbs are basic natural diuretics. But before using them, you need to know that diuretic herbs for swelling of the legs help only in mild cases. Therefore, with a pronounced or widespread process, it is necessary to use pharmaceuticals. It is also extremely undesirable to self-medicate, since the use of diuretic herbs in the presence of a number of pathologies is strictly prohibited. The following are prepared from herbs that have a diuretic effect:

    tinctures;

Also in pharmacies, special diuretic preparations are widely available, which include several medicinal plants with a similar effect. An alternative pharmaceutical products is the independent collection of medicinal herbs, but this can only be done if you have the necessary skills and experience. It is highly not advisable to purchase medicinal herbs from random persons and in spontaneous markets.

A decoction or tea made from lingonberry leaves has a moderate diuretic effect. The product begins to act 2-4 hours after consumption (the speed of onset of the effect depends on the amount of drink drunk and its strength). Due to its mild effect on the body, the product is suitable for pregnant and lactating women, but it should be used with caution by people with kidney disease. Price – 150-270 rub.

A natural diuretic used for edema associated with impaired renal or cardiac function, with a pronounced effect. Use an infusion of 1 tbsp. spoons of pre-chopped fruits, which need to be filled with 200 ml of warm water and heated in a water bath for 20 minutes. Apply 20-30 ml orally after eating (3-5 times a day). Price – 200-300r.

Chamomile flowers and leaves

Tea made from chamomile flowers and leaves is a time-tested folk remedy for eliminating swelling on the legs. You need 2-4 tbsp. Brew spoons of the plant in 300-400 ml of water and let the resulting tea brew for at least 12-15 hours. After which the drink can be consumed 1 glass 3-5 times during the day, preferably within half an hour after meals. Cost – 60-110 rub.

Centaury grass

A decoction, infusion or tincture of golden-thousand grass has a diuretic effect ranging from mild to moderate degree severity (depending on the form of preparation). Use of the plant is prohibited during pregnancy and lactation, persons under 12 years of age, patients with peptic ulcer and gastritis with increased acidity. Cost – 100-230 rub.

Horsetail as a diuretic

A herb such as horsetail has a strong diuretic and anti-inflammatory effect due to the presence of silicic acid, flavonoids, carotene, essential oils and ascorbic acid. A decoction is used based on 2-3 tbsp. spoons of the plant and 300 g of boiling water, infused for 30-40 minutes over low heat. Use 1 tbsp. spoon of decoction 3-5 times during the day. Price – 50-130 rub.

Special diuretic fees

Sold in pharmacies special herbal mixtures , which contain several plants that have a diuretic effect (strengthen each other or promote the absorption of active substances). Pharmacies offer diuretic fees No. 1-3, which have diuretic effects of varying severity, so you should consult a specialist before purchasing. Cost – 90-230 rub.

Important! Herbal diuretics, although they have a less pronounced effect compared to medications, the effect can cause significant harm to health. Therefore, we strongly recommend that you seek help from a doctor - he will tell you which diuretics are suitable in a particular case.

Which diuretic is better to choose?

To choose the optimal remedy, you need to know what effect a particular diuretic has. Pharmaceuticals, due to the differences in active components, differ significantly in their mechanism of action and effect on the body. In addition, they have a number of side effects. So loop diuretics are contraindicated for long-term use, otherwise there is high risk development of dangerous conditions. Thiazide drugs are only effective when used long-term and also have serious side effects. Based on this, the best diuretics for eliminating edema that are not associated with acute and severe conditions are potassium-sparing diuretics .

The best folk diuretic is a diuretic mixture. Since it consists of several components, which allows you to achieve best result than when using an infusion or other remedy from a single plant. This is due to the combined effects of the collection components. But the effectiveness of natural remedies is low compared to pharmaceutical diuretics. Therefore, we cannot recommend them.

Considering the speed of onset of the effect, its severity and duration of action, Among loop diuretics, it is better to use long-acting agents – Veroshpiron, Amiloride, Spironolactone. Among the listed drugs, Veroshpiron has the most affordable price. Therefore, when considering value for money, it is an optimal pharmaceutical diuretic.