Diuretics for swollen eyes: to use or not?

Common causes of swelling in the eye area

The tissue around the eyes is loose in structure and contains a lot of fatty tissue, which easily retains moisture. Therefore, if the fluid balance is disturbed, swelling in this area appears quite quickly. Swelling may be caused by one of the following reasons:

• abuse of salty foods;
• consumption of alcoholic beverages;
• inflammatory process due to eye disease;
• allergic reaction;
• eye fatigue;
• kidney diseases, diseases of the genitourinary system;
• tumors;
• eyelid deformities;
• eye injuries;
• lymph stagnation.

If the swelling is not caused by disease or inflammation, then drug treatment is usually not required. With a pathological cause of swelling under the eyes, it can persist for a long time, increasing in size. In such situations, diuretics and other medications may be needed. But using them without a doctor’s prescription is strictly contraindicated; first you need to accurately diagnose the cause.

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Metabolic and nutritional disorders: Uncommon: hypercholesterolemia (increased blood cholesterol levels), hypertriglyceridemia (increased blood triglyceride levels), polydipsia (increased thirst). Nervous system disorders: Common: dizziness, headache, drowsiness. Uncommon: muscle cramps of the lower extremities. Frequency not known: confusion, fainting, paresthesia in the extremities (feeling of numbness, crawling and tingling), Cardiovascular disorders: Uncommon: extrasystole (heart rhythm disturbance), tachycardia (increased heart rate), increased palpitations, redness of the face. Frequency not known: excessive hypotension, deep vein thrombosis (formation of blood clots), thromboembolism, hypovolemia (decreased circulating blood volume). Respiratory, thoracic and mediastinal disorders: Uncommon: nosebleeds. Digestive system disorders: Common: diarrhea. Uncommon: abdominal pain, flatulence. Frequency not known: nausea, vomiting, loss of appetite, pancreatitis, dyspeptic disorders. Renal and urinary tract disorders: Common: increased frequency of urination, polyuria (increased urine production), nocturia (increased urination at night). Uncommon: increased urge to urinate. Frequency not known: urinary retention (in patients with urinary tract obstruction), increased concentrations of urea and creatinine in the blood, General disorders and disorders at the injection site: Uncommon: asthenia (exhaustion), thirst, weakness, fatigue, hyperactivity, nervousness. Laboratory and instrumental data: Uncommon: increased platelet count. Frequency not known: hyperglycemia (increased concentration of glucose in the blood), hyperuricemia (increased concentration of uric acid in the blood serum), hypokalemia (decreased potassium in the blood), decreased concentration of cellular components of the blood (red blood cells, leukocytes and platelets), slight increase in alkaline concentration phosphatases in the blood, increased activity of some “liver” enzymes (for example, gamma-GT), hyponatremia, hypochloremia, metabolic alkalosis. Visual disorders: Frequency not known: visual disturbances, Hearing and labyrinthine disorders Not known: tinnitus and hearing loss (usually reversible), Skin and subcutaneous tissue disorders: Frequency not known: skin reactions (itching, rash, photosensitivity).

Will diuretics remove swelling under the eyes?

Diuretic or diuretic drugs increase urine formation and thereby promote the rapid removal of excess moisture from the body. Therefore, sometimes their use for edema may be advisable. But such drugs have a number of side effects. Therefore, in which cases it is permissible to use diuretics, and in which it is better to choose other methods of treatment, a specialist should determine, focusing on the patient’s condition and the cause of the edema. As a rule, diuretics are prescribed for the following indications:

• severe swelling that persists for more than one day and progresses;
• spread of swelling to the face, in particular the cheeks;
• darkening of the skin in the edematous area;
• narrowing of the palpebral fissure (a dangerous symptom that can cause displacement of the eye).

It should be noted that the cause of such symptoms is most often pathological, which means it is not enough to remove excess moisture from the body. It is necessary to begin therapy aimed at combating the underlying disease. Thus, diuretics can only be effective as part of complex treatment.

Diuretics in the treatment of patients with congestive heart failure

Potassium-sparing diuretics are prescribed to prevent hypokalemia. They may be useful in cases where angiotensin-converting enzyme inhibitors (ACEIs) are not used for some reason or, despite the use of ACEIs, the potassium level in the blood remains low. The prophylactic use of potassium preparations for oral administration in patients with CHF during treatment with diuretics is considered ineffective (thus, to maintain the concentration of this ion in the blood at the level of 4.5 - 5.0 mmol/l, it is often required to be supplied from outside in a daily dose of 20 - 60 mmol, which corresponds to 1.5 - 4.5 g of potassium chloride). In severe CHF, adding a small dose of spironolactone (25 - 50 mg/day) to a combination of ACE inhibitors and diuretics with a different mechanism of action can increase the effectiveness of treatment. Since the use of potassium-sparing diuretics can lead to hyperkalemia, it is necessary to monitor the level of creatinine and potassium in the blood (initially every 5 - 7 days until the values ​​of these indicators stabilize, then every 3 - 6 months), and also begin treatment with small doses of the drug. In all cases, diuretics should be combined with ACE inhibitors. If symptoms of fluid retention persist despite the prescription of a combination of loop and thiazide diuretics, as well as an increase in the severity of the clinical manifestations of CHF, it is recommended to first increase the dose of the drugs; if the effectiveness is insufficient, switch to using a loop diuretic twice a day, and if this does not help, add a low dose dose of spironolactone. Doses of diuretics (in mg) for oral administration recommended by experts of the European Society of Cardiology

After stabilization of the patient's condition, a constant maintenance dose of a diuretic is required. A number of placebo-controlled studies have demonstrated worsening of symptoms following cessation of diuretic use for mild CHF. Apparently, it is possible to abandon their regular use for a sufficiently long period of time only in a number of cases in patients with mild symptoms of CHF who are taking ACE inhibitors. However, it remains unclear whether a loop diuretic should be taken daily during maintenance treatment or an intermittent regimen should be used, prescribing the drug only when body weight increases. In any case, it is absolutely necessary to monitor your body weight daily, recording the result in the appropriate diary. Its increase by 1 - 2 kg may be evidence of fluid retention and be the basis for a temporary (for several days) increase in the dose of the diuretic used or the prescription of a combination of loop and thiazide diuretics. After reducing body weight to the original values, they usually return to the previous maintenance treatment. Particular attention should be paid to the intake of salt into the body, which should be limited (down to 2 g/day or less) even before deciding on the need for more aggressive use of diuretics. We must not forget that the administration of non-steroidal anti-inflammatory drugs predisposes to the occurrence of fluid retention and hyperkalemia. Their use in CHF should be avoided. Hopes for more effective prevention of CHF decompensation are associated with the emergence of new loop diuretics with high and stable oral bioavailability (for example, torsemide).

Literature:

1. Guidelines for the Evaluation and Management of Heart Failure. A report of the American College of Cardiology/American Heart Association Task Force on Practical Guidelines (Committee on Evaluation and Management of Heart Failure). JACC 1995;26:1376-98. 2. The treatment of heart failure. The Task Force of the Working Group on Heart Failure of the European Society of Cardiology. Eur Heart J 1995;16:741-51. 3. Cleland JGF, Swedberg K, Poole-Wilson PA. Successes and failures of current treatment of heart failure. Lancet 1998;352(suppl. I):19-28.

Commonly Prescribed Diuretics

The list of diuretics presented is incomplete, but it includes tablets that are often prescribed for swelling of the eyes. It is important to understand that the use of any of these medications is permissible only after consultation with a doctor.

"Furosemide".

A powerful prescription drug. For edema it acts very quickly, but has an impressive list of side effects.

"Veroshpiron".

Its speed of action is slower than that of furosemide, but it is also considered an effective drug for quickly relieving edema.

List of diuretic tablets (use only as prescribed by a doctor)

There are many drugs with a diuretic effect that can be effective for swelling of the visual organs and the periocular area. Let's list just a few of them.

"Furosemide".

This drug has a strong diuretic effect and is good for swelling. It can only be purchased with a prescription.

"Veroshpiron".

The medicine does not act as quickly as furosemide, but is considered less dangerous to the body. The peculiarity of the drug is that it removes fluid from any tissue of the human body.

Where do bags under the eyes come from?

Before you run to the pharmacy for pills and ointments for bags under the eyes, you need to understand why they appeared. The unsightly appearance in the morning or around the clock is caused by either puffiness or the growth of fatty tissue under the lower eyelids. And if the structural features depend on a hereditary factor, then the causes of edema are different, including serious problems that require urgent treatment. These include eye diseases, infectious diseases, endocrine diseases, and oncological diseases.

And most often, problems with the kidneys or heart function and vascular spasms caused by migraines. But even a healthy body may not be able to cope with the removal of excess moisture in one of the following cases:

• disturbance of sleep and rest patterns, stress;
• abuse of fatty and salty foods;
• imbalance and lack of microelements in the diet;
• smoking, drinking alcohol;
• improper care of the area around the eyes;
• low-quality cosmetics;
• prolonged eye strain;
• age-related weakening of the skin;
• negative influences of the external environment.

Prolonged and intense sobs can ruin the appearance of the hostess for a long time. Just like the love of sleeping face down on a pillow. All these factors lead to a decrease in nutrition and oxygen enrichment, and the skin under the eyes is already the most sensitive and vulnerable.

Often, limiting fluid intake 2 hours before bedtime is enough to avoid swelling in the eye area.