6 best diuretics, or diuretics for edema

Features of treatment

A significant proportion of the adult population suffers from edema, which reduces their standard of living. Swelling is often observed in the legs, arms, back and face, and in severe cases is localized in the spinal cord, brain, abdomen and chest. Fluid retention leads to disruption of many functional processes and is fraught with complications of provoking diseases.

Water retention in tissues causes general dehydration of the body and disrupts the balance of electrolytes.

When swelling occurs, the body needs outside help.

In addition to medications, which are selected depending on the type of pathological process, traditional medicine is widely used in the treatment of edema. Several components are used at home:

1. Medicinal plants with a diuretic effect
   . Herbal teas and infusions accelerate the flow of urine and have a rapid anti-inflammatory effect.
2. Selected foods
   (vegetables and fruits with high water content). Eating certain vegetables and fruits helps remove excess fluid from the body and normalizes intestinal function.

Folk remedies restore normal diuresis and regulate salt balance, which is disturbed by dehydration.

How the drug works

The active elements of Veroshpiron are easily introduced into the body and provoke a decrease in the acidity of urine. This allows the product to have a beneficial effect on the condition of the genitourinary system, prevent or eliminate various abnormalities in it.

Diuretic tablets begin to act already on the 2-3rd day of use. It is during this time that excess fluid is gradually removed from the body and swelling on the body disappears. The medicine also has a beneficial effect on the condition of blood vessels; after taking it, the lumen in the arteries increases and the blood begins to circulate faster.

Approximately 97% of the product begins to interact with blood fluid. Due to this, its contents are not retained in the body, but are quickly eliminated during urination.

Medicinal herbs

A number of medicinal herbs are successfully used in the treatment of diseases that are accompanied by pathological fluid retention in intercellular structures. Plant components restore the functional activity of the urinary tract, normalize water-salt balance and facilitate the functioning of affected organs. The table shows diuretic herbs and preparations that are most effective for physiological and pathological edema.

When treating with diuretic herbs, tea, coffee and alcoholic beverages must be excluded from the diet, since these products reduce the effectiveness of herbal infusions and aggravate swelling.

Diuretic decoctions and infusions

Medicinal herbs for edema can be taken as part of preparations or combined independently. The following herbs have a pronounced diuretic effect:

• horsetail;
• orthosiphon (kidney tea)
• bearberry;
• cowberry;
• cutter (sickle cutter).

Burdock roots, nettle and rowan berries have a mild diuretic effect. Herbal diuretics are taken orally, in the form of decoctions and tinctures. Ready-made products can also be used for compresses (wraps) or added to bath water.

Alternative to tablets

Today, kidney tea is used quite often to combat swelling in women during pregnancy. This product allows you to remove excess fluid from the body that can accumulate in tissues.

Kidney teas are available in a wide range of pharmacies. However, not all of them are allowed to be used during pregnancy. Remember that you should drink tea according to the instructions, and also exactly follow the prescription that your doctor previously made. This course of treatment should last no more than four weeks. In this case, one glass of tea is not drunk immediately, but this dose should be divided into three or four approaches.

Tea with duaretic properties is made from:

• Birch leaves.
• Horsetail.
• Bearberry.
• Mint.
• Oats.
• Linden trees.
• Viburnum.
• Birch buds.

Do not forget that any diuretic tea must be prescribed by your doctor. Self-medication of swelling during pregnancy on your own is prohibited.

Decoction for cardiovascular edema

In heart failure, hypertension and other cardiovascular pathologies, swelling appears primarily in the lower extremities. As the provoking disease progresses, the swelling spreads higher and is localized directly in the lumbar region, inside the chest and on the face.

One of the effective traditional medicines used to treat swelling of the legs and chest organs is a decoction based on hawthorn.

Herbal infusions for cardiovascular edema have a strong diuretic effect and help against high blood pressure.

In the treatment of CNS and hypertension, it is recommended to take a course of the drug, which is prepared from the following ingredients:

• 1 tsp bearberry leaves;
• 1 tbsp. l crushed flowers and rhizomes of marshweed;
• 1 tsp peppermint or lemon balm;
• 1/2 tsp dill seeds;
• 1/3 cup hawthorn berries;
• 1/4 cup rose hips.

Place the hawthorn, rose hips and dill seeds in an enamel saucepan, add 0.25 liters of hot water and place over very low heat. After boiling, add dried cucumbers, add another 0.75 liters of warm filtered water and bring to a boil again. After boiling, add the remaining ingredients and remove from heat. The decoction can be drunk both hot and cold, up to 1 liter during the day. The course of treatment is 14-20 days, then a break of up to 1.5 months is needed.

Why are internal edema dangerous?

While carrying a child, expectant mothers may experience not only external swelling, but also internal swelling. They are more dangerous at 37 and 38 weeks of pregnancy than in the first months.

The pathology of internal swelling can be recognized if there is an increase in weight. The optimal weight gain is 500 grams per week.

If weight gain increases by more than 1 kg, doctors prescribe various tests to identify the cause of the swelling.

There are a number of pathologies that can be dangerous due to internal swelling:

• The appearance of gestosis, fetal hypoxia.
• Premature birth.
• C-section.
• Development of fetal pathology.

In severe cases, after a full examination of the pregnant woman and identification of the cause of internal edema, she is placed in hospital treatment, where special therapy is prescribed.

Treatment of renal edema

The main cause of edema in renal pathologies is functional disorders of the kidneys, which impede the formation and outflow of urine. Such conditions are characterized by swelling in the eye area, the face becomes sallow and puffy, swelling spreads to the abdominal cavity, upper and lower extremities. Collections for renal edema have a positive effect on the following aspects:

• normalize urine flow;
• restore water-salt metabolism;
• stop inflammatory processes;
• dissolve urinary stones.

In case of chronic renal failure (CRF), decoctions based on plant raw materials must be taken for a long time to maintain the functional activity of the affected organs. Such compositions can be given to both adults and children without harm, since all components have a targeted effect. Homemade diuretics are also suitable for older adults suffering from chronic kidney disease.

Decoction for chronic kidney disease

An effective herbal recipe that helps with cystitis, pyelonephritis and chronic renal failure contains the following components:

• 1/2 tsp each of orthosiphon, crushed burdock roots, horsetail, lingonberry leaves, parsley and yarrow;
• 6 dry red beans;
• 1 tbsp. l birch leaves.

Pour all components into 1 liter of water and bring to a boil in a water bath. You need to drink the prepared decoction in the morning (250 ml) and at lunchtime. In addition to oral administration, the decoction can be used for direct action on bags under the eyes. An application that relieves swelling is recommended only in the first half of the day.

Diuretic for diabetes mellitus

In patients with diabetes, the kidneys are a vulnerable point - almost half of patients develop diabetic nephropathy. Pathology leads to dehydration and other complications, which are manifested by severe swelling. The best remedy for diabetic edema is bearberry with bay leaves and bean leaves. To prepare the decoction you need:

• 1 tbsp. l dried bearberry;
• 2 large bay leaves;
• 10 dried red beans.

We combine the leaves with the leaves, add 500 ml of water and simmer over low heat for 5 minutes. Add bearberry to the broth with bay leaves and bean leaves, bring to a boil and remove from heat. The drink is consumed in the first half of the day because it is a fast-acting remedy that causes excessive urination and lowers blood sugar levels. It must be taken with caution, as side effects may occur (nausea, vomiting).

Swelling of the upper eyelid - symptoms

Many inflammatory eye diseases begin with a slight itching in the eyelid area. Due to allergies or the spread of infection, inflammation, the skin of the lower or upper eyelid undergoes a change: it turns red, stretches due to the accumulation of fluid, painful rashes appear on it, etc. Symptoms can be very different and depend on the cause of the disease.

The eyelid is swollen - what could it be? If barley ripens, then in addition to itching and redness of the skin, the eyelid will burn and hurt greatly due to swelling. Usually in this case the painful condition is one-sided, but with allergies, the eyelids of both eyes often swell. If a person, in addition to swelling, also has profuse lacrimation, the conjunctiva turns red and small rashes appear on the skin of the eyelids, this may indicate the development of herpetic viral conjunctivitis. This is why you should not start treatment on your own, because the treatment plan largely depends on the cause of the disease. If a patient has allergies, that person's eyes will be swollen, and they may also experience a cough and runny nose. For allergies, antihistamines, adrenaline, and corticosteroids are prescribed, and for viral infections, antiviral medications; for bacterial infections, antibiotics.

Swelling of the eyelid - symptoms:

• itching, redness, photophobia;
• soreness of the eyelids on palpation (one or two);
• possible purulent discharge from the eyes and severe lacrimation;
• red eyes, voluminous swelling that makes it difficult to open the upper eyelid;
• ulcers on the eyelids, stye, etc.

The upper eyelid is swollen - what to do? If you notice unpleasant symptoms, your eyelid or eye itself hurts, be sure to consult a doctor to receive qualified medical care. Eye diseases take a long time to treat, and if adequate treatment is not received, unwanted complications may appear and then the treatment period lasts up to two to three months.

Diuretics during pregnancy

Pregnancy often occurs with the development of swelling, which is more pronounced in the extremities. Fluid retention occurs as a consequence of hormonal and physical changes during pregnancy, and becomes worse in the last trimester. In some cases, preeclampsia may develop, associated with dehydration and generalized swelling.

To minimize risks, women can use natural herbal diuretics, which have a moderate effect on the urinary system and maintain water-salt balance. Harmless and effective diuretics during pregnancy include natural juices and herbal infusions. Juices or smoothies that are safe for the baby and the expectant mother can be made from the following ingredients:

• carrot;
• pumpkin;
• chokeberry;
• irga;
• Birch juice.

Viburnum, stewed in the oven, is especially useful as a decongestant. Also effective are light diuretic decoctions prepared from plantain leaves, berries and lingonberry leaves, oat grains, chicory roots, mint flowers and leaves. When preparing a decoction or juice, you need to take into account that some herbs and fruits can reduce blood pressure.

Causes of swelling of the eyes

Note! The area under the eyes is one of the few areas on the human body where loose fatty structures and fiber are located under the skin.

Such tissues tend to quickly absorb moisture , and in case of any disturbances that unbalance the fluid balance, moisture accumulation occurs in such tissues.

The following pathological and non-pathological reasons can contribute to the development of such a symptom

• eating a lot of salt;
• any inflammatory eye pathologies;
• abuse of alcohol, which in the body itself plays the role of an adsorbent (a substance that absorbs moisture);
• allergic reactions;
• eye-strain;
• pathologies of internal systems and organs;
• lymph flow disorders;
• oncological diseases;
• congenital disorders of the tissue structure of the eyelids;
• injuries in the visual area.

Sometimes such swelling goes away within a few days and may not appear for a long time.

Such manifestations are considered isolated and do not relate to pathological cases, therefore, to eliminate them, you can do nothing or use cosmetic or folk decongestants.

If the pathology does not disappear over time and, moreover, the swelling increases, it is considered chronic.

For your information! To eliminate them, it is recommended to use special medications, including diuretics, which help remove excess fluid from the body with urine.

Natural remedies for weight loss

Natural components are used not only as therapeutic and restorative agents. Herbal infusions and dietary products can be used to achieve the following effects:

• reducing body weight and minimizing the area of ​​edema in obese people;
• stimulation of lymph outflow for cellulite.

Herbs with a diuretic effect stimulate the excretory ability of the kidneys and bladder, and juicy fruits and vegetables stimulate metabolism, regulate daily diuresis and have a mild laxative effect.

Diuretic mixture for weight loss

To relieve swelling localized in the area of ​​subcutaneous adipose tissue, an anti-cellulite diuretic mixture is used. It is prepared based on the following components:

• 1 tbsp. l corn silks;
• 1 tbsp. l dandelion grass;
• 0.5 cups of dried wild strawberries;
• 0.5 tbsp. l sage flowers.

To prepare a decoction for weight loss, combine all the ingredients in an enamel container, pour in 1.5 liters of warm boiled or filtered water and quickly bring to a boil. Immediately remove the boiled mixture, wrap it in a terry towel and leave for 30 minutes. Strain the finished broth and drink throughout the day, 100-250 ml per dose.

Nutrition correction

Obese people are much more susceptible to developing edema because fatty tissue stops the drainage of lymphatic fluid and impedes blood circulation. In most cases, swelling is a consequence of excessive consumption of fatty and sweet foods, which contribute to fluid retention in the body.

The health condition also suffers from insufficient drinking regime and is aggravated by the low physical activity characteristic of obese people.

Excess weight often accompanies cardiovascular pathologies and metabolic disorders.

Swelling in case of excess weight or in the presence of provoking diseases can be reduced by correcting the diet. The diet includes foods that normalize digestion and speed up the functioning of the urinary system, such as:

• watermelon;
• fresh cucumbers;
• pumpkin;
• cherries;
• greens (parsley, dill, celery);
• onions and green onions;
• leafy vegetables (lettuce, spinach, chard);
• cowberry;
• beet;
• oat grains;
• dried apricots.

Vegetables can be eaten fresh, as salads or smoothies, as simple or complex side dishes. Fruits and berries are consumed fresh, as well as in jams and juice. The dietary regime also requires excluding from the diet foods high in salt (sodium) and foods that are difficult for the digestive tract (fried and sweet foods).

Herbal diuretic tablets

Taking medications to relieve swelling is necessary. They remove excess exudate, which is located in the subcutaneous tissue and puts pressure on the nerve endings. As a result, severe pain occurs.

Herbal diuretic tablets

Name and effect of the medicine:

• Flaronin. It has a powerful diuretic effect and improves blood circulation in the kidneys. Used for a month, 3 times a day.
• Lespenefril. Increases filtration in the renal tubules, reduces the ratio of nitrogenous substances in the blood, improves urination. Indicated for use in kidney diseases. Available in tincture form.
• Aflazin or hibiscus extract. Has anti-inflammatory, diuretic effect. Do not use for children under 6 years of age and pregnant women. Allergic reactions are possible.
• Phytolysin. Without chemical components, plant based, available in the form of a paste. For use: dissolve 0.5 teaspoon in a glass of warm water. Apply 3 times a day.

Flaronin

Lespenefril

Aflazin

Phytolysin

28-32 weeks of pregnancy: 5-6 meals a day

Metabolism has already increased by 20%! The baby grows, and, naturally, to create a body he needs more and more energy. Its primary source is glucose, a simple carbohydrate, which very quickly goes into the resynthesis of the energy molecule ATP.

The hormone insulin plays an important role in carbohydrate metabolism. It is released as a response to increased blood glucose and promotes fat deposition if the amount of glucose goes off scale. And this happens quite simply when consuming, first of all , refined, sweet and flour products , and most of all - industrial ones!

Take an interest in the GI table - glycemic indices. The higher this indicator, the greater the likelihood of converting glucose into fat. The list of dangerous foods for your figure includes polished rice, potatoes, pasta, and baked goods.

Complex carbohydrates from unrefined whole foods also contain glucose, but due to fiber, it is absorbed slowly and enters the bloodstream slowly, maintaining a stable, normal level. Sources: fruits, vegetables, greens, bran, whole grains, legumes.

Small meals 5-6 times a day (every 2-3 hours) will also help to constantly maintain normal blood glucose levels and prevent the wild desire to eat. And it’s easier for our digestive system, crushed by the large uterus.

During this period of pregnancy, sensitivity to glucose, which dominated in earlier months, is replaced by resistance to it. Insulin resistance is a decrease in the biological response of tissues to the action of insulin. Most often, it is a weakening of the sugar-lowering effect of the hormone. In practice, this means that more glucose will go to the baby, and less will contribute to the accumulation of fat deposits in the mother.

But this does not mean at all that you can relax and eat everything. Maintaining homeostasis, the balance of all processes, for two bodies at once is an extremely difficult task, and the main thing here is to avoid any sudden imbalances or too large doses of certain substances.

Moderation, caution and awareness are your best guides for objective responses to the body's desires. Learn to be a calm, wise, loving, but strict teacher now in your own body - this will help you develop the right mothering skills.

And, as we mentioned in the previous month, your decisions determine whether your child will be overweight. Probably, hypersecretion of insulin, a factor in hereditary obesity, is caused by the mother's indiscriminate eating during pregnancy. So now you are responsible for shaping his figure.

Thyroid hormones are, in a sense, insulin antagonists - they activate fat oxidation. It makes sense throughout pregnancy to maintain good thyroid function by eating seaweed - the best source of iodine, which it simply needs.

Rating of the best diuretics

Furosemide (Lasix)

Rating: 4.9

Perhaps you need to start with the most famous diuretic, which is sold both in tablets and ampoules. This is furosemide, or Lasix. It is purchased by all hospitals, and ampuled Lasix is ​​also purchased by ambulance stations to relieve a hypertensive crisis. Furosemide acts in the area of ​​the ascending loop of Henle, as well as in the area of ​​the proximal tubule. Furosemide begins to act actively within half an hour, after intravenous administration, the onset of action is after 5-10 minutes, and after taking one or two tablets, the effect begins to appear within an hour. Furosemide works for about two to two and a half hours. Of course, it is safer to use not furosemide injections, which are available in the form of ampoules containing 2 ml of a 1% solution, but 40 mg tablets.

As for the official indications, these are various forms of edematous syndrome in chronic heart and kidney failure, nephrotic syndrome, complex therapy of hypertensive crisis, in toxicology to maintain forced diuresis. If there are indications for use, a single dose is half a tablet, this is the minimum. It can be increased to 2 tablets orally, but the maximum dose, which is extremely rarely used, is 600 mg per day. This is 15 tablets of furosemide per day, and, perhaps, if the patient does not respond to such powerful stimulation of the kidneys, then this indicates severe forms of renal failure.

One package, No. 45, produced by the Indian division of Sanofi is very, very inexpensive, on average 35 rubles.

Advantages and disadvantages

The advantage of furosemide (Lasix) is its fairly fast, powerful and short action. At the same time, it promotes the removal from the body of not only sodium and chlorine, potassium, and, to a lesser extent, calcium and magnesium. Most often, it is an overdose of furosemide and other diuretics that leads to the development of hypokalemia, and less often, hyponatremia. In the mildest cases, this phenomenon of hypokalemia will manifest itself as unpleasant, pulling cramps in the calves. In more severe cases, heart rhythm disturbances may occur, for example, with the development of paroxysm of atrial fibrillation, especially in old age. Therefore, furosemide and other diuretics from this group can always be used only with the support of potassium and magnesium preparations, for example Panangin.

It is also prohibited to use Furosemide in case of low blood pressure, dehydration, in case of obstructive, mechanical obstacles to the outflow of urine, so as not to overstretch or even rupture the bladder. The drug is contraindicated during pregnancy and breastfeeding, in patients with allergies to sulfonamides. Lasix should be used with great caution in case of edema in the presence of gout and increased concentration of uric acid, pancreatitis, systemic lupus erythematosus.

You should also keep in mind the numerous symptoms of side effects, including tachycardia, drop in blood pressure, dry mouth and thirst. With long-term use, especially in high dosages, a decrease in the number of leukocytes and platelets in the blood plasma, metabolic alkalosis, and numerous allergic reactions are possible. One should be very careful when using one-time use of diuretics so as not to cause an overdose with hemoconcentration, cardiac arrhythmias, and the development of thrombophlebitis. There are also a large number of different interactions between furosemide and other drugs that must be taken into account.

Torasemide (Britomar, Diuver, Lotonel, Trigrim)

Rating: 4.8

The difference between torasemide and furosemide is, first of all, that it acts much longer and at the same time causes less loss of potassium ions. Therefore, torasemide and its analogues have a more favorable safety spectrum, especially in patients with renal and heart failure.

It is a loop diuretic and is generally more active than furosemide. About an hour after taking the medicine orally, the tablets develop a diuretic effect. It reaches its maximum peak on average after 4-5 hours, and the duration of the diuretic effect is from 8 to 10 hours. This highly active loop diuretic is indicated for a variety of edematous conditions, for chronic renal and heart failure, for hepatic, that is, protein-free edema, and for various forms of arterial hypertension.

Torsemide is produced in the form of the drug Britomar, produced in Spain, at a price of 420 rubles for 30 tablets of 10 mg. A good generic of European quality is produced by the Pliva company from Croatia; 20 tablets of 10 mg each will cost from 360 rubles, and in a dosage of 5 mg - from 230 rubles. Perhaps the cheapest domestic analogue is torasemide from Canonpharma Production, which can be purchased even at a price of 130 rubles. But in this case, you should always prioritize quality rather than price. It is advisable to use torasemide for edema in a dose no greater than 1 or 2 tablets of 10 mg once a day. If we are talking about renal edema, then the initial dose is two 10 mg tablets once a day, and for hepatic edema, the dose is usually half as much. However, the maximum single dose should not be more than 40 mg. The medicine can be prescribed for long-term treatment, and in the case of arterial hypertension, a dosage of 5 mg once a day is sufficient.

Advantages and disadvantages

As mentioned above, the main advantage of torasemide is the lower excretion of potassium in the urine, greater activity than furosemide, and the duration of the effect. It is also important that elderly patients do not need to change the dosage. However, the medicine has standard contraindications, for example, allergy to sulfonamides, low potassium concentration, severe dehydration, acute glomerulonephritis, and age under 18 years. Torsemide is strictly contraindicated in case of an overdose of cardiac glycosides, that is, in case of digitalis intoxication.

With caution - if there is a tendency to low blood pressure, there is diarrhea and pancreatitis, diabetes and gout. Torsemide should not be used together with corticosteroid hormones, cardiac glycosides, or certain groups of antibiotics (aminoglycosides). Torsemide should not be used if the patient has high-grade atrioventricular block or sinoatrial block. It is prohibited for pregnant and lactating women and persons with diagnosed hypokalemia. The patient may also develop side effects, for example, increased cholesterol levels, dizziness and muscle cramps, extrasystole and rapid heartbeat, facial flushing and ringing in the ears. Of course, with an overdose of diuretics, dry mouth and thirst are possible.

The interactions of this diuretic with other medications should also be considered. It enhances the effect of drugs for high blood pressure, increases the nephrotoxic and ototoxic effects of antibiotics, and when taking acetylsalicylic acid, especially in large doses, its toxic effect may appear. If the patient has a diagnosis of diabetes mellitus, then it should be taken into account that prescribing this diuretic weakens the effect of drugs to lower blood sugar concentrations, this is important for long-term use. If the patient receives lithium drugs prescribed by a psychiatrist, then prescribing a diuretic increases their toxic effect.

Hydrochlorothiazide (hypothiazide, esidrex)

Rating: 4.7

The strongest and most powerful diuretic drugs were listed above. All the others are much weaker, they do not cause such a powerful and quick effect, they should not be used for emergency purposes, and that is why they are still safer. Many of them are contained in complex medications for the treatment of hypertension, and a typical representative of such a mild diuretic and inexpensive drug is hypothiazide. This is a thiazide diuretic, a rather moderate action, which removes sodium, potassium, water and chlorine from the body, and does not affect the acid-base balance.

This is a typical "medium" in its effect, and it is weaker because it does not affect one of the sections of the loop of Henle, which passes through the medulla of the kidney. But, although Hypothiazide needs to be “harnessed for a long time,” it “rides” for a long time. The diuretic effect develops after about 2 hours, the maximum peak of urine output occurs after 4 hours, and then begins a moderate period of milder action, which lasts about 12 hours.

If the patient has a pronounced decrease in glomerular filtration, then the diuretic effect of this drug is reduced and stops completely if we are talking about numbers less than 30 ml per minute. If the patient has diabetes insipidus, then this substance has a positive antidiuretic effect. Hypothiazide is able to reduce the volume of circulating blood, reduces the influence of adrenaline and norepinephrine, and is usually indicated for the mild treatment of arterial hypertension, the slow and gradual reduction of various edema, for example, caused by nephrotic syndrome, portal hypertension and chronic renal failure with filtration figures exceeding 30 ml per day. minute. When there is a high concentration of calcium salts in the urine, it is prescribed to prevent the formation of urinary stones. This drug is not available in injection ampoules, only in tablets. You need to take it one tablet in the morning, or twice, but both times in the first half of the day, so that the diuretic effect ends by the time you go to bed. Hypothiazide is available in tablets of 25 and 100 mg, and the cost of it, even for a high dosage, does not exceed 100 rubles. Hypothiazide is produced by the Hungarian pharmaceutical company Quinoin.

Advantages and disadvantages

The big advantage of Hypothiazide will be the high duration of the diuretic effect with at the same time low intensity and, accordingly, a low risk of developing hypokalemia, the ability to use it against the background of acute glomerulonephritis and when prescribing corticosteroid hormones to patients. Hypothiazide is contraindicated in Addison's disease, in children under three years of age, with severe liver and kidney failure, refractory (resistant) to treatment hypokalemia, hyponatremia and a marked decrease in calcium in the blood plasma. It is very important, but you can use this drug during pregnancy, but only in the second and third trimesters.

The drug penetrates the placenta, and therefore it is necessary to assess in advance the possible risks for the baby and for the mother, as it can cause jaundice in newborns, which will last for quite a long time. It is forbidden to use Hypothiazide during breastfeeding, as it passes into milk.

An important and valuable effect can be considered that after a single dose, the medicine will still act, although not so strongly, for 3-4 days, and if it is taken for a whole month, then only then will the optimal diuretic effect develop. If treatment with Hypothiazide is stopped, the increased diuresis will persist for another whole week.

However, like many diuretics, it has dose-dependent side effects. This is an increase in blood sugar, the appearance of symptoms of interstitial nephritis, with long-term treatment - a decrease in the number of leukocytes and platelets in the blood plasma, various allergic reactions. Its overdose symptoms are standard, like those of other diuretics. There are also various interactions with many medications, for example, it enhances the effect of antihypertensive drugs.

Indapamide (Arifon)

Rating: 4.6

Indapamide, or Arifon, is rarely taken “in its pure form” because it does not have a powerful and fast effect. Its main application is the complex treatment of arterial hypertension and chronic heart failure in the presence of edema. Arifon is prescribed in small doses: once a day in a dose of 2.5 mg, and much less frequently, in case of severe rise in blood pressure and severe edema, the dose is doubled. It is not used as a means for urgent weight loss, or sobering up and eliminating hangover syndrome. It's not his job.

According to its mechanism of action, it is close to the thiazide diuretics described above; it removes sodium and chlorine in the urine, but at the same time it is sensitive to the excretion of potassium and magnesium. A good difference between indapamide is that it is not a diuretic “in its pure form”, since it has the properties of a calcium channel blocker that is located in the walls of blood vessels. Arifon increases their elasticity, and therefore it reduces total peripheral vascular resistance, through which the second hypotensive effect is realized. Additionally, Indapamide reduces myocardial hypertrophy of the left ventricle, and if it is prescribed in high doses, then, despite the increase in diuresis, it does not “increase” blood pressure.

It is necessary to use Indapamide as a planned therapy, since there is an improvement in well-being and a decrease in clinical symptoms about 10 days after the start of its planned use. The usual dosage of Arifon is 1 tablet 1 time per day, 2.5 mg. Preliminary results of treatment should be assessed after 1-2 months. The maximum development of the effect, associated with a gentle effect on the heart and effect on the vascular channels, develops somewhere 2-3 months after the start of administration, and continues for several months. After a single dose of the drug, its diuretic effect continues throughout the day. Arifon is produced by the well-known French company Servier, and one package of 30 tablets of 2.5 mg will cost 330 rubles in early spring 2020.

Advantages and disadvantages

The narrower the specialization of a drug, the higher its effectiveness, and the fewer questions there are in which areas to use it. There are no such questions about Indapamide or Arifon: its scope of application is the treatment of hypertension. However, we must remember that there are a number of contraindications, which are quite common among hypertensive patients. These are ischemic stroke, or acute cerebrovascular accident, severe renal failure, a sharp decrease in the concentration of potassium in the blood plasma, taking cardiac glycosides, pregnancy and childhood.

It is undesirable to use indapamide in cases of severe edematous syndrome, ascites, in the presence of massive therapy with antiarrhythmic drugs, in decompensated diabetes mellitus and various disorders of water-electrolyte metabolism. It should not be used during pregnancy, since the combination of the properties of a calcium blocker with a diuretic can cause fetoplacental ischemia syndrome and fetal underdevelopment or malnutrition. Since Indapamide is secreted in breast milk, when prescribing this drug it is necessary to transfer the child to artificial feeding.

There are also various side effects that should be assessed by the attending physician. These are dry mouth, increased uric acid in the blood plasma, dizziness and drowsiness, decreased blood pressure when standing (orthostatic hypotension), palpitations and various allergic reactions. In case of overdose, these symptoms can be even more pronounced, nausea and vomiting, and a sharp decrease in blood pressure may occur. Since Arifon can interact with other medications, it is necessary for the attending physician to study this section of the official instructions, especially in the case of combining Arifon with ACE inhibitors, calcium supplements, and indirect anticoagulants.

Spironolactone (Aldactone, Veroshpiron)

Rating: 4.5

This drug for increasing diuresis belongs to completely different molecules in chemical structure; it is a steroid drug that acts for a long time, but at the same time almost does not remove potassium from the blood plasma into the urine. This potassium-sparing effect comes at the cost of low activity and prolonged acceleration of the diuretic effect. If you take a Veroshpiron tablet, then if you forget that you took it, then most likely, even in the evening you will not feel any special diuretic effect. It will appear somewhere on the 4th day of treatment, and after stopping the drug it will subside on the second or third day.

This medicine is used to treat arterial hypertension, and not as an independent remedy for monotherapy, but in combination. It is prescribed in dosages from 25 to 100 mg per day, divided into 3-4 doses. It is inexpensive, and one package of the drug of 25 mg, in the amount of 20 pieces, produced by the Hungarian company Gedeon Richter in March 2020 will cost an average of 65 to 95 rubles.

How does Veroshpiron work? Its action is different from thiazides and loop diuretics. It is a competitive antagonist of the mineralocorticoid hormone aldosterone, which regulates water-salt metabolism. Spironolactone prevents aldosterone from retaining water and sodium, and potassium is saved by suppressing the corresponding effect of aldosterone, reducing the synthesis of special enzymes in the part of the collecting ducts that depends on aldosterone. The diuretic effect, as mentioned above, will appear on average on the 4-5th day of treatment, and just as slowly, after a few days, a decrease in blood pressure will begin to be realized.

In addition to essential hypertension, you can still use this drug in the complex treatment of edema, with high aldosterone activity, for example, with secondary hyperaldosteronism. This condition quite often accompanies cirrhosis of the liver, resulting in edema and ascites. The big advantage of this drug is the ability to use it as a diuretic and hypotensive against the background of low blood potassium concentrations, in primary hyperaldosteronism, or Conn's syndrome before surgery.

Advantages and disadvantages

When prescribing Veroshpiron, it is always necessary to take into account the patient’s mineralocorticoid metabolism. It is contraindicated in Addison's disease and high concentrations of potassium in the blood plasma, with low sodium and severe forms of renal failure, in pregnant women, children, children and for some other reasons. It is possible, only with caution, to use Veroshpiron with a high concentration of calcium in the plasma and the presence of atrioventricular block. Arrhythmologists know that a high concentration of potassium increases the risk of developing this type of heart rhythm disorder, and Veroshpiron, unlike other diuretics, prevents the excretion of potassium from the body. A relative contraindication is diabetes mellitus, and especially diabetic nephropathy.

How to take veroshpiron? In the case of simple hypertension, this is usually a dose of 50-100 mg per day, which can be doubled, but always gradually, over the course of a week. You should also expect a response to increasing the dose somewhere around the second week. In the case of treatment of primary hyperaldosteronism, for its diagnosis (Veroshpiron is used as a provocative test), it is prescribed for 4 days at 400 mg per day, but always under the supervision of an endocrinologist. If we are talking about nephrotic syndrome in the presence of various edemas, then the daily dose for adults should not exceed 200 mg.

Side effects and overdose of Veroshpiron are the same as those of other diuretics described above. However, given the fact that Veroshpiron is a hormone-like drug, it can cause gynecomastia in men, which is reversible, erectile dysfunction and decreased potency, and in women - hirsutism and menstrual irregularities.

You also need to be aware of the presence of standard side effects, such as calf muscle cramps and dry mouth. As a hormone-like substance, Veroshpiron may interact with other medications. It reduces the sensitivity of blood vessels to norepinephrine, enhances the effect of other diuretics, and together with calcium supplements increases the risk of developing hyperkalemia. The latter is very important if, for example, while taking furosemide, the patient received Panangin, and then he was transferred to Veroshpiron, but they forgot to stop Panangin. Then the risk of high potassium in the plasma increases significantly.

Hydrochlorothiazide + triamterene (Triampur Compositum)

Rating: 4.4

Finally, the last of the popular drugs considered among the known modern diuretics will be Triampur Compositum. Why "compositum"? This prefix, or more precisely, a double name, is usually found in homeopathic medicines. In fact, Triampur Compositum has nothing to do with homeopathy, it is simply a composite diuretic of two drugs. This is hydrochlorothiazide, which is combined with triamterene, another potassium-sparing diuretic. Triampur Compositum is produced by the Croatian company Pliva, and one package of 50 tablets containing both components in different dosages will cost from 300 to 570 rubles.

Why is this drug needed? This is another diuretic that conserves potassium, is quite gentle and has an average duration of action. It is the drug of choice for arterial hypertension, and various, but usually mild, edema, for their planned treatment. This drug does not make sense to use during a hypertensive crisis, since it does not have a quick and active effect. In the case of arterial hypertension, it is prescribed twice a day, two tablets, morning and afternoon. If there is swelling, you can prescribe it in the same dose, or one tablet twice a day. If necessary, you can give up to 4 tablets daily, but no more.

Advantages and disadvantages

The set of both advantages and disadvantages is standard for this diuretic. Among the advantages, one can list its mildness and the inability to cause a rapid development of side effects in the patient, but it cannot be used in cases of advanced renal failure, in the case of pregnancy and breastfeeding, in case of a decrease in circulating blood volume, disorders of electrolyte metabolism, in the case of anuria and acute glomerulonephritis.

Use, but with caution, is possible in moderate stages of chronic renal failure, gout, diabetes. Caution is also needed in case of alcoholic cirrhosis of the liver and folic acid deficiency. The medicine, despite its mild effect, may also have side effects, which can be considered standard for all diuretics. An overdose of Triampur weakens the effect of glucose-lowering drugs, and when prescribed simultaneously with beta blockers, it can cause erectile disorders.

In general, in conclusion of a brief review of diuretics, it should be said about side effects that electrolyte disturbances most often occur. If you use non-potassium-sparing diuretics (and they are usually prescribed to themselves by beautiful women with edema and by men with a hangover), then it is hypokalemia that develops as a complication in 40% of cases, especially with high doses of drugs. Quite often the level of uric acid increases, and especially if there was initially a phenomenon of hyperuricemia.

It is possible to develop insulin resistance, a decrease in blood pressure, the appearance of heart rhythm disturbances, as well as transient hyperglycemia, which itself can resolve with long-term treatment with diuretics. In conclusion, let us remind you that it is advisable to be treated with even short courses of diuretics, even in the case of a one-time dose, only after a doctor’s prescription, since there can be quite serious complications associated with an independent overdose.