Update: October 2018
Diuretics are diuretics, they facilitate elimination.
fluids from the body, from tissues and increase the amount of excretion
urine. Depending on which part of the kidneys they are stronger
affect and from their chemical structure they are subdivided into several
It should be remembered that taking any medication should
be carried out only on prescription, including diuretics,
only according to strict indications. Diuretics have a number of
contraindications and a lot of side effects and are appointed in
depending on the disease, the causes of edema (see folk diuretic
How to choose diuretic tablets
In various diseases and conditions, certain
- Saluretics – diuretic, remove potassium and magnesium ions, causing
- loop – furosemide, bumetanide, torasemide, lasix, ethacrine
- sulfonamides – chlorthalidone, clopamide (usually chlorthalidone,
Clopamide is used in combination with beta-adenoblockers, with
antihypertensive drugs), indapamide – antihypertensive
- thiazide – cyclomethiazide, hypothiazide
- carbonic anhydrase inhibitors – acetazolamide, diacarb
- loop – furosemide, bumetanide, torasemide, lasix, ethacrine
- Diuretic potassium-sparing — работают в отводящем
tubule, preventing potassium losses – amiloride, spironolactone,
triamteren, veroshpiron, eplerenone
- Osmotic diuretics prevents reabsorption
fluid due to the difference in osmotic pressure in the tubules –
mannitol, urea (intravenous).
What doctors appoint when:
- Hypertension (high blood pressure) –
thiazides and indapamide
- Nephrotic syndrome and heart failure – loop
diuretic. On the background of heart failure, intense swelling of the legs
– parenteral administration of furosemide or lasix.
- Diabetes mellitus, metabolic disorders – indapamide
- Increased secretion of aldosterone by the adrenal glands –
- Osteoporosis – Thiazides
By the action of diuretics can be divided:
|Strong||Furosemide, Trifas, Uregit, Lasix|
|Average||Hypothiazide, Циклометиазид, Оксодолин, Гигротон|
|Weak||Veroshpiron, Triamteren, Diakarb|
For the duration of action
|Long work (up to 4 days)||Eplerenone, Верошпирон, Хлорталидон|
|Mid-term (up to 14 hours)||Диакарб, Клопамид, Триамтерен, Hypothiazide, Индапамид|
|Short acting (up to 8 hours)||Манит, Furosemide,Лазикс, Торасемид, Этакриновая acid|
By the speed of the effect
|Fast (after 30 minutes)||Furosemide, Торасемид, Этакриновая acid, Триамтерен|
|Average (через 2 часа)||Diacarb, Amiloride|
|Slow (2 days)||Верошпирон, Eplerenone|
Loop diuretics increase sodium excretion by the kidneys, and
respectively, and water. Cause strong, fast coming, but
short-term diuresis (not more than 6 hours), therefore, as a rule,
used for emergency care. With chronic heart
failure with severe edema may apply
Эти мочегонные, эффективны при нарушениях функции почек, в
difference from others. But since when taking loop diuretics goes
loss of magnesium and potassium in the body, it adversely affects
the work of the heart.
Contraindications: acute renal failure with anuria,
severe liver failure, hypersensitivity, acute
glomerulonephritis, urinary tract calculus calculus (see
kidney stones), pancreatitis, urethral stenosis,
hyperuricemia, gout, acute myocardial infarction, mitral or
aortic stenosis, hypotension, violation
water and electrolyte metabolism.
Side effects: tachycardia, pressure drop, arrhythmias,
collapse, weakness, confusion, headache, drowsiness,
dizziness, hearing and vision impairment, dry mouth, nausea,
vomiting, thirst, loss of appetite, exacerbation of pancreatitis, acute
задержка urine, снижение потенции, гематурия, интерстициальный
nephritis, pruritus, fever, photo-stabilization, erythema,
dermatitis, anaphylactic shock, leg muscle cramps, muscular
|Furosemide 40 мг. 50 pcs. 20-30 rub.||Lasix 40 mg. 45 pcs. 50 rub.|
|Trigrim 10 mg. 30 pcs 500 rub. 5 mg. 30 шт 270 rub.||Диувер 10 мг 20 шт 450 rub., 5 мг 20 pcs. 320 rub.|
These include Indapamide – a means of reducing arterial
pressure (diuretic, vasodilator), which is close to
pharmacological properties of thiazides. Therapeutic effect
occurs after 1-2 weeks of administration, the maximum is reached in 2-3
month and lasts up to 2 months.
Contraindications: severe liver failure,
hypersensitivity, children under 18 years old, women during lactation,
with lactose intolerance, with caution during pregnancy, with
disorders of water and electrolyte metabolism, hyperuricemia,
Side effects: a fall in blood pressure, palpitations, arrhythmia, changes
on ECG, cough, sinusitis, pharyngitis, dizziness, drowsiness,
headache, nervousness, drowsiness, insomnia, muscle spasm,
indisposition, depression, irritability, anxiety, constipation or
diarrhea, nausea, vomiting, dry mouth, pancreatitis, nocturia,
polyuria, urticaria, itchy skin, etc.
Indapamide: Akuter-Sanovel, Arindal, Arifon, Indap, Indipam,
Indiour, Ionik, Ipres-Long, Lorvas, Retapres, Tenzar, as well as:
|Arifon 2.5 mg. 30 pieces 450 rub.||Indap 2.5 mg. 30 pieces 100 rub.||Acripamide 2.5 mg. 30 pieces 50 rub.|
|Indapamide 2.5 mg. 30 pieces 100 rub.||Ravel 1.5 mg. 30 pcs 200 rub.|
The point of application of the action of thiazide diuretics –
distal tubules of the kidney. It is based on the fact that drugs
inhibit the reabsorption of sodium ions, followed by a gradient
pressure follows water. As a result, sodium is excreted along with
Thiazide diuretics generally exhibit a diuretic effect.
medium strength. Some drugs in this group possess and
ability to dilate vessels.
- By reducing the swelling of the vascular wall drugs group
thiazide diuretics are widely used for prolonged
combination therapy for hypertension.
- The ability to clean external and internal edema makes these
means relevant in the treatment of heart failure.
- Also used for edema associated with cirrhosis of the liver and
Drugs are quickly absorbed and begin to act later.
half an hour after taking. Their duration is about 12
hours, which allows you to take drugs once a day in
as an antihypertensive and up to 2 times with the elimination of edema
cardiac origin. The advantage of this type of diuretic is
that they do not disturb the acid-base balance of the blood.
Features reception of thiazide diuretics:
- Can interfere with the level of potassium and magnesium (with prolonged
- Increase the level of uric acid (undesirable when
- Increase sugar levels (undesirable in sugar
Thiazide preparations: Hygroton, Hypothiazide, Dichlothiazide,
25 mg. 20 pcs. 100 rub.
100 mg. 20 pcs. 120 rub.
25 mg. 20 pcs. 50 rub.
100 mg. 20 pcs. 70 rub.
Like thiazide drugs, potassium-sparing diuretic include
to saluretics and work at the level of the distal tubules. Principle
works similar to thiazides (impaired sodium reabsorption) and
its loss with water (amiloride, triampur).
Spironolactone has the effect of aldosterone
(adrenal hormone, retaining sodium and water). but
the effect of potassium-sparing diuretic is weak and develops slowly
(ко 2- 5 суткам от начала therapy).
- As a consequence, potassium-sparing diuretics are not suitable for
self-diuretic therapy and are usually prescribed in
as an additional diuretic, for example,
secondary hyperaldosteronism, heart failure,
resistant to basic therapy, nephrotic syndrome, cirrhosis
- Also this group becomes the drug of choice when
intolerance to potassium wash-up drugs for heart therapy
diseases, such as myocarditis, with edematous syndrome.
- When combined with a loop or thiazide diuretic
potassium-sparing drugs prevent significant potassium losses
- Primary hyperaldosteronism (adrenal gland tumor) also
requires the appointment of data diuretic (weoshpiron). Drugs
suitable for patients with diabetes and gout.
Potassium-sparing agents: Spironolactone (Veroshpiron), Amiloride,
|Верошпилактон 25 mg. 20 pcs. 70 rub.||Верошпирон 25 mg. 20 pcs. 90 rub.||Эспира, Инспра 25 mg. 30 pieces 2600 rub.|
|Triampur compositum 50 pcs 310 rub.||Apo-Triazid 50 pcs. 200 rub.|
Carbonic anhydrase inhibitors
This group of drugs include Diacarb. Normal enzyme
Carbonic anhydrase promotes the formation of carbonic acid in the kidneys.
from water and carbon dioxide that replenishes alkaline reserve
blood. By blocking the enzyme, diacarb promotes urinary excretion.
sodium, which pulls water. Simultaneously with the urine is lost
and an increased amount of potassium. Diacarb gives a weak effect, which
develops quite quickly (after an hour when taken in pill,
in half an hour with intravenous infusion). Duration
actions about 10 hours (4 hours with parenteral administration).
The drug is used for:
- intracranial hypertension
- increased intraocular pressure
- with salicylate and barbiturate poisoning for alkalization
- with cytostatic treatment
Although medicinal herbs are not synthetic
drugs, and natural herbal teas that have diuretic
action, to their reception also stands related to the medicine. They
also have contraindications and side effects (most often
allergic reactions), on the effectiveness and speed of action is not
can be compared with drugs. But in some cases their
impact is enough to remove excess fluid in
организме (см. herbal diuretics).
- Broths and infusions of herbs are usually used for renal
edema, in addition to the diuretic action, many herbs have
antibacterial and anti-inflammatory effects, which is valuable when
inflammatory diseases of the urinary system.
- Also diuretic herbs can be used when
treatment of pregnant women (not all herbs) and children, and in those cases
when drugs are contraindicated.
- Herbal teas are taken in courses, because the body is fast
gets used, and the effectiveness of therapy is reduced.
- Together with the liquid with long-term use of the grass derive
potassium and sodium (but to a lesser extent than drugs), therefore
требуется контроль показателей blood.