Diuretics (Diuretics)

Drugs that accelerate the removal of urine from the body are called diuretics . These drugs reduce the ability of the kidneys to reabsorb electrolytes by the kidneys, against the background of an increasing concentration of which fluid is released.

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


  • 1 Area of ​​application of diuretics
  • 2 Classification of diuretics
  • 3 Principle of action of diuretics
  • 4 Diuretics and weight loss
  • 5 Indications for the use of diuretics
  • 6 Contraindications to taking diuretics
  • 7 Side Effects and Health Risks
  • 8 Popular diuretics: how they affect the body
  • 9 Diuretics of natural origin
  • 10 Reception of diuretics during pregnancy and lactation

Scope of diuretics

Reception of diuretics contributes to:

  • elimination of puffiness with heart and vascular insufficiency;
  • lowering blood pressure with hypertension;
  • relieving symptoms of kidney disease;
  • the removal of toxins during intoxication.

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

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

The elimination of toxins through the use of diuretics in clinical medicine is called "forced diuresis." This method consists in the fact that after intravenous administration of solutions to a patient in a similar manner, a certain dose of a diuretic highly effective drug is administered. This leads to the fact that, simultaneously with the liquid, toxic substances are washed out of the body.

Classification of diuretics

There are several varieties of diuretics, which differ in the mechanism of action used in the treatment of various pathologies.

Diuretics are of three types:

  1. Affecting the work of the epithelial tissue of the renal tubules . The following drugs belong to the group of these drugs: Triamteren, Hydrochlorothiazide, Bumetanid, Cyclomethiazide, Chlortalidone, Bendroflumethiazide, Ethacrylic acid, Clopamide, Methclothiazide, Amiloride, Metolazone, Furosemide, Indapamide, Torasemide.
  2. Calcium-preserving antagonists of aldosterone (mineralocorticoid) receptors . Diuretics of this type include Spironolactone, which is known under such a trade name as Veroshpiron.
  3. Osmotic, for example, Mannitol (Monitol).

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

  • highly effective (leaching 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 and dilate blood vessels. Maintaining vascular tone and lowering the concentration of fluid allows you to stop arterial hypertension.

Reception of diuretics relaxes myocardial cells, reduces platelet adhesion, improves microcirculation 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 intended 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 arteries, bile ducts, and bronchi.

Diuretics and weight loss

The desire to get rid of hated kilos pushes people to rather dubious experiments. This fate befell diuretic drugs. Many people mistakenly believe that these drugs help to 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 like Indapamide lowers bad cholesterol in the blood. This in no way means that taking diuretics will allow you to get rid of fat. It remains in place, only the liquid leaves. The positive effect of the drug is that it reduces the risks of developing stroke, atherosclerosis, heart failure.

Diuretic drugs affect various systems, but more so on the urinary tract. If medicines are taken exclusively for their intended purpose, they normalize the balance of water and electrolytes. The uncontrolled use of diuretics, on the contrary, leads to numerous health problems, even a fatal outcome is possible.

Withdrawal of fluid from the body is impossible without loss of ions. The latter regulate the work 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 ionic imbalance. Against this background, cardiac arrhythmia, hypotension develops, vision decreases, a general state of weakness is felt, dizziness attacks occur. With a strong overdose, hallucinations and collapse are possible.

Those wishing to use a diuretic for weight loss need to remember that these drugs are included in the category of prohibited for athletes. The reason for this was the death of an athlete who abused the intake of diuretics in order to obtain relief muscles. Only people far from medicine can recommend these drugs for weight loss.

Indications for the use of diuretics

Diuretics are prescribed for people suffering from arterial hypertension, which is especially acute in old age, with an excess of sodium due to the delay and accumulation of this substance in the body. The latter condition is observed in chronic heart and kidney failure, ascites. Those with osteoporosis are recommended to take thiazides, people with congenital Liddle syndrome - potassium-sparing diuretics, from heart edema, glaucoma, intraocular pressure, cirrhosis - drugs that affect the work of the kidneys.

Diuretic thiazide-like drugs are indicated during therapy and as a prophylaxis of arterial hypotension. With moderately elevated pressure, small doses are taken. Preventive use of these drugs reduces the risks of stroke. Without the need to take large doses of these drugs is not recommended. This can cause hypokalemia. To prevent a drop in the level of potassium in the blood, thiazide diuretics are combined with potassium-sparing.

Diuretic therapy is active and supportive. With active treatment with diuretics, patients are prescribed moderate dosages of potent drugs, for example, Furosemide, and with maintenance, regular administration of drugs with a diuretic effect.

Contraindications to taking diuretics

Contraindications to the appointment of diuretics are:

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

These drugs should not be taken in patients with individual intolerance to sulfanamide derivatives. Preparations of the thiazide group, for example, Methiklothiazide, Bendroflumethiazide, Cyclomethiazide, Hydrochlorothiazide, can cause a sharp increase in blood sugar.

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

Side Effects and Health Risks

Thiazide drugs can increase uric acid in the blood. This side effect of the use of drugs of this group must be considered by patients with gout. The use of thiazides with this pathology can lead to an exacerbation of the disease, worsen the patient's condition.

Medium-efficiency diuretics, such as hydrochlorothiazide or hypothiazide, require a strict dosage. If the dose is not calculated correctly, the patient may feel nausea, weakness, increased drowsiness, headache, dry mouth. Overdose can be accompanied by diarrhea. Similar symptoms are observed with individual intolerance to the drug. Against the background of an imbalance of ions, muscle weakness, skeletal muscle spasms, arrhythmias, allergies develop, and there may be an increase in sugar and a decrease in male libido.

Furosemide may have the following side effects: reduce magnesium, calcium, potassium, cause nausea, frequent urination, dizziness, and dry the oral mucosa. Disturbances in ion exchange provoke an increase in glucose, uric acid, calcium. The high content of these substances adversely affects hearing, is manifested by paresthesia, rashes on the skin.

Uregit is a drug with an increased irritating effect. His use may adversely affect hearing.

Aldosterone antagonists can cause seizures, diarrhea, vomiting, rashes on the skin, gynecomastia. Incorrect prescription of these medications causes menstrual irregularities in women, and for men it threatens with impotence.

Osmotic drugs with the wrong approach to the treatment of heart failure can increase the load on the heart muscle by increasing plasma volumes. This side effect leads to pulmonary edema.

Popular diuretics: how they affect the body

Drugs whose pharmacological action is directed to the renal tubules remove sodium along with urine.

Diuretics from the thiazide-like group, for example, methiclotiazide, 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 the English word "salt", meaning "salt".

Diuretics with moderate effectiveness, contributing to the withdrawal of sodium, are prescribed, as a rule, for swelling and kidney disease, in patients with heart failure. Hypothiazide is most often used as a hypotensive agent. This is due to the fact that this medication leaches excess sodium, 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 the composition of Hypothiazide lower the level of calcium ions and prevent the accumulation of salts in the kidneys. It is often prescribed in the treatment of diabetes insipidus, urolithiasis.

Indapamide (known under the trade name 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 that begins to act within ten minutes after intravenous administration. It is prescribed for patients with arterial hypotension, peripheral edema, acute left ventricular failure with pulmonary edema, in order to remove toxins from the body. A diuretic such as Ureghit 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 the reduction of potassium and magnesium ions, preventing the absorption of sodium ions. Indications for the appointment of diuretics from this group are: hypertension, edema, stagnant processes against the background of acute or chronic disorders of the heart muscle.

Osmotic diuretics have low penetration through membranes. The most common and effective drug for this group of diuretics is Monitol, administered intravenously. It reduces intracranial and intraocular, but increases the osmotic pressure of plasma. It is prescribed for patients with oliguria, against the background of which severe blood loss, trauma, burns occur, with 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 appearance of synthetic diuretics. The lower effectiveness of folk methods is offset by harmlessness and softness. Properly selected dosage allows you to use decoctions for a sufficiently long time without any side effects and harm. Natural diuretics, as well as synthetic drugs, should be taken only after finding out the true reason why the fluid is retained in the body.

If fluid retention is caused by swelling and malfunctioning of the heart, drink a decoction made from birch leaves or strawberries. Birch leaves are used as compresses for swelling of the upper and lower extremities. Inflammation of the bladder and kidneys is treated with tansy, lingonberries, shepherd's purse. Flaxseeds, bearberry, rose hip, orthosiphon are most often used in the treatment of puffiness. Rosehip tea is taken during prolonged antibacterial treatment and recovery after surgery.

Orthosiphon is a traditional kidney tea that has both a diuretic and an antispasmodic, anti-inflammatory effect. Natural diuretics are not only herbs, but also other vegetable crops. The elimination of fluid contributes to the use of pumpkins, melons, celery, parsley. Instead of fresh herbs, to prepare a salad that reduces puffiness, you can use cucumber and dandelion leaves.

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 fact that the expanding uterus squeezes the vena cava. You can not ignore puffiness. It can signal the development of pathological conditions such as renal failure and gestosis. When dietary compliance does not bring visible results, synthetic or natural diuretics are prescribed for a pregnant woman.

Most diuretics are contraindicated at any time during pregnancy. Diuretic drugs should only be taken as prescribed by a doctor and with extreme caution. In the early stages, almost all drugs are prohibited, and in the later, only some are prescribed by a specialist. An improperly selected diuretic or dosage can change the composition of the blood, become an impetus for the appearance of problems with the kidneys, hearing, eyesight and even lead to a disease such as jaundice.

Even folk remedies can harm a pregnant woman and the fetus. Regular use of herbal supplements upsets the electrolyte balance and negatively affects further pregnancy. You can not take juniper, wild strawberry, parsley root. The safest remedy is orthosiphon. It can be used both during pregnancy and during lactation.

If it is impossible to do without taking diuretic drugs, the attending physician prescribes Kanefron tablets. This medicine can be drunk almost at any stage of pregnancy. Drops of this drug are not prescribed, since they contain alcohol. If swelling occurs without acute inflammatory processes in the kidneys, a herbal preparation such as Phytolysin 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, epilepsy attacks, with a sick heart. Assigning it during lactation, a specialist assesses the risk and the real need for taking this drug.