6 best diuretics, or diuretics for edema

*Overview of the best according to the editors of Healthy Food Near Me. About selection criteria. This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.

Everyone intuitively understands what edema is. This is a condition when excess fluid, that is, water, accumulates not in the vascular bed, but in tissues, intercellular fluid, or in various cavities of the body. The main cause of edema is a change in capillary water pressure, or hydrostatic pressure. After all, the capillary bed is extremely huge in its area, and far exceeds the area of ​​large main vessels.

The second reason can be considered a drop in blood plasma pressure associated with the concentration of proteins, or oncotic pressure, along with an increase in oncotic pressure in the interstitial fluid. The reason for the increase in the accumulation of fluid in the tissues may be a violation of the lymph flow. In old age, edema is most often a complication, and it can be considered a marker of severe pathology of the cardiovascular system, especially if the edema is located on the legs.

If edema exists on the face, then this most often indicates a chronic pathology of the kidneys. Doctors know that the appearance of any edema, especially not local, but generalized, is an important symptom of the pathology of the cardiovascular and excretory systems. Edema becomes noticeable and pronounced when the body weight of a person increases by 15% due to the volume of accumulated fluid, and for a person of average weight of 70 kg, this is two extra liters of fluid.

If you list the diseases, then, in addition to chronic cardiovascular insufficiency, the causes can be chronic and acute glomerulonephritis, nephrotic syndrome and chronic liver diseases such as cirrhosis. Edema often leads to hypothyroidism or myxedema, as well as the use of certain drugs. Of these, one can name combined oral contraceptives, COCs. We will not understand in detail the classification of general and local edema, we will only say what are the characteristic symptoms of certain edema with their different origins.

We distinguish the cause of edema

Of course, this material is not addressed to doctors, but a specialist should understand the causes of edema. But the modern system of Russian health care is designed in such a way that it is extremely difficult to get to a narrow specialist right away for free, you must first visit a therapist as a “breeder”. Therefore, many turn to a paid doctor, and the main thing is to choose exactly who to contact with edema: a cardiologist, a vascular surgeon who deals with varicose veins, or, for example, a nephrologist.

In order to understand this right away and not spend extra money, we can tell you general, but important information about edema:

1. a cardiologist should be visited if edema occurs on the legs, they are symmetrical and painless, intensify in the evening, and leave a pit of doughy consistency after pressure. Additional symptoms include shortness of breath, the patient often has long-term chronic heart damage, such as valvular disease, myocardial infarction or arrhythmia;

2. in the event that swelling also occurs on the legs, but together with a feeling of heaviness in the calves, aching pains, night cramps, and appear after a long standing or long walk, while decreasing overnight, then this is due to varicose veins of the lower extremities . This is especially true if, after a long period of such edema, spider veins, skin peeling, or the phenomenon of varicose dermatitis occur. Need a phlebologist, or a vascular surgeon;

3. if in this case the edema of the lower leg arose asymmetrically, on the one hand, the leg is hotter than the other, then, most likely, we are talking about thrombosis of the venous vessels, and here you need to contact a vascular surgeon;

4. if the patient has a long-term chronic pathology of the kidneys, edema appears on the face, on the eyelids, does not change its location depending on the change in the state of the body in space, is not accompanied by shortness of breath, and in the analyzes of matches a high protein is determined, more than 3 g per day, then speech about nephrotic syndrome. If the patient has high blood pressure and a small amount of urine, then it is urgent to visit a nephrologist, specialists in kidney diseases;

5. if a person had jaundice, active hepatitis, cirrhosis was diagnosed, the amount of protein in the blood plasma was reduced, the level of bilirubin and transaminases was high, and his stomach swelled like a drum, the navel protruded, then everything is clear. We are talking about the development of ascites, or the accumulation of fluid in the abdominal cavity and portal hypertension, and here it is necessary to visit either a hepatologist for liver diseases, or an infectious disease specialist in case of chronic viral hepatitis, or a surgeon.

Finally, if lymphatic edema associated with lymphostasis occurs, then at first the edema may be asymmetrical, on the one hand. But even if they become bilateral, they can also be different. At first, these are soft swellings, like dough, they can intensify in hot weather, the skin above them easily shifts. If they exist for a long time, then the skin above them thickens and thickens, the fossa no longer remains, and in the later stages, complete tissue fibrosis develops. The skin becomes bumpy, and is separated by deep folds. This happens when the lymph nodes and lymphatic vessels are compressed, and in our country this is most often found in advanced forms of oncological pathology. An urgent consultation is needed, first of all, an oncologist.

Treatment of edema should always be comprehensive, and treatment should begin with attempts to eliminate the cause. So, if the cause is chronic heart failure, then it is necessary to strengthen the work of the heart, for example, by using cardiac glycosides. In the presence of glomerulonephritis, hormones and cytostatics should be used, in the presence of hypothyroidism and myxedema, thyroid hormones should be prescribed, and so on.

However, in addition to etiotropic treatment aimed at the immediate cause of edema, it is necessary to limit fluid intake, and with generalized edema, salt intake should also be limited, and one of the most important ways of pathogenetic treatment of edematous syndrome is the appointment of modern diuretics, or diuretic drugs. How are diuretics used, and what are diuretics? What care should be taken by patients and doctors in the process of their use?

Modern diuretics

Once again, we recall that this material is intended, for the most part, not for patients suffering from edematous syndrome, who are observed by a cardiologist for heart failure, and routinely take diuretics. Still, they are under the control of doctors, and have a significantly lower risk of uncontrolled use of diuretics. This material is intended for those people who for some reason decided to use diuretics at their own peril and risk on their own.

It is no secret, for example, that the use of 1-2 tablets of furosemide in combination with intensive drinking of mineral water, with vitamin C, with a hot shower, allows you to quickly eliminate a hangover and bring a person into shape. Yes, forced diuresis is one of the effective means of removing the human body from the state of alcohol intoxication, and even from hard drinking.

But at the same time, it is necessary to remember those disadvantages that even the best modern diuretics have. So, treatment with only these drugs, without correction of the ionic composition of the plasma, can lead to a large loss of fluid, mineral salts from the vascular bed, and this output will be greater than from the intercellular space. This can lead to a decrease in the amount of the liquid part of the blood, or plasma, a decrease in the pumping function of the myocardium and a sharp drop in blood pressure, which may manifest as collapse. If the patient also has symptoms of heart failure, this will cause a reduced return of venous blood to the heart, further exacerbating the low cardiac output.

Always, using this or that diuretic, you need to find out about its capabilities, how powerful it is. Thus, thiazide diuretics, which act on the renal tubules and reduce the activity of carbonic anhydrase, are very widespread, and the most powerful are loop diuretics. Quite mild and relatively harmless can be considered potassium-sparing diuretics, since they have a rather weak effect.

Diuretics from the osmotic group, for example, Mannitol, will not be listed below. The scope of their application is quite different, for example, Mannitol is widely used in neuroreanimation and neurosurgery for the prevention and treatment of cerebral edema-swelling after surgical interventions and in case of severe traumatic brain injury. This section will not talk about those drugs for edema that reduce the symptoms of chronic venous insufficiency and are used in the treatment of varicose veins. These include various plant bioflavonoids, horse chestnut, rutin preparations, diosmin and others. They will be discussed in the relevant materials on the treatment of varicose veins, their scope is completely different, and they are not diuretics.

We will look at diuretics that have a common mechanism of action and affect the kidneys. There are not many of these drugs, and there are not many commercial copies, or generics, of them. But in any case, the international non-proprietary name (INN) will be given first, then, if available, the original drug will be named first, which is first introduced to the market, has the largest number of studies on efficacy and safety. Then the various generics, or commercial copies, will be named, and then the price. Prices are valid for the beginning of spring 2020 for pharmacies of all forms of ownership in the Russian Federation.

The following list of drugs does not aim to create advertising or anti-advertising for any manufacturer or drug, all these drugs are included in the State Pharmacopoeia, and are used in accordance with national and clinical guidelines for the management of patients with edematous syndrome. Some of the drugs that cannot be found in pharmacies will not be listed here, as well as the old, obsolete, rather toxic mercury diuretics.

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. Furosemide or Lasix. It is purchased by all hospitals, and ampouled Lasix – by ambulance stations, to stop a hypertensive crisis. Furosemide acts in the area of ​​the ascending part of the loop of Henle, as well as in the area of ​​the proximal tubule. Furosemide begins to actively act 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 after an hour. Furosemide works for about two, 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 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, an average of 35 rubles.

Advantages and disadvantages

The advantage of furosemide (Lasix) is in a fairly fast, powerful and short action. At the same time, it contributes to the excretion of not only sodium and chlorine, potassium, and to a lesser extent calcium and magnesium from the body. 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 as unpleasant, nagging cramps in the calves. In more severe cases, heart rhythm disturbance is possible, 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, such as Panangin.

It is also forbidden to use Furosemide in case of low blood pressure, dehydration, in case of obstructive, mechanical obstruction to the outflow of urine, so as not to get overdistension or even rupture of the bladder. The drug is contraindicated during pregnancy and lactation, in patients allergic to sulfonamides. With great care, Lasix should be used in case of edema in the presence of gout and an increased concentration of uric acid, with pancreatitis, systemic lupus erythematosus.

It should be borne in mind the numerous symptoms of side effects, among which are tachycardia, a drop in blood pressure, dry mouth and thirst. With prolonged use, especially at high dosages, a decrease in the number of leukocytes and platelets in the blood plasma, metabolic alkalosis, and numerous allergic reactions are possible. It should be very careful to come to a single 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 of furosemide with other drugs that must be taken into account.

Torasemide (Britomar, Diuver, Lawtonel, Trigrim)

Rating: 4.8

The difference between torasemide and furosemide is primarily 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 potent than furosemide. About an hour after taking the medicine inside, a diuretic effect develops in tablets. 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 shown in a variety of edematous conditions, in chronic renal and heart failure, in hepatic, that is, protein-free edema, and in various forms of arterial hypertension.

Torasemide is produced in the form of a Spanish-made Britomar preparation at a price of 420 rubles for 30 tablets of 10 mg. A good generic of European quality is produced by Pliva 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 bought even at a price of 130 rubles. But in this case, you should always prioritize not price, but quality. It is advisable to use torasemide for edema at a dose not exceeding 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 exceed 40 mg. The drug can be prescribed for long-term treatment, and in the case of arterial hypertension, a dosage of 5 mg once a day is quite 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 drug has standard contraindications, such as allergy to sulfonamides, low potassium levels, severe dehydration, acute glomerulonephritis, and age under 18 years. Torasemide is categorically contraindicated in case of an overdose of cardiac glycosides, that is, with digitalis intoxication.

With caution – if there is a tendency to low blood pressure, there is diarrhea and pancreatitis, diabetes and gout. You can not use torasemide together with corticosteroid hormones, cardiac glycosides, some groups of antibiotics (aminoglycosides). Torasemide should not be used if the patient has high-grade atrioventricular block or sinoatrial block. It is forbidden to take it to pregnant and lactating women, persons diagnosed with hypokalemia. The patient may also develop side effects, for example, increased cholesterol levels, dizziness and muscle cramps, extrasystole and heart palpitations, redness of the face and ringing in the ears. Of course, with an overdose of diuretics, dry mouth and thirst are possible.

The interaction of this diuretic with other drugs should also be considered. It enhances the effect of high blood pressure drugs, increases the nephrotoxic and ototoxic effects of antibiotics, and against the background of 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 borne in mind that the appointment of this diuretic weakens the effect of drugs to reduce blood sugar concentration, this is important for long-term use. If the patient receives lithium preparations prescribed by a psychiatrist, then the appointment of a diuretic increases their toxic effect.

Hydrochlorothiazide (hypothiazid, ezidrex)

Rating: 4.7

The most powerful and powerful diuretic drugs have been listed above. All the others are much weaker, they do not cause such a powerful and fast effect, they should not be used for ambulance purposes, and that is why they are still safer. Many of them are contained in complex drugs for the treatment of hypertension, and hypothiazide is a typical representative of such a mild diuretic and inexpensive agent. This is a thiazide diuretic, a fairly moderate action that removes sodium, potassium, water and chlorine from the body, and at the same time does not affect the acid-base balance.

This is a typical “middling” in its action, and it is weaker, since it does not affect one of the sections of the loop of Henle, which runs in the medulla of the kidney. But on the other hand, although Hypothiazid 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 a moderate period of milder action begins, which lasts about 12 hours.

In the event that the patient has a pronounced decrease in glomerular filtration, then the diuretic effect of this drug decreases, 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 it 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 minute. With 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 ampoules for injection, only in tablets. You need to take it one tablet in the morning, or twice, but both times in the morning, so that the diuretic effect is over by the time you go to bed. Hypothiazid is produced in tablets of 25 and 100 mg, and its cost, even at a high dosage, does not exceed 100 rubles. The hypothiazide is produced by the Hungarian pharmaceutical company Quinoin.

Advantages and disadvantages

A big plus of Hypothiazide will be the high duration of the diuretic effect with a simultaneously low intensity, respectively, a low risk of developing hypokalemia, the ability to use it against the background of acute glomerulonephritis and when prescribing corticosteroid hormones to patients. Hypothiazid is contraindicated in Addison’s disease, in children under three years of age, in severe hepatic and renal failure, refractory (resistant) to the treatment of 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 agent 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 flow 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 the medicine after a single dose will still act, although not so strongly, for 3-4 days, and if it is taken for a whole month, only then does the optimal diuretic effect develop. If treatment with Hypothiazid is stopped, then increased diuresis will persist for another 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. Overdose symptoms are standard, like other diuretics. There are various interactions with many drugs, for example, it enhances the effect of antihypertensive drugs.

Indapamide (Arifon)

Rating: 4.6

Indapamide, or Arifon, is rarely taken “in pure form” because it does not have a powerful and fast action. 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 at a dose of 2,5 mg, and much less often, with a 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 the 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. The good thing about indapamide is that it is not a “pure” diuretic, since it has the properties of a blocker of calcium channels that are found in the walls of blood vessels. Arifon increases their elasticity, and therefore it reduces the total peripheral vascular resistance, through it the second hypotensive effect is realized. In addition, Indapamide reduces left ventricular myocardial hypertrophy, and if it is prescribed in high doses, then, despite the increase in diuresis, it does not “fill up” 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 somewhere 10 days after the start of its planned intake. The usual dosage of Arifon is 1 tablet 1 time per day, 2,5 mg. Preliminary results of treatment should be evaluated after 1-2 months. The maximum development of the effect, associated with a sparing effect on the heart and an effect on the vascular channels, develops somewhere in 2-3 months after the start of the intake, and lasts for several months. After a single dose of the drug, its diuretic effect lasts for a day. Arifon is produced by the well-known French company Servier, and one pack of 30 tablets of 2,5 mg will cost 2020 rubles in early spring 330.

Advantages and disadvantages

The narrower the specialization of a drug, the higher its effectiveness, and the fewer questions in which areas it should be used. There are no such questions for Indapamide or Arifon: its scope is the treatment of hypertension. However, it must be remembered that there are a number of contraindications, which is quite common in hypertensive patients. This is an ischemic stroke, or acute cerebrovascular accident, a severe form of renal failure, a sharp decrease in the concentration of potassium in the blood plasma, taking cardiac glycosides, pregnancy and childhood.

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

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

Spironolactone (Aldactone, Verospiron)

Rating: 4.5

This drug to increase diuresis is completely different in terms of the chemical structure of the molecule, 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. For such a potassium-sparing effect, one has to pay with low activity, and a long 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 the drug is discontinued, it will subside on the second or third day.

This medicine is used to treat arterial hypertension, and not as an independent agent 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 pack of the drug, 25 mg each, 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 specific enzymes in that area 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 therapy of edema, with high aldosterone activity, for example, with secondary hyperaldosteronism. This condition often accompanies cirrhosis of the liver, resulting in edema and ascites. A big plus of this remedy is the ability to use it as a diuretic and hypotensive against the background of a low concentration of blood potassium, with primary hyperaldosteronism, or Conn’s syndrome before surgery.

Advantages and disadvantages

When prescribing Veroshpiron, it is always necessary to take into account the mineralocorticoid metabolism in the patient. 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, toddlers, in childhood, and for some other reasons. You can, only carefully, use Veroshpiron with a high concentration of calcium in the plasma, and the presence of atrioventricular blockade. Arrhythmologists know that a high concentration of potassium increases the risk of developing this type of heart rhythm disturbance, and Veroshpiron, unlike other diuretics, just 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. It is also necessary to wait for a response to increasing the dose somewhere around the second week. In the case of the 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 edema, 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 reversible gynecomastia in men, erectile dysfunction and reduced potency, and hirsutism and menstrual irregularities in women.

You also need to be aware of the presence of standard side effects, such as calf muscle cramps, dry mouth. As a hormone-like substance, Veroshpiron may interact with other medicines. It reduces the sensitivity of blood vessels to norepinephrine, enhances the effect of other diuretics, and together with calcium preparations 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 cancel Panangin. That’s when the risk of high potassium in the plasma will increase significantly.

Hydrochlorothiazide + triamterene (Triampur Compositum)

Rating: 4.4

Finally, the last of the considered popular drugs from the known modern diuretics will be Triampur Compositum. Why “composite”? Such a prefix, or rather a double name, is commonly found in homeopathic remedies. In fact, Triampur Compositum has nothing to do with homeopathy, it is simply a compound diuretic of two drugs. This is hydrochlorothiazide, which is connected together with triamterene, another potassium-sparing diuretic. Triampur Compositum is produced by the Croatian company Pliva, and one pack 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, acts quite gently and has an average time of action. It is the drug of choice for prescribing for arterial hypertension, and various, but usually mild edema, for their planned treatment. This drug does not make sense to use in 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, in the morning and afternoon. If there is swelling, you can prescribe at 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

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

Application, but with caution, is possible with moderate stages of chronic renal failure, gout, diabetes mellitus. Caution is also needed for alcoholic cirrhosis of the liver, with a deficiency of folic acid. The drug, despite its mild effect, can also have side effects, which can be considered standard for all diuretics. An overdose of Triampur weakens the effect of hypoglycemic agents, and when administered simultaneously with beta-blockers, it can cause erectile disorders.

In general, in concluding 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 usually beauties with edema and men with a hangover “prescribe” them to themselves), 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 rises, and especially if there was initially a phenomenon of hyperuricemia.

Perhaps the development of insulin resistance, lowering blood pressure, the appearance of heart rhythm disturbances, as well as transient hyperglycemia, which itself can disappear with long-term treatment with diuretics. In conclusion, we recall that it is desirable to be treated even with short courses of diuretics, even in the case of a single dose, only after a doctor’s prescription, since there can be quite serious complications associated with self-overdose.

Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.