10 best diuretics

Means and preparations

Review of the best according to the editorial board. On the selection criteria. This material is subjective and does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.

Diuretics, or, in medical terms, diuretics, are usually recommended when, for some reason, the balance between the flow of fluid into the body and its excretion by the kidneys is disturbed. All medicines with a diuretic effect, with the exception of phytopreparations, should be prescribed only by a doctor. It is absolutely unacceptable to prescribe diuretics on your own for swelling on the face or legs, or, worse, for weight loss!

When diuretics are prescribed

When talking about diuretics, people usually mean the need to remove excess fluid in case of edema. But in practice, the most common indication for the use of diuretics is arterial hypertension, or, simply put, high blood pressure.

One of the reasons for this condition is a violation of the regulation of sodium metabolism, which begins to linger in the body. Together with sodium, water is retained. The volume of circulating blood increases, in response to this, the capillaries narrow – this is called an 'increase in peripheral resistance' – and the diastolic, or 'lower' pressure increases. To overcome this resistance, the heart increases the force of the ejection of blood: the systolic or 'upper' pressure also rises.

Of course, this is not the only mechanism for the development of arterial hypertension, but it is the easiest to influence it: it is enough to prescribe diuretics that will remove excess sodium and water from the body. Some diuretics can also dilate blood vessels, thus also lowering blood pressure. But these funds begin to act no earlier than 3 hours after use, and to achieve the maximum effect, several days of their regular use are necessary. Therefore, such drugs are prescribed for continuous use in order to prevent an increase in blood pressure, and not to reduce an already elevated one.

In addition, diuretics can be used for:

  1. edema of various origins (except for situations where edema is caused by renal failure);
  2. increased intracranial pressure;
  3. edema of the brain, lungs – in this case, fast-acting diuretics are prescribed, usually intravenously;
  4. with some poisoning, to accelerate the excretion of toxic substances by the kidneys, simultaneously with the intravenous infusion of large volumes of fluid (forced diuresis).

A separate case is indications for herbal diuretics. They are usually recommended for infections of the renal pelvis and urinary tract. They have a weak anti-inflammatory effect, but this is not the main effect of relieving the condition of patients. By creating a constant stream of urine, herbal diuretics mechanically flush out bacteria and their waste products, reducing the activity of inflammation.

No diuretic is in any way suitable for weight loss. The weight loss that occurs after taking a strong diuretic is due only to dehydration, not fat breakdown. They do not remove mythical 'slags'. Moreover, a decrease in the volume of circulating blood due to dehydration increases the concentration of toxic substances in it and disrupts normal metabolism. Against this background, such serious diseases as gout, chronic tubulointerstitial nephritis, up to chronic renal failure may appear.

Most diuretics are prescription drugs and require constant medical supervision. Therefore, offering the readers' attention the rating of the best diuretics, we are obliged to warn you – it is for informational purposes only and in no case is a recommendation.

Rating of the best diuretics

Nomination a place Name of product price
Best fast acting diuretics 1 Torasemid 158 RUB
2 Furosemide RUB 23
Best medium-acting diuretics 1 Indapamide RUB 25
2 Hydrochlorothiazide RUB 54
The best long-acting diuretics 1 Spironolactone 42 RUB
2 Chlorthalidone
The best natural remedies 1 Lingonberry leaves RUB 104
2 Kanephron 469 r
3 Fitonefrol (urological collection) RUB 61
4 Phytolysin 313 r
Why you can't 'prescribe' yourself diuretics !!!

Best fast acting diuretics

The drugs from this section of the rating are 'classic' diuretics, which are heard not only by specialists, but also by the population (which is why they are often abused). They begin to act in 15 minutes – an hour after ingestion, the duration of the effect is from 4 to 18 hours.

Torasemid

Rating: 4.9

TORASEMID

Trade names: Diuver, Britomar, Trigrim.

A more modern analogue of the well-known furosemide, which will be discussed below. In comparison with it, it does not actively 'wash out' potassium from the body. Acts relatively mild: the effect develops within 2 – 3 hours after administration and lasts up to 18 hours, usually without forcing the patient to 'watch' near the toilet. However, individual response options are possible.

On the other hand, it is precisely because of this delayed action that torasemide is not suitable for forced diuresis in case of intoxication, and therefore it is usually prescribed for edema.

Contraindicated in pregnant women and children under 18 years of age.

Dispensed by prescription.

Advantages

  • relatively 'gentle' action that does not restrict daily activities.

disadvantages

  • it is impossible during pregnancy.

Furosemide

Rating: 4.8

FUROSEMIDE

Time-tested, very inexpensive and still a 'working' tool. Despite the many possible side effects, it is over-the-counter, which earned him popularity among those who want to lose weight (recall that it removes only liquid, but does not break down fat) and notoriety among specialists dealing with victims of this method of losing weight: gout against the background of long-term use of furosemide not a rarity for a long time.

Another popular reason for taking furosemide on its own is getting rid of a hangover, supposedly, together with water and edema, it removes the toxins that cause this condition. The tool really relieves hangover swelling, getting rid of excess water, but does not remove any toxins. Acetaldehyde – a product of the metabolism of ethyl alcohol and the main cause of a hangover – is not excreted from the body with the kidneys, but is rendered harmless in the liver (by the way, alcohol is also not excreted in the urine, but partially exits with exhaled air, for the most part it is rendered harmless by liver cells). So to reduce a hangover, as well as to lose weight, using furosemide is useless.

In fact, its main purpose is to quickly and actively remove fluid, therefore, furosemide is usually used in emergency medicine: for cerebral or pulmonary edema (injectable forms), for forced diuresis with some intoxications, with acute renal failure, eclampsia of pregnant women, hypertensive crisis. Of course, in the instructions as indications there are also 'usual', edema, which does not require urgent resolution, and hypertension. But given that the remedy begins to act within 15 to 20 minutes after application and literally 'ties' a person to the toilet, in such non-urgent situations, doctors usually prefer milder diuretics, which will be described in more detail in other sections of the rating of the best diuretics.

Despite the fact that the use during pregnancy is not only not prohibited, but also indicated under certain circumstances, it is recommended to carefully monitor the development of the fetus, since the active substance penetrates the placenta. According to the FDA criteria, furosemide belongs to class C, that is, animal studies have identified potential threats to the fetus, there is no exact data on humans, but the intended benefits outweigh the possible risks. Indeed, eclampsia is a deadly condition for both the mother and the fetus.

With regular use, furosemide removes potassium from the body, so you need to add foods high in potassium to your diet (bananas, dried apricots, baked potatoes with peels), and it is better to take drugs containing this element.

Advantages

  • fast and powerful action,
  • extremely cheap,
  • sold without a prescription.

disadvantages

  • many side effects,
  • removes potassium from the body,
  • with prolonged uncontrolled intake is addictive,
  • with prolonged uncontrolled intake, it causes gout and kidney damage.

Best medium-acting diuretics

If the funds from the previous section of the rating are most often used in emergency or close to emergency situations, then drugs from this section are usually prescribed as planned. Most often, the indication is not edema, but arterial hypertension. Moreover, diuretics can be used as an independent means to control blood pressure, and in combination with hypotensive drugs, which allows you to minimize dosages.

Indapamide

Rating: 4.7

INDAPAMIDE

Trade names: Indap, Arifon,

Controls pressure not only by draining excess fluid and decreasing peripheral vascular resistance, but also by directly dilating the systemic and renal arteries. It does not affect the lipid composition of the blood and carbohydrate metabolism, does not change the sensitivity of tissues to insulin, unlike many other diuretic drugs. That is why indapamide is one of the most frequently prescribed diuretics for hypertension, both 'solo' and in combination with antihypertensive drugs.

Among the shortcomings, it should be noted that potassium is excreted from the body, which is traditional for most diuretics.

Regarding the use of indapamide during pregnancy, the instructions of different manufacturers of indapamide differ: some categorically prohibit the consumption of the drug, others propose to correlate the potential harm and benefit. According to the FDA classification, indap belongs to category B, that is, studies on animals have not revealed any harmful effects on the fetus, and in humans, for obvious reasons, such studies have not been carried out.

Advantages

  • does not interfere with normal metabolism;
  • dilates blood vessels,
  • can be used during pregnancy (with reservations).

disadvantages

  • removes potassium.

Hydrochlorothiazide

Rating: 4.5

HYDROCHLOTHIAZIDE

Trade names: Hypothiazide, Dichlothiazide.

Among the indications are edema syndrome (including edema in PMS), arterial hypertension, control of polyuria in diabetes insipidus and prevention of the formation of oxalate kidney stones.

Many patients with hypertension are wondering: which is better – indapamide or hydrochlorothiazide? The answer is unequivocally in favor of indapamide. Hydrochlothiazide disrupts cholesterol metabolism, provoking atherosclerosis, reduces tissue sensitivity to insulin and, like furosemide, increases the concentration of uric acid salts in the blood. If the drug is used in short courses, such changes are not too dangerous, since after cancellation, metabolic processes return to normal. But with hypertension, treatment is lifelong: recall that diuretics are taken, first of all, to prevent an increase in blood pressure. And in this case, hydrochlorothiazide can cause unwanted changes in the body.

To prevent them, some manufacturers are producing combination drugs that combine this diuretic with sartans, antihypertensive drugs that improve insulin sensitivity, help restore uric acid metabolism and lower blood 'bad' cholesterol.

Prohibited for use in the first trimester of pregnancy.

Advantages

  • low price,
  • smooth onset of action, not limiting activity.

disadvantages

  • can provoke atherosclerosis, gout, reduces insulin sensitivity;
  • removes potassium.

The best long-acting diuretics

This section of the rating includes diuretics, which begin to act after a few hours, and sometimes even days after the first use, and lasts 2 – 3 days.

Spironolactone

Rating: 4.6

SPIRONOLACTONE

Trade names: Veroshpiron, Aldacton.

This diuretic is a potassium-sparing diuretic. Unlike the funds from the previous sections of the rating of the best diuretics, it does not enhance the excretion of potassium from the body and does not disturb the electrolyte balance.

Acts very slowly – the effect occurs not earlier than on the second day and not later than on the fifth day after administration. Therefore, it is used only in courses to treat edema of cardiac or hepatic origin. With hypertension, it should be taken continuously.

Reduces sensitivity to vasoconstrictor substances, slows down the development of chronic heart failure.

A separate indication for the use of spironolactone is dependence on furosemide. Spironolactone suppresses the renin-angiotensin-aldosterone system – mechanisms aimed at fluid retention in the body, which are activated when furosemide is taken uncontrolled to avoid dehydration. With this dependence, spironolactone is taken simultaneously with furosemide, and the dose of the latter is gradually reduced, up to complete cancellation. After that, spironolactone is gradually canceled.

Of the problems with its long-term use, hormonal imbalance should be noted. Spironolactone acts on receptors that are sensitive to androgens (male hormones) and progestins (female hormones). Therefore, with prolonged use in women, masculine features may appear – a harsh voice. increased hair growth, disrupted menstrual cycle. In men, on the contrary, gynecomastia (breast enlargement) may develop, libido may decrease and potency may be impaired.

Not approved for pregnancy and lactation.

Advantages

  • smooth development of the effect, without disrupting daily life;
  • slows down the development of cardiovascular failure.

disadvantages

  • with prolonged use, it can disrupt the hormonal balance.

Chlorthalidone

Rating: 4.4

Oxodoline.

Trade name: Oxodolin.

It is prescribed for edema of various origins, including premenstrual tension syndrome (PMS) and late gestosis.

It is used to treat hypertension. It has not only a diuretic effect, but also dilates small vessels. Improves the condition of the endothelium – the inner wall of blood vessels, reduces the severity of left ventricular hypertrophy.

Among the disadvantages, it should be noted the relatively high frequency of adverse events – a decrease in blood potassium levels, dizziness, increased sugar levels, erectile dysfunction.

The action begins approximately 4 hours after application and lasts up to 52 hours.

Advantages

  • can be used during pregnancy,
  • prevents complications of hypertension.

disadvantages

  • possible side effects.

The best natural remedies

We have taken these drugs to the hotel section not because we think they are fundamentally worse or better than others. Plant extracts act much milder than 'chemical' agents, and they can be used to treat yourself, but it is not so easy to disrupt the water-electrolyte balance, so they are safer. On the other hand, they do not have a clearly standardized effect, like drugs from other sections of the ranking of the best diuretics. Therefore, they are not recommended either for arterial hypertension or for edema that requires correction.

Herbal diuretics have a separate indication that 'chemical' diuretics do not – kidney and urinary tract infections, which was described in detail above. In addition, it is herbal remedies that are usually recommended for edema of pregnant women.

It is because of security and additional indications that we have withdrawn these funds into a separate group. But we remind you that 'herbs' are by no means harmless and also have contraindications and side effects.

Lingonberry leaves

Rating: 4.3

LIVING LEAVES

A classic herbal diuretic with almost complete absence of contraindications: the only thing indicated in the instructions is individual intolerance. Can be used during pregnancy, is extremely cheap and readily available.

Advantages

  • there are almost no contraindications,
  • allowed during pregnancy,
  • inexpensive.

disadvantages

  • not.

Kanephron

Rating: 4.2

KANEFRON

Available in the form of an alcohol solution or tablets. Active substances – lovage, rosemary, centaury. In addition to a diuretic, it has anti-inflammatory and antimicrobial effects.

The remedy is contraindicated in children under one year old (for tablets – up to 6 years old), with gastric ulcer and individual intolerance to any of the components. Alcohol solution is not recommended for alcoholism.

According to the patients who took the funds, it is quite 'soft' – there is no need to limit activity, taking into account the availability of the toilet.

At first glance, the package is quite large – 60 tablets, but given that an adult will need 6 tablets per day, the tool turns out to be by no means economical.

Advantages

  • soft action,
  • can be pregnant
  • different forms of release.

disadvantages

  • inconvenient regimen (2 tablets 3 times a day);
  • high price per course of treatment.

Fitonefrol (urological collection)

Rating: 4.1

FITONEPHROL (UROLOGICAL COLLECTION)

Contains bearberry, marigold (calendula), dill, peppermint, eleutherococcus. Like other phytopreparations, it not only 'drives', but also relieves spasms, reduces inflammation and fights infection.

The herbal tea should be brewed according to the instructions and taken ⅓ cup 3 times a day.

Contraindicated in pregnant women, lactating women, children under 12 years of age.

Advantages

  • profitability.

disadvantages

  • bitter taste
  • not recommended for pregnant women.

Phytolysin

Rating: 3.9

PHYTOLISIN

Rating: 3.9.

A paste consisting of 9 plant extracts and 4 essential oils. China. a spoonful of paste should be dissolved in half a glass of water and taken 3 times a day after meals.

Contraindicated in renal and heart failure, glomerulonephritis and kidney phosphate stones. It is also not recommended for children under 18 years of age and pregnant women, since for obvious reasons, safety studies have not been conducted in these categories of patients.

There is no need to talk about the efficiency of the drug. In a tube there is 100 g of paste, that is, it is enough for about a week of treatment (in 1 teaspoon – 5 g). The course recommended by the manufacturer is from 2 weeks to 1.5 months.

Advantages

  • natural composition

disadvantages

  • unpleasant smell and taste,
  • multicomponent composition that increases the likelihood of allergic reactions,
  • it is impossible during pregnancy,
  • expensive.

Why you can't 'prescribe' yourself diuretics

Usually, people take diuretics on their own for two reasons – because of edema or wanting to lose weight. Why you can't take diuretics for weight loss, we wrote just above. But even with edema, when, it would seem, the indication is obvious, you cannot start drinking diuretics on your own.

  1. Firstly, if there really is edema, you need to find their cause and, if possible, eliminate it. It is possible that drugs that normalize cardiac activity or vascular tone will be much more effective than diuretics. For example, swelling of the legs in the evenings often becomes the first sign of varicose veins, which appears long before the visible venous nodes. And, of course, no diuretics will help here. Or edema before menstruation, which can be a sign of PMS, is much more efficiently removed by phytopreparations aimed at normalizing hormonal levels.
  2. Secondly, people, especially young women, often mistake the physiological morning swelling of the face for edema. And instead of just waiting or doing a light lymphatic drainage self-massage, they drink diuretics. Of course, the 'swelling' goes away after that – but the body, worried about the sudden loss of fluid, turns on systems that increase water retention in the body. And the next day, the swelling from the imaginary becomes real, followed by a new dose of diuretic. This is how a vicious circle is completed. Over time, the daily number of tablets increases, reaching 15 – 20 tablets per day for some.
  3. Against the background of uncontrolled intake of diuretics in the body, the water-electrolyte balance is disturbed, which disrupts the work of all its systems. Decreases skin sensitivity, or, conversely, paresthesias appear – a feeling of 'goose bumps' on the skin. The rhythm of the heart is disturbed. Blood glucose levels rise. Muscle weakness occurs, up to hypokalemic (caused by a lack of potassium) paralysis.

Therefore, any diuretics, except herbal remedies, should be prescribed only by a doctor and taken only under his control.


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

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