27.10.2020

Indapamide and Furosemide, the choice of drug

Talking about which drug is better is incorrect in this case. These are completely different drugs . And the purpose of their application is different.

The doctor is more likely to prescribe “Indapamide” for hypertension, which is not complicated by heart failure.

Since the second drug has a strong diuretic effect and severe “side effects”, it is not suitable for daily use in the treatment of hypertension.

The powerful “loop” diuretic “Furosemide” is usually used to quickly relieve severe or life-threatening conditions when it is necessary to remove stagnant fluid from the body as soon as possible. In such situations, Indapamide will be useless.

But he will show a good result with a long, course treatment of hypertension, when you need not strong, but prolonged exposure.

In any case, a diuretic should be chosen by a nephrologist or urologist, depending on the specific disease. With hypertension, a cardiologist or therapist is involved in this issue.

Diuretics (diuretics) are very often used in the treatment of chronic diseases, accompanied by edema due to the presence of excess fluid in the body. They are also used in the management of emergency conditions, such as cerebral or pulmonary edema.

On the shelves of pharmacies, such drugs are presented in an extensive assortment, including more than twenty-five items.

Well-known and decades-tested drugs – Indapamide and Furosemide stand out from this list.

 “Indapamide”: description of the drug

“Indapamide” – a diuretic and antihypertensive drug of the second generation. Belongs to the class of thiazide-like diuretics , sulfonamide derivatives. It has a mild effect on the body.

Indapamide

In addition to diuretic and antihypertensive effects, it has cardioprotective and vasodilating effects.

Manufacturing countries: Hungary, Serbia, Israel, Czech Republic, Russia, Poland.

The main active component of the drug is indapamide .

The release form of the medication is tablets. The amount of the main component in each pill is 2.5 mg. In addition, there are a number of additional substances: talc, crospovidone, sodium dodecyl sulfate, hypromellose, etc.

Indications and contraindications

According to official instructions, there is only one indication for Indapamide – arterial hypertension .

However, cardiologists often prescribe this medication to prevent edema in heart failure (chronic course only).

The use is contraindicated in:

  • Pregnancy
  • Renal failure accompanied by anuria.
  • Lactose intolerance.
  • Hypokalemia.
  • Lactation
  • Lactase deficiency.
  • Severe liver failure.
  • Allergies to drug components and other sulfonamide derivatives.
  • He is under the age of 18.
  • Gout.
  • ONMK.

Caution and special attention requires prescribing the medicine to patients with endocrine diseases ( hyperparatiosis ), a decompensated form of diabetes mellitus, and functional disorders of the liver and kidneys.

Side effects may appear during treatment. They are expressed: shortness of breath, arrhythmia, dry cough, dizziness, nocturnal enuresis, allergies, dry mouth, nausea, stool disorders, general weakness, chest pain, hypokalemia, hyponatremia.

The manifestation of side effects is noted in a small percentage of cases. For the most part, the medication is well tolerated.

pharmachologic effect

The main effect of the drug is manifested in the renal vessels and tissues. Due to the suppression of sodium reabsorption in the cortical part of the Henle loop, the drug helps to increase urination and the removal of chlorine and sodium in the urine. Magnesium and potassium are released to a lesser extent.

Removal of excess salts and fluid from the body helps to reduce the load on the myocardium, eliminate puffiness, and lower blood pressure.

Having a vasodilating effect, the medication improves the metabolism in small arteries, reduces the resistance of peripheral vessels. Protects heart muscle tissue from hypertrophy.

The antihypertensive effect of “Indapamide” is manifested if it is taken in the recommended dosage – 2.5 mg / day . At the same time, urination increases slightly. A decrease in pressure is observed 1 hour after administration.

The half-life of the drug from the body varies between 15-20 hours . This makes it possible to take it only once a day.

With systematic use, a stable therapeutic effect occurs after 7 days , and the maximum effect is observed after 1 month .

The specifics of the pharmacological properties of the pharmaceutical product include its ability not to affect the carbohydrate and lipid metabolism, which is inherent to other thiazide-like diuretics.

Therefore, it can be taken by patients with high cholesterol and diabetics, provided that the diabetes has a compensated form.

What is the detrusor of the bladder

“Furosemide”: description of the drug

“Furosemide” is a potent diuretic. Belongs to the first generation of “loop” diuretics. Due to its powerful therapeutic effect, it qualifies as a “high” or “ceiling” diuretic.

Furosemide

Manufacturing countries: Russia, Belarus, India.

The active substance of the drug is furosemide , a derivative of sulfonamides.

The pharmaceutical product goes on sale in two forms:

  1. Oral tablets.
  2. Injection.

40 mg of the active ingredient and a number of auxiliary substances (gelatin, milk sugar, MCC, silicon dioxide, etc.) fall per 1 tablet.

The concentration of furosemide in the ampoule solution is 10 mg per 1 ml. The solution is supplemented with water d / injection, sodium chloride, sodium hydroxide.

Indications and contraindications

The main indication for use is edematous syndrome of various etiologies.

The medication is prescribed for such conditions as:

  • Cirrhosis of the liver, accompanied by ascites.
  • Malignant hypertension.
  • Hypercalcemia.
  • Nephrotic syndrome.
  • Pulmonary edema caused by acute heart failure.
  • Eclampsia.
  • Peripheral edema.
  • Edema with toxicosis (late pregnancy).
  • Cerebral edema.
  • Hyperkalemia
  • Hypertensive crisis.
  • Edema syndrome in heart failure.

Also, the use of a drug gives a great effect with the method of forced diuresis . This method is used to quickly remove toxins from the body. For example, in acute poisoning with morphine, barbiturates or other substances that are excreted by the kidneys.

Ampoule solution has similar indications for use. But for the most part, it is used in a clinical setting.

Contraindications for use are:

  • Hypovolemia (low circulating blood volume).
  • Acute glomerulonephritis.
  • Anuria
  • Stenosis of the aorta and mitral valve (in decompensated form).
  • Urethral stricture.
  • Severe potassium-sodium deficiency.
  • Hyperuricemia
  • Hepatic coma or precomatose state.
  • Lactation.
  • Galactose intolerance.
  • Violation of water-salt balance.
  • Acute heart attack.
  • Severe kidney failure.
  • Digital intoxication.
  • Age less than 3 years (for the use of tablets).
  • Urinary tract blockage with calculi.
  • Allergy to the main or excipients.
  • Pregnancy (first trimester).
  • Diabetic coma.
  • Hypertrophic cardiomyopathy.

Caution is prescribed to patients with lupus erythematosus, pancreatitis, diabetes mellitus, as well as older people and those with a history of ventricular arrhythmias.

When prescribing a diuretic to patients with diabetes mellitus, strict monitoring of the blood glucose level is necessary. “Furosemide” has the ability to increase its level, which is fraught with the development of hyperglycemia .

Side effect is manifested by a sharp decrease in A. D. tachycardia. paresthesias. hepatic encephalopathy. impaired stool, nausea, pancreatitis. cramps, muscle weakness. changes in clinical analyzes of peripheral blood. pronounced water-electrolyte imbalance. various allergic reactions (up to anaphylactic shock).
pharmachologic effect

The diuretic acts directly on the Henle loop , blocking the absorption of chlorine and sodium throughout its entire length.

Due to this , the outflow of urine increases and improves . Excess fluid is rapidly eliminated from the body.

The active component of the drug improves renal blood flow, relaxes smooth vascular muscles. Activates glomerular filtration.

Also, the ability of the drug to expand peripheral veins reduces the load on the heart.

The pharmacological properties of the drug can reduce the volume of circulating blood and intercellular fluid. Due to this, there is a decrease in blood pressure.

The therapeutic effect after taking the pill occurs in 30-50 minutes , after the injection in 5-10 minutes .

The diuretic effect does not last long, only 3-5 hours .

What are the drugs like?

The pharmaceutical products under consideration have some common features.

  • They both belong to the group of diuretics .
  • They affect the body according to a similar principle – by blocking the absorption of sodium and chlorine.
  • The list of contraindications contains a number of pathologies and conditions when both medicines are prohibited.
  • Incompatibility of both drugs with alcohol is noted.
  • During the period of treatment with these pharmaceuticals, parallel intake of drugs containing potassium is recommended.
  • The instructions indicate that during admission, care must be taken when driving a car and working with mechanisms, as dizziness is a common side effect of medications.
What is the difference

The difference between the drugs presented is as follows:

  1. “Indapamide” has a milder and gentle effect on the body.
  2. Furosemide has an extensive list of contraindications and side effects. And side effects are manifested more vividly, and more often than with the second medication.
  3. Due to the power of the diuretic effect, Furosemide is used as needed. For the second medical facility, a coursework is provided. Moreover, some patients have been using it for several years.
  4. Despite the mildness and relative safety of Indapamide, pregnant women and people under the age of 18 are not allowed to take it. Another drug can be prescribed in case of emergency, both to pregnant women and children.
  5. Furosemide has both solid (tablets) and liquid (solution) release forms. The second remedy is available only in pills.
  6. The preparations also differ in chemical composition . They have various active ingredients.

The difference in prices, although not critical, is also present. “Indapamide”, depending on the manufacturer, costs in pharmacies from 16 to 110 rubles . “Furosemide” of any format of release – from 19 to 23 rubles .

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