Which diuretics are used to treat edema?
Edema can become a problem in systemic diseases of the heart, liver or kidneys. Diuretic therapy can be initiated, often alleviating the edema. The most potent diuretics are loop diuretics, so-called because they work in the portion of the kidney tubules referred to as the loop of Henle. The kidney tubules are small ducts that regulate salt and water balance, while transporting the forming urine. Clinical loop diuretics available are:
- furosemide (Lasix),
- torsemide (Demadex),
- butethamine (Bumex),
- ethacrynate (Edecrin)
The doses of these diuretics vary depending upon the patient's clinical circumstances. These drugs can be given orally, although seriously ill patients in the hospital may receive them intravenously for more prompt or effective response. If one of the loop diuretics is not effective alone, it may be combined with an agent that works further down (more distally) in the tubule. These agents include the thiazide type diuretics, such as hydrochlorothiazide (HydroDIURIL), or a similar but more potent type of diuretic called metolazone (Zaroxolyn). Other thiazide diuretics include chlorthalidone (Thalitone) methyclothiazide (enduron), chlorthalidone (Hygroton), indapamide (Lozol), and metolazone (Zaroxolyn, Diulo, Mykrox). When diuretics that work at different sites in the kidney are used together, the response often is greater than the combined responses to the individual diuretics (synergistic response).