Divers: instructions for use

Diver is a diuretic diuretic.

This is a popular cure for edema caused by heart failure or other causes. Sometimes it is prescribed to take it every day from high blood pressure. The active substance of the drug Dyuver - torasemide.

On this page you will find all information about the Diver: the full instruction on the application for this medicine, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used Diver. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Diuretic.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is Diver? The average price in pharmacies is at the level of400 rubles.

Form of issue and composition

Produce the drug in such a dosage:

1. Diver tablets 5 mg- white or almost white round biconvex tablets with a fault line on one side and embossed 915 on the other side.
2. Diver tablets 10 mg- white or almost white round biconvex tablets with a fault line on one side and embossed 916 on the other side.

In addition to the biologically active component of torasemide, which can be in a dosage of 5 or 10 mg, depending on the form of release, as part of the drug the following auxiliary substances are present (the mass part is indicated according to the amount of the active ingredient):

• lactose monohydrate - 58.44 / 116.88 mg;
• corn starch - 14.56 / 29.12 mg;
• sodium carboxymethyl starch - 0.8 / 1.6 mg;
• anhydrous silicon dioxide - 0.6 / 1, »mg;
• magnesium stearate - 0.6 / 1.2 mg.

Pharmacological effect

The main active ingredient in the preparation is torasemide, it works as a diuretic with a lasting effect. Additional components - corn starch, lactose monohydrate, sodium carboxymethyl starch. There are magnesium stearate, anhydrous silicon dioxide.

The drug Diver has indications for use in puffiness, its action helps:

• improvement of myocardial function;
• limiting potassium withdrawal;
• reduced fibrosis;
• decrease osmotic pressure in renal cells;
• elimination of excess fluid from tissues;
• suppression of water absorption, sodium ions.

Indications for use

According to the instructions to the Diuwer, the use of the drug is indicated in the treatment:

1. Arterial hypertension.
2. An edematous syndrome caused by chronic heart failure, kidney disease, liver, lungs, or other pathologies.

Contraindications

According to the annotation, the following conditions and diseases are contraindications to the use of Diver:

• hyperuricemia;
• lactose intolerance;
• intoxication with cardiac glycosides;
• deficiency of lactase;
• severe hypokalemia or hyponatremia;
• hepatic precoma and coma;
• renal failure accompanied by anuria;
• acute glomerulonephritis;
• hypertrophic obstructive cardiomyopathy;
• glucose-galactose malabsorption;
• hypovolaemia or dehydration;
• lactation period;
• decompensated aortic and mitral stenosis;
• children and adolescents under 18;
• increase in central venous pressure (up to 10 or more mm Hg. item);
• a pronounced violation of the outflow of urine of any etiology (including with unilateral damage to the urinary tract);
• hypersensitivity to torasemide, to any auxiliary component of the drug or to sulfonamides.

Assign Diver, but with extreme caution to pregnant women, as well as patients with:

• arterial hypotension;
• hypoproteinemia;
• pancreatitis;
• gout;
• diabetes mellitus;
• anemia;
• acute myocardial infarction;
• ventricular arrhythmia in the anamnesis;
• hepatorenal syndrome;
• predisposition to hyperuricemia;
• stenosing atherosclerosis of cerebral arteries;
• a violation of the outflow of urine caused by hydronephrosis, narrowing of the urethra or benign prostatic hyperplasia

Application in pregnancy and lactation

Biologically active components of the Diver do not have a teratogenic or mutagenic effect, do not have a fetotoxic effect, but are able to penetrate the barrier between the placenta and the fetus.

Due to this, torasemide can cause a decrease in the number of blood platelets or disturbances in the water-electrolyte balance, which will have a destructive effect on the laying of organs and tissues of the future child. Therefore, a pharmaceutical preparation can only be used if the beneficial therapeutic effect for the mother is significantly greater than the potential risk to the fetus.

The use of Diver in the period of breastfeeding is prohibited, since it is not known whether the active substance penetrates into the milk. If therapy is necessary, lactation should be interrupted and the child transferred to artificial feeding with a mixture.

Instructions for use

The instructions for use indicate that the Diver is intended for oral use.

As a rule, prescribe the drug in the morning, regardless of food intake. The tablet should be taken whole, washed down with a small amount of drinking water or tea. The dose of Diver and the duration of the course of therapy depends on the patient's condition and the tolerability of torasemide.

Treatment with Diver can be started only after correction of hypovolemia, hyponatremia and hypokalemia.

• Adults with edema are usually prescribed 5 mg torasemide (1 tablet Diver 5) per day. If necessary, the dose of torasemide is gradually increased to 10-20 mg per day (the dose is prescribed for 1 dose).
• Adults with essential hypertension are usually recommended to administer 2.5 mg of torasemide (1/2 tablet Diver 5) per day. If a few weeks after the start of the treatment, the therapeutic effect of the drug is not enough to increase the dose to 5 mg torasemide (1 tablet Diver 5) per day. Taking more than 5 mg of torasemide per day does not lead to an additional reduction in blood pressure and is not appropriate for essential hypertension. It should be borne in mind that the maximum hypotensive effect of torasemide is achieved after 12 weeks after the initiation of therapy.

Older patients should be prescribed torasemide in minimum doses and adjust dose with caution.

Side effects

Given the prolonged effect of the drug, it must be understood that its administration may be associated with the development of certain adverse reactions from various body systems.

Specialists distinguish the following side effects:

1. Nausea, vomiting, pancreatitis, epigastric pain;
2. Acute circulatory insufficiency, arrhythmia, tachycardia;
3. Reversible hearing, dizziness and pain, tinnitus;
4. Reducing the number of platelets and leukocytes in the blood;
5. Retention of urine, increase in the amount of salts, hematuria, hydronephrosis;
6. Exicosis, dehydration, metabolic alkalosis, increased blood viscosity;
7. Atherosclerosis, gouty diseases, provocation of manifestations of diabetes.

Often, patients face the manifestation of skin reactions, presented in the form of rashes, hives, itching and dermatitis. Allergic reactions can develop, up to the onset of anaphylactic shock.

Overdose

Typical signs of intoxication are not known. If an overdose has occurred, diuresis may occur with the risk of losing fluid and electrolytes, which can lead to drowsiness and confusion, hypotension and circulatory collapse. There may be gastrointestinal disturbances. Treatment: there is no specific antidote.

Symptoms and signs of an overdose require a dose reduction or withdrawal of torasemide, as well as simultaneous replacement of fluid and electrolytes.

special instructions

Apply strictly according to the doctor's prescription.

1. Patients with hypersensitivity to sulfonamides and sulfonylureas may have cross-sensitivity to the Diver.
2. Diuretic effect persists up to 18 hours, this facilitates the tolerability of therapy due to the lack of a very frequent urination in the first hours after taking the drug inside, limiting the activity of patients.
3. Patients receiving high doses of Diver for a prolonged period, to avoid the development of hyponatremia, metabolic alkalosis and hypokalemia, a diet with a sufficient content of table salt and the use of potassium preparations is recommended.
4. When azotemia and oliguria occur in patients with severe progressive kidney disease, it is recommended to suspend treatment.
5. In patients in the unconscious state, with prostatic hyperplasia, narrowing of the ureters, diuretic control is necessary in connection with the possibility of acute urinary retention.
6. Selection of the dosing regimen in patients with ascites against the background of liver cirrhosis should be carried out in a hospital (violations of water-electrolyte balance may lead to the development of hepatic coma). This category of patients shows regular monitoring of plasma electrolytes.
7. In patients with diabetes mellitus or with reduced glucose tolerance, periodic monitoring of glucose concentrations in the blood and urine is required.
8. Increased risk of development of violations of water-electrolyte balance is observed in patients with renal insufficiency. During course treatment it is necessary to periodically monitor the concentration of electrolytes in the blood plasma (including sodium, calcium, potassium, magnesium), acid-base state, residual nitrogen, creatinine, uric acid and, if necessary, appropriate corrective therapy (with a higher multiplicity in patients with frequent vomiting and against parenteral fluids).

Drug Interactions

1. Salicylates increase the toxicity of torasemide and increase the risk of side effects.
2. Drugs that block tubular secretion, increase the concentration of torasemide in the blood.
3. Torasemide increases the effectiveness of diazoxide and theophylline and reduces the effectiveness of hypoglycemic agents, allopurinol.
4. Non-steroidal anti-inflammatory drugs, sucralfate, probenecid or methotrexate reduce the therapeutic effect of the drug.
5. The combined use of torasemide with angiotensin II receptor antagonists and ACE inhibitors can lead to a reduction in blood pressure.
6. Torasemide increases the concentration of cephalosporins, aminoglycosides, chloramphenicol, ethacrynic acid, cisplatin, amphotericin B, which leads to an increased risk of nephro- and ototoxic effects.

Reviews

We picked up some feedback from people about the Diver:

1. Olga. Diver is a very good diuretic. Its action lasts a long time and the maximum effect from the administration appears after 1.5-2 hours. These pills my father took because of heart failure to get rid of excessive puffiness (his legs swelled, he could not move himself). Before the divider tried everything, but no noticeable and expected effect was not. I heard about him accidentally in the pharmacy queue and decided to buy for a sample, as the check showed - not in vain. No side effects were observed during the use of the drug. The main thing is to observe the dosage and the regimen. Huge pluses - the price and effectiveness of the drug.
2. Catherine. Torasemide Canon I was appointed by an endocrinologist, indications for use are strong swelling. I did not know what to walk about-my feet did not fit into any shoes. I liked that the medicine works gently, there is no constant urge to go to the toilet. Already on the second day the puffiness began to pass, and a week later I noticed that weight loss had begun. I feel fine.

In general, the reviews on Diver confirm its high effectiveness in the treatment of edematous syndrome with a variety of different pathologies. So a positive opinion about the drug was made by patients with chronic heart diseases, kidney damage and diseases, accompanied by a violation of the regulation of the release of fluid from the body.

Analogues

The cost of the drug in question is not the lowest, so patients are often in search of good substitutes, but which will have a lower price. Inexpensive, but less effective, you can be treated with a drug called Furosemide, but there are other loop diuretics acting as substitutes, for example:

• Torasemide;
• Tigrim;
• Britomar.

Before using analogues, consult your doctor.

Diver or furosemide: which is better?

Diver and furosemide - similar drugs, loop diuretics. They remove water and salt, acting on Henle's loop in the kidneys. Combine these drugs can not! Furosemide (trade name Lasix) is a rather short-acting drug (4 hours). Diver - a medicine that appeared later. It has a longer diuretic effect (6-12 hours). It can be taken less often than furosemide.

Sometimes the Diver can be used in patients with renal insufficiency, which furosemide no longer helps. Diver has other important advantages in comparison with furosemide, which improve the quality of life of patients with heart failure, cirrhosis and hypertension.

Therefore, if the patient is interested in what is best - Diver or furosemide, usually the doctor recommends the first drug.

Storage conditions and shelf life

Diver must be stored in a well-ventilated, protected from light, dry and inaccessible place for children, at a temperature not exceeding 30 ° C.

The shelf life of tablets, subject to the main recommendations of the manufacturer, is three years.

How to choose probiotics for the intestine: a list of drugs.

Effective and inexpensive cough syrups for children and adults.

Modern non-steroidal anti-inflammatory drugs.

Review of tablets from the increased pressure of the new generation.

Antiviral drugs are inexpensive and effective.