# Debate: The Best Diuretic?



## rexwal (Oct 8, 2011)

Im Getting ready for my show and want some competitors opinions on what the _best diuretic_ to use. Some people like lasix, some say it leaves you to flat and prefer aldactone. What do you all think. Also in Anabolics 2009 it mentions Lasilactone, a combination of lasix/aldac. 50mg/20mg. It sounds good and want some feedback? Come on guys I know there should be a lot of opinions on the best diuretic.


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## ripped_one (Dec 20, 2011)

Timing has more to do with it than the actual diuretic itself...


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## Goldy (Dec 21, 2011)

I dont compete so i dont know much about it.  i have heard lasix and aldactone are the best, but you have to be VERY careful with them as you can DIE!  dont fuck around with diuretics please!


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## gymrat827 (Dec 22, 2011)

watch out.  carefully research all of this to the T


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## PrecisionPinz (Dec 30, 2012)

Aldactone/Diazide is the best combo to use.  I will never use lasix again.


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## TheExperiment (May 30, 2013)

Lasix is best if you know you have a lot of water weight left to shed. A lot of guys make the mistake and use this when they don't have that much water weight left to use, and it completely flattens them out and spares none of the minerals.


Aldactone/Dyazide combo is the best to use if you have just a few films of water left.


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## pirovoliko (May 30, 2013)

aldactone/diazide is the much much safer option...


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## meat (Feb 18, 2014)

PrecisionPinz said:


> Aldactone/Diazide is the best combo to use.  I will never use lasix again.



Agreed. I've seen backstage what lasix can do. FLAT!


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## Big Worm (Feb 18, 2014)

Bad chinese usually does it to me.


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## ERandICU-RN (Mar 3, 2014)

Hmmmm, Ive never really research the use of diuretics in competing, BUT i do know that there are a TON of options out there in different diuretics. Bumex, Lasix, Albumin/Lasix, Mannitol/Lasix, Albumin/Bumex, ]Mannitol/Bumex, Potassium sparring diuretics, distal loop diuretics, proximal loop diuretics, Even alcohol is a diuretic as it inhibits ADH or "antidiuretic hormone". These a just a FEW of the ones that we commonly see in the ICU and from personal exp ( ETOH lol) Anyway, I know this doesn't help telling you which one is the best, but it might give you a started point on different ones to research. Please remember my first comment, "Ive never researched the use of these in competing", but i do know that these meds make my patients put out at least 5L-6L/ per day of urine (remember these people are usually fluid overloaded and are on fluid restrictions and aren't taking in much fluid throughout the day.)


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## coltmc4545 (Mar 3, 2014)

My personal experience with lasix was not good at all so I definitely can't recommend it. I will say that this thread is 3 years old.


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## meat (Mar 5, 2014)

PrecisionPinz said:


> Aldactone/Diazide is the best combo to use.  I will never use lasix again.



EXACTLY!!!! Dyazide all the way! I've seen lasix flatten, and cramp guys up sending them home vs taking the stage.


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## Steven (Apr 11, 2014)

I've got a question about a website, can anyone help me out?


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## Yaya (Apr 11, 2014)

Steven said:


> I've got a question about a website, can anyone help me out?



Yes............


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## DocDePanda187123 (Apr 11, 2014)

Steven said:


> I've got a question about a website, can anyone help me out?



Steven, welcome to the forums. Please respect our house and our rules. Reread them if you need to. This is not a source board and talk of sources is prohibited as well as phishing for sources. Have fun and read everything you can to learn from these fine ppl but understand we have rules and this is your warning to stay within them. Thanks.


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## Crim Crim (Apr 22, 2014)

I've been wondering about a newish drug called Samsca (tolvaptan)?  It works in the collecting duct of the renal tubule (AFTER the proximal and distal tubules and loop of Henley) so it just pulls water and no electrolytes (sodium, potassium, chloride, etc. are all spared).  It blocks the effect of antidiuretic hormone (AVP, or vasopressin) at the vasopressin V2 receptors and therefor promotes free water clearance by urination.

In the studies it pulled off an average of about 2-3 liters of water (4-6 lbs) with just one pill, on day one of therapy.  

It actually pulls fluid from the interstitium (extracellular), rather than the intravascular space like Lasix.  Does this mean that it would lead to less of the "flattening" phenomena to which is referred in this thread?  That fluid would have to be transitioned from the interstitium to the intravascular and I can't make my brain remember those details now, but it seems like it would have some potential merit, if the obvious safety issues could be overcome.

Anyway, it's relatively new on the market in the US but I have seen it listed in foreign pharmacies and also as a research chemical from a supplier that services universities.  I would suspect that somebody somewhere has experimented with it. .. ..


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## hulksmash (Apr 23, 2014)

Crim Crim said:


> I've been wondering about a newish drug called Samsca (tolvaptan)?  It works in the collecting duct of the renal tubule (AFTER the proximal and distal tubules and loop of Henley) so it just pulls water and no electrolytes (sodium, potassium, chloride, etc. are all spared).  It blocks the effect of antidiuretic hormone (AVP, or vasopressin) at the vasopressin V2 receptors and therefor promotes free water clearance by urination.
> 
> In the studies it pulled off an average of about 2-3 liters of water (4-6 lbs) with just one pill, on day one of therapy.
> 
> ...




Well yea-any pro would experiment with it. Time for me to do some research on it (and not use it since I do care a LITTLE about health LOL)...


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## Crim Crim (Apr 23, 2014)

hulksmash said:


> Well yea-any pro would experiment with it. Time for me to do some research on it (and not use it since I do care a LITTLE about health LOL)...



the thing to worry about with this drug is a rise in serum sodium.  Remember that serum sodium is calculated as a ratio to water, so if you offload water but the sodium stays the same, the sodium ratio will rise.  Normal sodium is 135-145 mEq/L.  Raising it too fast or too high can cause problems, but of course the antidote is just to drink more water.  Starting at maybe half the smallest dose would be smart.


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## hulksmash (Apr 23, 2014)

Crim Crim said:


> I've been wondering about a newish drug called Samsca (tolvaptan)?  It works in the collecting duct of the renal tubule (AFTER the proximal and distal tubules and loop of Henley) so it just pulls water and no electrolytes (sodium, potassium, chloride, etc. are all spared).  It blocks the effect of antidiuretic hormone (AVP, or vasopressin) at the vasopressin V2 receptors and therefor promotes free water clearance by urination.
> 
> In the studies it pulled off an average of about 2-3 liters of water (4-6 lbs) with just one pill, on day one of therapy.
> 
> ...




That's because it's a V2R Antagonist; V2R receptors are STRICTLY for water reabsorption via inhhibiting the action of the renal collecting duct, thus limiting water reabsorption.


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## hulksmash (Apr 23, 2014)

Crim Crim said:


> the thing to worry about with this drug is a rise in serum sodium.  Remember that serum sodium is calculated as a ratio to water, so if you offload water but the sodium stays the same, the sodium ratio will rise.  Normal sodium is 135-145 mEq/L.  Raising it too fast or too high can cause problems, but of course the antidote is just to drink more water.  Starting at maybe half the smallest dose would be smart.



Yep yep with plenty of h2o ml's


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## zenergy (Aug 19, 2016)

lasix is the superior loop diuretic.  Don't use unless you have soft goods for an iv consisting of lactated ringers , nacl, potassium in liquid form or solid. period


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