The
diuretic response of patients with
congestive heart failure to establish doses of
diapamide (750 mg) and
furosemide (80 mg) was compared in an open, crossover study. Peak urine output occurred in the first 6 hours after administration of
furosemide but somewhat later (12 to 18 hours) with
diapamide. Both agents produced active diuresis and natriuresis in most patients. Comparisons of
drug effect during the first days of each treatment period and analysis of the entire first treatment period indicated that urine output with
furosemide was significantly greater than with
diapamide. Urinary
sodium excretion on the first day of treatment was not significantly greater with
furosemide than with
diapamide, nor were the differences significant on subsequent days. The observed differences between drugs on urinary
potassium and
chloride excretion were not statistically significant. The most frequently occurring adverse reaction was mild to moderate
nausea, which was reported by five patients receiving
diapamide and two patients receiving
furosemide.
Diarrhea and
vomiting were also more frequent with
diapamide.
Diapamide would appear to serve a role between the milder
thiazide diuretics and the more effective
furosemide.