৳ 6.02/unit
Pack: ৳ 6.02
৳ 6.02/unit
Pack: ৳ 6.02
At a glance
Frusemide + Spironolactone is a combination diuretic used for the treatment of hypertension, congestive heart failure and edema.
Indications
- Essential hypertension
- Chronic congestive heart failure
- Hepatic cirrhosis - with collection of fluid in the abdominal cavity (ascites)
- Edema - swelling due to excess fluid retention
- Hyperaldosteronism
- Resistant edema associated with secondary hyperaldosteronism
Pharmacology
Spironolactone (potassium sparing diuretic) and Furosemide (loop diuretic) have different but complementary mechanisms and sites of action. Furosemide inhibits the Na+/K+/2Cl- co-transporter in the ascending Loop of Henle and blocks reabsorption of sodium, potassium and chloride ions; thereby increasing sodium and water excretion. This induces potassium loss. Spironolactone inhibits sodium reabsorption in exchange for potassium at the distal tubule by antagonising aldosterone action, greatly favouring sodium excretion and reducing excess potassium loss induced by Furosemide.
Dosage
Adult Dose:
- Furosemide 20 mg + Spironolactone 50 mg: 1 to 4 tablets daily (20-80 mg Furosemide and 50-200 mg Spironolactone) according to patient response.
- Furosemide 40 mg + Spironolactone 50 mg: For previously stabilized patients requiring higher dosage, 1-2 tablets daily (40-80 mg Furosemide and 50-100 mg Spironolactone).
Children: Not suitable for use in children.
Elderly: May be excreted more slowly in the elderly.
* Use as directed by the registered physician
Side effects
Common Side Effects:
- Headache and drowsiness
- Gastrointestinal distress - including cramp and diarrhoea
- Ataxia
- Mental confusion
- Skin rashes
- Gynaecomastia - not uncommon
- Hirsutism, deepening of voice, menstrual irregularities, impotence
Serious Side Effects: Hyperkalemia, hyponatremia, dehydration, cardiac arrhythmias.
Use in pregnancy
Use in Pregnancy: Spironolactone and its metabolites may cross the placental barrier. Furosemide may cause fetal abnormalities. Weigh benefits against potential risks.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
Precautions:
- Caution in patients liable to electrolyte deficiency.
- Use with caution in diabetes, enlarged prostate, hypotension and hypovolemia.
- Increased risk of hyperkalemia with ACE inhibitors or potassium salts.
Overdose effects
Overdose: Excessive diuresis may result in dehydration and circulatory collapse, especially in elderly patients. Serious depletion of potassium and magnesium may lead to cardiac arrhythmias.
Storage conditions
Storage: Keep below 30°C, away from light and moisture. Keep out of reach of children.