FUROSEMIDE (FRUSEMIDE) + AMILORIDE HYDROCHLORIDE

 

FUROSEMIDE (FRUSEMIDE)

+

AMILORIDE HYDROCHLORIDE

Chemical Class: Anthranilic acid derivative, Pyrazine

Therapeutic Class: Antihypertensive; diuretic, loop,potassium-sparing

BRAND NAMES	MANUFACTURER	DOSES FORM	GENERIC
Duride	Bosch phamra	Tab	Furosemide + Amiloride
Frulimoride	Medera	Tab	Furosemide + Amiloride
Fruseride	Werrick pharma	Tab	Furosemide + Amiloride
Lasoride	Sanofi Aventis	Tab	Furosemide + Amiloride
Truride	Fynk pharma	Tab	Furosemide + Amiloride

 

INDICATIONS:

Where dieresis id required and where potassium and magnesium conservation is important e.g. in fluid retention due to cardiac, hepatic or renal disorders and hypertension.

DOSEAGE & ANDMISTATION:

ADULT

Depending upon the severity of the clinical condition, up to 2 tablets may  be administered daily, preferably in the morning. In view of possible risk of hyperkalemia in those with reduced renal reserves, such as in the elderly, the dosage should be adjusted according to renal function, serum electrolytes and diuretic response.

CONTRA INDICATIONS:

Pregnancy, hyperkalemia (serum k+>5.3mmol/l) acute renal failure, anuria, renal impairment with serum cretinine >1.8mg/dl and cretinine clearance< 30ml/min, hyponatremia, hypovolemia, hypotension per comatose states associatd with cirrhosis.

Known sensitivity to frusemide, amiloride or sulfonamides. Hypokalaemia must be corrected before the start of treatment.

WARNING / PRECAUTIONS:

It may be necessary to increase the dose of hypoglycemia agents in diabetic. Lasoride should be discontinued before a glucose tolerance test. Lactation period.

SIDE EFFECTS:

Nausea, comiting, diarrhea, and hypercalcemia ( cardiac arrhythmia, tiredness), muscuylar weekness inlegs has been observed in patients receiving amiloride. Regular monitoring of electrolytes id recommended. Regular complications include minor psychiatric distrubances; disorders of hearing and acute pancreatitis, necessitating withdraw. The hepatopoietic state should be regularly monitored furing treatment. Transient rise in serum cholesterol, iriglyceride and serum urea levels, calcium depletion, nephrocalcinosis in premature infants or metabolic alkalosis may accur. Reduced mental alertness may impair ability to drive or operate dangerous machinery. Reduced glucose tolerance. Int the event of excessive dieresis, particularly in the elderly feeling of pressure in the head, headache, dizziness, dryness of muth, visual impairment, dehydration, hypotension, circulatory collapse, thrombophilia. Increase in serum uric acid concentration. Symptoms of obstructive micturition may manifest or aggravate. Especially with severely restricted salt intake, hyponatremia may accur leading to orthostatic hypotension, calf muscle cramps, weakness, loss of appetite, dizziness drowsiness, vomiting, allergic reactions (e.g. skin rashes, interstitial nephritis, fever vasulitis) or changes in blood picture (leucopenia, agranulocytocis, hemolytic anemia, thrombocytopenia) rarely accur necessitating withdrawal.

INTERACTIONS

Drugs

The effect of neprotoxc may be increase by concomitant administration of diuretic such as lasoride. In common with other diuretics, serum lithium levels may be increased when lithium is givenconcomitantly with frusemide, necessitating adjustment of the lithium dosage. NSAIDs (e.g. acetylsaliclylic acid, indomethacin, attenuation of frusemide  action renal failure in cas of pre existing hypokalemia). Frusemide may sometimes attenuate the effects of other drugs (e.g. the effect of anti diabetics and pressor amines). And sometimes potentiate them (e.g. relaxants). Interaction shave aldo been reported with ototoxic antibiotics and anbti hypertensive agents and cardiac glycosides. Glucocorticoids given the lasoride may cause electrolyte disturbances. Carefull monitoring of potassium levels id recommended when using lasoride with ACE inhibitors to prevent risk of hyperkalemia and during concomitant use of porassium sparing agents ( rriamterene, spironolactone) and porassiun salt, lasoride should be used with caution in patients habituated to excessive use of laxativesm wich ca render electrolyte imbalance.