Frusemide + Amiloride
Indications
Frusemide + Amiloride is used for:
Hypertension; Oedema
Adult Dose
Oral
Hypertension; Oedema
Adult: Per tablet contains furosemide 40 mg and amiloride 5 mg: 1-2 tablets daily, preferably in the morning.
Child Dose
Renal Dose
Administration
Contra Indications
Severe Na and water depletion, hypersensitivity to sulphonamides and furosemide, hypokaelemia, hyponatremia, precomatose states associated with liver cirrhosis, Addison's disease, K sparing agents, K supplements, impaired renal function, hyperkalaemia, anuria, hypersensitivity.
Precautions
Hepatic or renal impairment, pregnancy, lactation, gout, diabetes, impaired micturition and metabolic or resp acidosis.
Pregnancy-Lactation
Interactions
Phenytoin and indometacin may reduce effects of furosemide. May provoke severe hypotensive response with ACE inhibitors. NSAIDs inhibit diuretic and antihypertensive effects. Effects of antihypertensive drugs are enhanced. Increased incidence of premature beats with cardiac glycosides. Action antagonized by corticosteroids. Diuretic induced vol depletion can potentiate aminoglycoside nephrotoxicity. Impairs action of oral hypoglycaemic agents. Enhances digitalis toxicity due to hypokalaemia. vol depletion enhances lithium toxicity; conversely sudden stopping of diuretic may result in subtherapeutic levels of circulating lithium. Prolonged paralysis with tubocurarine due to hypokalaemia. NSAIDs antagonize hypotensive action. Suppresses action of oral anticoagulants due to reduced prothrombin activity. Increased risk of hypokalaemia when corticosteroids given concurrently.
Potentially Fatal: Furosemide may enhance nephrotoxicity co-administered with cephalosporins, aminoglycosides and ototoxicity of aminoglycosides. Amiloride potentiates bone marrow suppression caused by anticancer drugs.
Adverse Effects
Side effects of Frusemide + Amiloride :
Nausea, diarrhoea, blurred vision, dizziness, headache, photosensitivity, hypotension, bone marrow depression (rare), hepatic dysfunction, hyperglycaemia, glycosuria, ototoxicity, hyponatraemia, idiosyncratic hypersensitivity, dry mouth, fatigue, muscle cramps, nausea, impotence, raised blood levels of glucose, urates, lipids, calcium, reduced levels of K and magnesium, raised CPK levels.
Potentially Fatal: Fluid and electrolyte imbalance, hypersens.
Mechanism of Action
Furosemide is a sulfonamide diuretic. It inhibits reabsorption of Na and chloride mainly in the medullary portion of the ascending limb of the Loop of Henle. Excretion of K and ammonia is also increased while uric acid excretion is reduced. It increases plasma renin levels and secondary hyperaldosteronism may result. Furosemide reduces BP in hypertensives as well as in normotensives. Amiloride is a potassium-sparing drug that possesses weak (compared with thiazide diuretics) natriuretic, diuretic, and antihypertensive activity. Amiloride exerts its potassium-sparing effect through the inhibition of Na reabsorption at the distal convoluted tubule, cortical collecting tubule and collecting duct; this decreases the net -ve potential of the tubular lumen and reduces both K and hydrogen secretion and their subsequent excretion.