Therapeutic Action
Loop diuretic
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Drug reference
Loop diuretic
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Oedema associated with renal, hepatic or congestive heart failure
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Do not administer to patients with dehydration, severe hypokalaemia and hyponatraemia. May cause: dehydration, hypotension, hypokalaemia, hyponatraemia, hyperuricemia; renal impairment, deafness, photosensitivity. Avoid or monitor combination with NSAIDs, ACE inhibitors (risk of renal impairment); ototoxic drugs (e.g. aminoglycosides, quinine); lithium (increased plasma concentrations of lithium). Monitor combination with: drugs that provoke hypotension (e.g. haloperidol, amitriptyline) and antihypertensive drugs (risk of hypotension); potassium-depleting drugs (e.g. corticosteriods, laxatives, amphotericin B), sodium-depleting drugs (e.g. SSRI, carbamazepine); oral antidiabetics and insulin (risk of hyperglycaemia). Pregnancy: administer only if clearly needed Breast-feeding: CONTRA-INDICATED (excreted in milk and reduces milk production)
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20 mg and 40 mg tablets
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Adult: start with 20 mg once daily. Increase, if necessary, according to clinical response up to 80 mg once daily or 2 times daily (max. 160 mg daily). Once oedema decrease, reduce to 20 to 40 mg once daily.
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According to clinical response
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Preferably take in the morning. A potassium-rich diet (dates, bananas, mangos, oranges, tomatoes, etc.) is recommended during treatment. If potassium level is < 3.5 mmol/litre, administer a sustained-release potassium supplement. Diuretics are not indicated in the treatment of nutritional oedema or oedema associated with pre- eclampsia.
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- Below 25 °C
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start with 20 mg once daily. Increase, if necessary, according to clinical response up to 80 mg once daily or 2 times daily (max. 160 mg daily). Once oedema decrease, reduce to 20 to 40 mg once daily.
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