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    Prescription under medical supervision


    Therapeutic action

    • Loop diuretic


    • Oedema associated with renal, hepatic or congestive heart failure

    Forms and strengths

    • 20 mg and 40 mg tablets


    • 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.


    • According to clinical response

    Contra-indications, adverse effects, precautions

    • 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)


    • 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.


    - Below 25 °C