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- 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;
- ren al 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);
- potassiu m-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