Edemide 40 mg+50 mg

Description

Indications
The combination of Frusemide and Spironolactone is used to treat the following conditions:

• Essential hypertension (high blood pressure)
• Chronic congestive heart failure
• Hepatic cirrhosis with ascites (fluid buildup in the abdominal cavity)
• Edema (swelling caused by fluid retention)
• Hyperaldosteronism (excess aldosterone production)
• Resistant edema linked with secondary hyperaldosteronism

Use this medication only as prescribed by a registered healthcare provider.

Pharmacology
Frusemide (a loop diuretic) and Spironolactone (a potassium-sparing diuretic) have distinct but complementary actions, working together to produce an enhanced diuretic effect.

Frusemide works by inhibiting the Na+/K+/2Cl- co-transporter in the ascending Loop of Henle, blocking the reabsorption of sodium, potassium, and chloride ions. This action leads to increased sodium excretion and water elimination through the urine, but also causes potassium loss.

On the other hand, Spironolactone acts at the distal tubule, blocking the effects of aldosterone, a hormone that promotes sodium retention. By inhibiting aldosterone, Spironolactone enhances sodium excretion and reduces the potassium loss caused by Frusemide.

Dosage & Administration

• Furosemide 20 mg & Spironolactone 50 mg: Take 1 to 4 tablets daily (equivalent to 20 to 80 mg of Frusemide and 50 to 200 mg of Spironolactone), based on the patient’s response.
• Furosemide 40 mg & Spironolactone 50 mg: For patients requiring a higher dose of both medications, take 1 to 2 tablets daily (equivalent to 40 to 80 mg of Frusemide and 50 to 100 mg of Spironolactone).

Use in Children: This medication is not recommended for children. Elderly individuals may experience slower excretion of the drugs.

Follow the dosage prescribed by your healthcare provider.

Interaction

• Combining this medication with ACE inhibitors or potassium salts may increase the risk of hyperkalemia (high potassium levels).
• Spironolactone can elevate the levels of cardiac glycosides, such as digoxin, in the blood, potentially causing digitalis toxicity.
• Corticosteroids, when used with Spironolactone, may lead to hypokalemia (low potassium levels).
• The blood pressure-lowering and diuretic effects of Frusemide may be diminished by NSAIDs, such as indomethacin.
• Furosemide may amplify the ototoxic effects (hearing damage) of aminoglycoside antibiotics.
• Co-administration of sucralfate with Frusemide may reduce its natriuretic and antihypertensive effects.

Contraindications
This medication should not be used by individuals with:

• Anuria (absence of urine production)
• Acute renal insufficiency or severe impairment of kidney function (creatinine clearance <30 ml/min)
• Hyperkalemia (high potassium levels)
• Addison’s disease
• Known hypersensitivity to Spironolactone, Furosemide, or sulphonamides

Side Effects
Spironolactone may cause:

• Headaches, drowsiness, and gastrointestinal discomfort (e.g., cramps and diarrhea)
• Ataxia (lack of coordination), mental confusion, and skin rashes
• Gynaecomastia (breast enlargement in men), which may persist in some cases
• Other endocrine issues like hirsutism (excessive hair growth), voice changes, menstrual irregularities, and impotence
• Mild acidosis and transient increases in blood urea nitrogen (BUN)
• Possible hyponatremia (low sodium) and hyperkalemia (high potassium)
• Excessive diuresis (urine production) may cause dehydration, reduced blood volume, and circulatory collapse, particularly in elderly individuals
• Severe depletion of potassium and magnesium can lead to arrhythmias (irregular heartbeats)

Pregnancy & Lactation

• Pregnancy: Spironolactone and its metabolites can cross the placental barrier. Its use during pregnancy should be based on a careful risk-benefit analysis, with consideration of the potential risks to both the mother and fetus. Animal studies suggest that Furosemide may cause fetal abnormalities, so its use should be carefully considered for women of childbearing age, ensuring adequate contraceptive methods are used.
• Lactation: Metabolites of Spironolactone can be passed through breast milk. If Spironolactone is deemed necessary, an alternative method of infant feeding should be considered. Furosemide is also present in breast milk, so breastfeeding should be avoided if treatment is essential.

Precautions & Warnings
This medication should be used cautiously in patients prone to electrolyte imbalances. It should also be used with caution in individuals with diabetes, enlarged prostate, hypotension, or hypovolemia (low blood volume).

Therapeutic Class

• Potassium-sparing diuretics
• Potassium-sparing diuretics & Aldosterone antagonists

Storage Conditions
Store below 30°C, away from light and moisture. Keep out of reach of children.