Amiloride / Furosemide

DAE Class; Rx

Common Brand Names; FRUMIL

• Loop Diuretics Potassium-Sparing Diuretics And Aldosterone Antagonists Potassium-Sparing Diuretics With Other Diuretics

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Ascites and oedema associated with hepatic cirrhosis
Congestive cardiac failure
Diuresis (potassium sparing) in nephrosis
Diuresis (potassium sparing) required due to corticosteroid therapy
Diuresis (potassium sparing) required due to oestrogen therapy
Prompt diuresis especially where potassium conservation is important

Acute renal failure
Addison’s disease
Anuria
Breastfeeding
Electrolyte imbalance
Galactosaemia
Hyperkalaemia
Hypovolaemia
Long QT syndrome
Pre-coma associated with hepatic cirrhosis
Pregnancy
Renal damage secondary to nephrotoxic agents
Renal impairment – creatinine clearance below 30ml/minute/1.73m sq
Renal impairment associated with hepatic coma
Renal impairment secondary to hepatotoxic agents
Severe hypokalaemia
Severe hyponatraemia
Torsade de pointes

Side Effects

Abdominal pain
Acute generalised exanthematous pustulosis
Agranulocytosis
Allergic reaction
Alopecia
Altered liver function tests
Anaphylactoid reaction
Anaphylaxis
Angina
Anorexia
Aplastic anaemia
Arthralgia
Bone marrow depression
Bullous pemphigoid
Cardiac arrhythmias
Cholestatic jaundice
Confusion
Constipation
Deafness
Decreased glucose tolerance
Dehydration
Delayed reactions
Diarrhoea
Dizziness
Drowsiness
Drug rash with eosinophilia and systemic symptoms (DRESS)
Dry mouth
Eosinophilia
Erythema multiforme
Exacerbation of systemic lupus erythematosus
Exfoliative dermatitis
Fever
Fluid and electrolyte disturbances
Gastric upset
Gastro-intestinal symptoms
Glycosuria
Gout
Haemolytic anaemia
Headache
Hepatic encephalopathy
Hyperglycaemia
Hyperkalaemia
Hypersensitivity reactions
Hyperuricaemia
Hypocalcaemia
Hypokalaemia
Hypomagnesaemia
Hyponatraemia
Hypotension
Hypovolaemia
Impaired concentration
Increase in blood urea nitrogen
Increase in plasma cholesterol
Increase in plasma triglyceride concentration
Increased calcium excretion
Increased intra-ocular pressure
Interstitial nephritis
Leucopenia
Light-headedness
Malaise
Metabolic acidosis
Metabolic alkalosis
Minor psychiatric disturbances
Muscle cramps
Nausea
Nephrocalcinosis
Nephrolithiasis
Orthostatic hypotension
Ototoxicity
Pancreatitis
Paraesthesia
Photosensitivity
Precipitation of diabetes
Pruritus
Purpura
Rash
Sensation of pressure
Serum creatinine increased
Sexual dysfunction
Shock
Skin reactions
Stevens-Johnson syndrome
Systemic lupus erythematosus
Tetany
Thirst
Thrombocytopenia
Tinnitus
Toxic epidermal necrolysis
Urinary retention
Urticaria
Vasculitis
Visual disturbances
Vomiting
Weakness

Children under 18 years
Elderly
Family history of long QT syndrome
Hypoproteinaemia
Predisposition to hypotension
Predisposition towards electrolyte imbalance
Benign prostatic hyperplasia
Diabetes mellitus
Glucose-galactose malabsorption syndrome
Gout
Hepato-renal syndrome
History of torsade de pointes
Hypotension
Lactose intolerance
Systemic lupus erythematosus
Urinary obstruction

Adjustment of hypoglycaemic therapy may be necessary in diabetes mellitus
Correct electrolyte disorders before treatment
Correct hypotension before initiating treatment
May exacerbate or activate systemic lupus erythematosus
Advise ability to drive/operate machinery may be affected by side effects
Correct hypovolaemia prior to administration
Contains lactose
Consider monitoring ECG in patients at risk of QT prolongation
Monitor blood urea
Monitor fluid and electrolyte status
Monitor haematological parameters regularly throughout treatment
Monitor serum potassium regularly
Excess consumption of liquorice may increase the risk of hypokalaemia
Increased risk of hyperkalaemia with K+ suppl. and K+ sparing diuretic
May precipitate diabetes mellitus
May precipitate gout
Discontinue treatment before glucose tolerance test
Discontinue if evidence of significant bone marrow depression
Withdraw drug if skin rash or pruritus occur
Advise patient not to take NSAIDs unless advised by clinician
Hypotensive effects may be potentiated by alcohol
Advise on problems of salt substitutes/high intake of potassium-rich food

Co-amilofruse is contraindicated in pregnancy.

Adults

Amiloride / Furosemide