Generic Formulary
Genito Urinary System
Sub Group: 
International Brand Name: 
40 MG
Unit of Packing: 
In treatment of: 
Treatment of Oedema associated w/ heart failure
Adverse Effects: 
1. Dizziness 2. Headache 3. Diarrhoea 4. Anorexia 5. Nausea 6. Polyurea 7. Vomiting 8. Constipation 9. Frequent urination 10. Nocturea 11. Altered renal function tests 12. Weakness 13. Altered liver function tests 14. Dry mouth 15. Hypo calcaemia 16. Hypo kalaemia 17. Hypo natraemia 18. Transient deafness 19. Gastro intestinal disturbances 20. Visual impairment 21. Muscle cramps 22. Decreased tolerance to carbohydrates 23. Hyper uricaemia. 24. Electrolyte imbalance 25. Orthostatic hypotension 26. Aplastic anaemia 27. Agranulocytosis 28. Paraesthesia 29.Ototoxicity
1. Hypo natraemia 2. Hypo kalaemia 3. Hypo volaemia 4. Hypotension 5. Hepatic coma 6. Hypersensitivity to the drug 7. Anuric renal failure
Special Precaution: 
1. Hepatic impairment 2. Renal impairment 3. Gout 4. Diabetes mellitus 5. Hypersensitivity to Sulfonamides 6. Fluid and electrolyte imbalance 7. Long term purgatives 8. Hepatic cirrhosis 9. Chronic Diarrhoea and dehydration.
Anticoagulants: Activity of anticoagulants may be enhanced. Aminoglycoside antibiotics: Frusemide increases potential for ototoxicity. Cisplatin: Frusemide increases potential for ototoxicity. Digitalis glycosides: Diuretics induced potassium loss may precipitate digitalis toxicity, increased frequency of cardiac arrhythmias. NSAIDs: Effect of frusemide reduced. Lithium: Therapeutic and toxic effects of lithium increased. Metolazone: Profound diuresis and greater than predicted electrolyte loss related to the ability of metolazone to block proximal tubular sodium reabsorption useful in patients refractory to frusemide. Non-depolarizing muscle relaxants: Action of succinylcholine & tubocurarine potentiated by low doses reversed by high doses. Food: Efficacy reduced when administered with food. Propranolol: Plasma propranolol level may be increased. Clofibrate: Increased diuretic responses. Hydantoins: May decrease the diuretic effects.
Oral: Oedema: 40mg in the morning. Increased if required; based on patient`s response up to 80mg. Maintenance dosage: 20 to 40mg daily or on alternate days. Maximum dose: 600mg/day. Children: 3mg/kg/day. I.V.: Adult: 20 to 50mg as slow I.V. or I.M. injection. Increased by 20mg every 2hours. Higher I.V. doses must be infused Children: 0.5 to 1.5mg/kg/day. Maximum child dose: 20mg/day. Oliguria: 250mg/day. Gradually increased; by 250mg at every 4 to 6 hours. Maximum dose: 2gm Hypertension: 40mg orally twice daily. Adjust the dosage according to patient`s response. Hypercalcaemia: 120mg orally/day or 80 to 100mg I.V. every 1 to 2 hours Acute pulmonary Oedema: Adults: 40mg slow I.V. injection. Then 80mg within 1hour if required. Children: 1mg/kg I.V.or I.M. Every 2 hours until desired response is gained. Maximum dose: 6mg/kg/day.

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