The Frusemide & Spironolactone combination is indicated for:

• Essential hypertension (high blood pressure)
• Chronic congestive heart failure
• Hepatic cirrhosis with collection of fluid in the abdominal cavity (ascites)
• Edema (swelling due to excess fluid retention)
• Hyperaldosteronism
• Resistant edema associated with secondary hyperaldosteronism

Spironolactone (a potassium-sparing diuretic) and Furosemide (a loop diuretic) have different but complementary mechanisms and sites of action. Therefore, when given together, they produce an additive or synergistic diuretic effect. Furosemide Component: Inhibits the Na⁺/K⁺/2Cl⁻ co-transporter in the ascending loop of Henle Blocks the reabsorption of sodium, potassium, and chloride ions ,Increases the quantity of sodium and the volume of water excreted in the urine. Characteristically induces potassium loss. Spironolactone Component: Inhibits the reabsorption of sodium in exchange for potassium at the distal tubule. Works by antagonizing the action of aldosterone.Promotes sodium excretion while reducing the excess loss of potassium induced by furosemide.

Furosemide 20 and spironolactone 50 mg: 1 to 4 tablets daily (20 to 80 mg of Furosemide and 50 to 200 mg of spironolactone) according to the patient's response.

Furosemide 40 and spironolactone 50 mg: For previously stabilized patients requiring a higher dosage of spironolactone and Furosemide. This tablet can be used at a dose of one to two tablets daily (Furosemide 40 to 80 mg and spironolactone 50 to 100 mg).

Use in children: Spironolactone and Furosemide is not suitable for use in children. Spironolactone and Furosemide may both be excreted more slowly in the elderly.

Concurrent use of ACE inhibitors or potassium supplements may increase the risk of hyperkalemia. Spironolactone can elevate blood levels of cardiac glycosides such as digoxin, potentially leading to digitalis toxicity. When used together with Spironolactone, corticosteroids may cause hypokalemia. The diuretic and antihypertensive effects of Furosemide may be reduced or neutralized when taken with indomethacin and possibly other non-steroidal anti-inflammatory drugs (NSAIDs). Furosemide may enhance the ototoxic effects of aminoglycoside antibiotics. Co-administration of sucralfate and Furosemide may decrease the natriuretic and antihypertensive effects of Furosemide.

This medication is contraindicated in patients with: Anuria, Acute renal failure, Rapidly worsening or severe renal impairment (creatinine clearance <30 ml/min), Hyperkalemia, Addison’s disease, Hypersensitivity to Spironolactone, Furosemide, or sulphonamides.

Spironolactone may cause headache, drowsiness, and gastrointestinal disturbances such as cramps and diarrhea. Other reported effects include ataxia, confusion, and skin rashes. Gynecomastia is relatively common and may persist in rare cases. Endocrine-related effects may include hirsutism, deepened voice, menstrual irregularities, and impotence. Temporary increases in blood urea nitrogen (BUN) and mild acidosis may occur. Spironolactone may also lead to hyponatremia and hyperkalemia. Excessive diuresis can result in dehydration, reduced blood volume, circulatory collapse, and an increased risk of thrombosis or embolism, especially in elderly patients. Severe depletion of potassium and magnesium may cause cardiac arrhythmias.

Pregnancy: Spironolactone and its metabolites can cross the placenta. Its use during pregnancy should be considered only if the potential benefits outweigh the possible risks to the mother and fetus. Animal studies suggest that Furosemide may cause fetal abnormalities. Therefore, Furosemide should be used in women of childbearing age only with proper contraception or when the benefits justify the risks.

Lactation: Metabolites of Spironolactone are found in breast milk. If treatment is essential, breastfeeding should be discontinued and alternative feeding methods used. Furosemide is also excreted in breast milk; therefore, breastfeeding should be stopped if treatment is necessary.

Caution is advised in patients prone to electrolyte imbalance. This medication should also be used carefully in patients with diabetes, enlarged prostate, low blood pressure (hypotension), and reduced blood volume (hypovolemia).

Potassium-sparing diuretics, Potassium-sparing diuretics & Aldosterone antagonists.

Keep below 30°C.,Protect from light and moisture., Keep out of the reach of children.