Diretic 20 mg+50 mg (Tablet)

Indications

• Essential hypertension
• Chronic congestive heart failure
• Hepatic cirrhosis with ascites
• Swelling due to excess fluid retention
• Hyperaldosteronism
• Resistant edema associated with secondary hyperaldosteronism

Pharmacology

• Complementary mechanisms of Spironolactone and Furosemide
• Additive or synergistic diuretic effect
• Inhibition of Na+/K+/2Cl- co-transporter
• Increased sodium and water excretion in urine
• Potassium-sparing diuretic and loop diuretic

Dosage & Administration

• Dosage range of Furosemide 20 to 80 mg and Spironolactone 50 to 200 mg
• Higher dosage option for stabilized patients
• Not suitable for use in children
• Slower excretion in the elderly

Interaction

• Increased risk of hyperkalemia with ACE inhibitors or potassium salts
• Elevated levels of cardiac glycosides with Spironolactone
• Reduced diuretic effects when used with corticosteroids or indomethacin
• Potential increase in ototoxicity with aminoglycoside antibiotics

Contraindications

• Anuria
• Acute renal insufficiency
• Severe impairment of renal function
• Hyperkalemia
• Addison's disease
• Hypersensitivity to Spironolactone, Furosemide, or sulphonamides

Side Effects

• Headache and drowsiness
• Gastrointestinal distress
• Ataxia and mental confusion
• Gynaecomastia and breast enlargement
• Hirsutism and impotence
• Dehydration and reduction in blood volume
• Hyponatremia and hyperkalemia
• Cardiac arrhythmias

Pregnancy & Lactation

• Potential hazards to mother and fetus during pregnancy
• Use in women of childbearing age with appropriate contraceptive measures
• Detection of Spironolactone metabolites in breast milk
• Excretion of Furosemide in breast milk

Precautions & Warnings

• Caution in patients prone to electrolyte deficiency
• Use with caution in diabetes, enlarged prostate, hypotension, and hypovolemia

Therapeutic Class

• Potassium-sparing diuretics
• Aldosterone antagonists

Storage Conditions

• Keep below 30°C temperature
• Away from light and moisture
• Keep out of reach of children

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