Furosemide + Spironolactone

Generic Details

Generic Name

Furosemide-Spironolactone

Other Names

  • Furosemide and Spironolactone combination

Drug Class

  • Diuretic combination

Chemical Formula

Molecular Weight

Mechanism of Action

  • Furosemide - loop diuretic inhibiting sodium and chloride reabsorption in the ascending loop of Henle
  • Spironolactone - potassium-sparing diuretic antagonizing aldosterone

Indications

  • Management of fluid retention and edema in conditions such as congestive heart failure
  • Hypertension that is uncontrolled with monotherapy

Common Dosage Forms

  • Tablet

Typical Dosage

  • Initial dose: furosemide 20-40 mg/spironolactone 50 mg once daily
  • Adjust dosage based on response
  • Maximum dose: furosemide 160 mg/spironolactone 400 mg daily

Pediatric Dosage

  • Not established

Geriatric Dosage

  • Dosage adjustment may be needed based on renal function

Side Effects

  • Electrolyte imbalance (hypokalemia, hyperkalemia)
  • Dehydration
  • Dizziness
  • Muscle cramps
  • Fatigue

Contraindications

  • Anuria
  • Hypersensitivity to sulfonamides
  • Severe renal failure
  • Hyperkalemia

Pregnancy Category

  • C - Discuss risks and benefits with a healthcare provider

Lactation Safety

  • Caution advised, excreted into human milk

Drug Interactions

  • NSAIDs may reduce diuretic and antihypertensive effects
  • ACE inhibitors may increase risk of hyperkalemia

Overdose Symptoms

  • Electrolyte disturbances
  • Dehydration
  • Hypotension

Antidote for Overdose

  • Symptomatic treatment and electrolyte repletion

Storage Conditions

  • Store at room temperature away from moisture and heat

Pharmacokinetics

  • Absorption: Well-absorbed orally
  • Distribution: Both drugs cross the placenta and are excreted in breast milk
  • Metabolism: Furosemide - hepatic
  • Excretion: Furosemide - renal, Spironolactone - renal

Precautions

  • Monitor electrolytes and renal function regularly
  • Avoid abrupt withdrawal
  • Caution in hepatic impairment

Warnings

  • Hyperkalemia risk with concomitant ACE Inhibitor or ARB use

Others