Frulac40 mg+ 50 mg

The Furosemide and Spironolactone combination is indicated for the treatment and management of the following conditions:

• Essential hypertension (high blood pressure)
• Chronic congestive heart failure
• Hepatic cirrhosis with accumulation of fluid in the abdominal cavity (ascites)
• Swelling caused by excess fluid retention (edema)
• Hyperaldosteronism
• Resistant edema associated with secondary hyperaldosteronism

* Always take medicines as prescribed by a registered physician.

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

Spironolactone (a potassium-sparing diuretic) and Furosemide (a loop diuretic) act through different but complementary mechanisms at separate sites in the kidney. When given together, they produce an additive or synergistic diuretic effect while balancing potassium levels.

The Furosemide component inhibits the Na⁺/K⁺/2Cl⁻ co-transporter in the ascending Loop of Henle, blocking the reabsorption of sodium, potassium, and chloride ions. This increases the amount of sodium and the volume of water excreted in the urine, but characteristically also causes potassium loss.

The Spironolactone component inhibits the reabsorption of sodium in exchange for potassium at the distal tubule by antagonising the action of aldosterone. As a result, sodium excretion is strongly favoured while the excess potassium loss induced by Furosemide is reduced, helping to maintain electrolyte balance.

• ACE inhibitors or potassium salts: Taking these together increases the risk of hyperkalemia (high blood potassium).
• Cardiac glycosides (e.g., digoxin): Spironolactone raises blood levels of digoxin, which may lead to digitalis toxicity.
• Corticosteroids: May cause hypokalemia (low potassium) when used with Spironolactone.
• NSAIDs (e.g., indomethacin): May reduce or abolish the blood-pressure-lowering and diuretic effects of Furosemide.
• Aminoglycoside antibiotics: Furosemide may increase their ototoxicity (risk of hearing damage).
• Sucralfate: Taken at the same time as Furosemide, it may reduce Furosemide’s natriuretic and anti-hypertensive effects.

Along with its intended effects, Frulac 40 mg+ 50 mg may cause some unwanted effects. Commonly reported side effects include:

• Headache and drowsiness
• Gastrointestinal distress, including cramps and diarrhoea
• Ataxia (loss of coordination) and mental confusion
• Skin rashes
• Gynaecomastia (breast enlargement in men), which in rare cases may persist
• Other endocrine effects such as hirsutism, deepening of the voice, menstrual irregularities, and impotence
• Transient increase in blood-urea-nitrogen concentrations and mild acidosis
• Hyponatremia (low sodium) and hyperkalemia (high potassium)

Excessive diuresis may lead to dehydration and reduced blood volume, with a risk of circulatory collapse and, in elderly patients, vascular thrombosis and embolism. Serious depletion of potassium and magnesium may cause cardiac arrhythmias. Seek medical attention if any severe or persistent symptoms occur.

Pregnancy: Spironolactone and its metabolites may cross the placental barrier, so its use in pregnant women requires the anticipated benefit to be weighed against possible hazards to the mother and fetus. Animal teratology studies indicate that Furosemide may cause fetal abnormalities. Therefore, Furosemide should only be used in women of child-bearing age when appropriate contraceptive measures are taken, or when the potential benefits justify the potential risks to the fetus.

Lactation: Metabolites of Spironolactone have been detected in breast milk; if its use is considered essential, an alternative method of infant feeding should be used. Furosemide is also excreted in breast milk, and breast-feeding should be discontinued if treatment is essential.

Caution should be taken in patients who are liable to electrolyte deficiency. Frulac 40 mg+ 50 mg should also be used with care in patients with the following conditions:

• Diabetes
• Enlarged prostate
• Hypotension (low blood pressure)
• Hypovolemia (reduced blood volume)

Regular monitoring of electrolytes, kidney function, and blood pressure is recommended during treatment.

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