Fusid Plus 40

Conditions Indicating Use

The combination of Frusemide and Spironolactone serves various medical purposes, including:

• Management of essential hypertension
• Treatment of chronic congestive heart failure
• Alleviation of hepatic cirrhosis accompanied by ascites (fluid accumulation in the abdominal cavity)
• Reduction of swelling due to fluid retention (edema)
• Addressing hyperaldosteronism
• Managing resistant edema associated with secondary hyperaldosteronism

Pharmacological Action

Frusemide, a loop diuretic, and Spironolactone, a potassium-sparing diuretic, operate through distinct yet complementary mechanisms. Their combined use results in additive or synergistic diuretic effects. Frusemide inhibits the Na+/K+/2Cl- co-transporter in the ascending Loop of Henle, leading to increased sodium and water excretion in the urine. Spironolactone antagonizes aldosterone, thereby promoting sodium excretion and reducing potassium loss induced by Frusemide.

Dosage and Administration

Dosage may vary based on individual patient response:

• For Frusemide 20mg and Spironolactone 50mg: 1 to 4 tablets daily, adjusted as needed (20 to 80 mg Frusemide, 50 to 200 mg Spironolactone)
• For Frusemide 40mg and Spironolactone 50mg: Recommended for stabilized patients requiring higher dosages, with one to two tablets daily (40 to 80 mg Frusemide, 50 to 100 mg Spironolactone)

Special Considerations

• Use in children: Not recommended
• Elderly patients: May experience slower excretion

Interactions

• Risk of hyperkalemia when combined with ACE inhibitors or potassium salts
• Increased blood levels of cardiac glycosides like digoxin when used concurrently with Spironolactone
• Potential for hypokalemia with corticosteroid use alongside Spironolactone
• Reduced efficacy of Furosemide when co-administered with indomethacin or other NSAIDs
• Increased risk of ototoxicity with aminoglycoside antibiotics alongside Furosemide
• Reduced effectiveness when combined with sucralfate

Contraindications

• Anuria, acute renal insufficiency, or severe impairment of renal function
• Hyperkalemia, Addison’s disease, or hypersensitivity to Spironolactone, Frusemide, or sulphonamides

Side Effects

Potential side effects may include headache, drowsiness, gastrointestinal distress, skin rashes, and gynaecomastia. Endocrine disorders like hirsutism and menstrual irregularities are also possible. Caution is advised to prevent dehydration and electrolyte imbalances.

Pregnancy and Lactation

• Use during pregnancy and lactation requires careful consideration of potential risks to the mother and fetus, with close monitoring and consultation with healthcare providers.

Precautions and Warnings

• Caution advised in patients prone to electrolyte imbalances, diabetes, enlarged prostate, hypotension, and hypovolemia.

Therapeutic Class

• Frusemide and Spironolactone belong to the therapeutic class of potassium-sparing diuretics and aldosterone antagonists.

Storage Conditions

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