Frumil (co-amilofruse)

How does it work?

Frumil tablets and Frumil LS tablets contain two active ingredients, amiloride hydrochloride and furosemide. Furosemide is a type of medicine called a loop diuretic, and amiloride is a type of medicine called a potassium-sparing diuretic. This combination of diuretics is also known as co-amilofruse. (NB. Co-amilofruse tablets are also available without a brand name, ie as the generic medicine.)

Diuretics are sometimes referred to as ‘water tablets’. They remove excess fluid from the body by increasing the production of urine.

Diuretics act in the kidneys. They work by causing the kidneys to increase the amount of salts, such as potassium and sodium, that are filtered out of the blood and into the urine. When these salts are filtered out of the blood by the kidneys, they draw water alongside them. As diuretics increase the removal of salts from the blood, they also cause more water to be drawn out of the blood and into the urine.

Loop diuretics like furosemide are strong diuretics that cause lots of potassium to be filtered out of the blood. This can sometimes cause the level of potassium in the blood to fall too low. A low blood potassium level is called hypokalaemia and can sometimes be dangerous, particularly for people with heart disease or liver disease.

Amiloride on the other hand, is a weaker diuretic that causes potassium to be retained in the body. It is used in combination with furosemide to prevent the amount of potassium in the blood from falling too low.

Co-amilofruse is used to treat conditions where excess fluid has been retained in the body (oedema) and where a drop in the amount of potassium in the blood could be dangerous.

For example, it is used in heart failure, where the pumping mechanism of the heart is less effective. This can cause fluid to build up in the ankles, causing swollen ankles, and in the lungs (pulmonary oedema), which makes it difficult to breathe. Furosemide helps the body to remove this excess fluid. Removing fluid from the blood vessels also decreases the pressure within the blood vessels. This makes it easier for a weak heart to pump blood around the body.

It is also used to remove excess fluid that can accumulate as a result of cirrhosis of the liver. This fluid may accumulate and cause swelling in the abdomen (ascites) or in the legs (peripheral oedema).

What is it used for?

Treating fluid retention (oedema) in conditions where it is important that the amount of potassium in the blood does not fall too low, for example in heart failure, liver cirrhosis, kidney disease, or oedema caused by treatment with corticosteroids or oestrogens.

Warning!

As diuretics cause your kidneys to produce more urine, you may prefer to take this medicine in the morning rather than before going to bed, as this will reduce the likelihood of you needing to get up in the night to visit the toilet. Seek further advice from your doctor or pharmacist.

While you are taking this medicine your kidney function should be checked regularly.You should have regular blood tests to monitor your blood sugar and the levels of electrolytes such as potassium and sodium in your blood.

If you experience any of the following symptoms while taking this medicine you should inform your doctor promptly, so that the amount of fluids and salts in your body can be checked: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, nausea and vomiting, abnormal heart beats, or seizures.

Use with caution in

Elderly people

Decreased kidney function

People with liver cirrhosis and decreased kidney function

People with difficulty in passing urine (urinary retention)

Enlarged prostate gland

Low blood pressure (hypotension)

Gout

Diabetes

People at risk of developing an imbalance in the levels of electrolytes in their blood, eg due to severe diarrhoea or vomiting, or other medicines being taken (see below)

People with low levels of protein in their blood, eg due to a kidney disorder called the nephrotic syndrome.

Not to be used in

Children under 18 years of age

Allergy to medicines from the sulphonamide group, eg the antibiotic sulfamethoxazole

People with a low volume of fluid in their blood (hypovolaemia), eg due to blood loss or dehydration

High levels of potassium in the blood (hyperkalaemia)

Very low levels of potassium in the blood (hypokalaemia)

Very low levels of sodium in the blood (hyponatraemia)

Kidney failure caused by poisoning with agents that have damaged the kidney or liver

Kidney failure that is preventing the production of urine (anuria)

People who are losing consciousness due to liver cirrhosis that is affecting the brain

Inadequate production of natural steroid hormones by the adrenal glands (Addison's disease)

Breastfeeding

Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Frumil and Frumil LS tablets contain lactose).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established. The manufacturer states that it is not recommended during pregnancy. Seek medical advice from your doctor.

There is no information available about the safety of amiloride during breastfeeding. Furosemide passes into breast milk and may decrease the production of breast milk. For this reason, the manufacturer states that this medicine should not be used by women who are breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Increased production of urine

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Dehydration

Decrease in blood pressure

Dizziness

Drowsiness

Weakness

Dry mouth

Headache

Confusion

Visual disturbances

Muscle cramps

Skin rashes

Increased blood sugar level

Increased level of uric acid in the blood (hyperuricaemia) which may cause gout

Disturbances in the levels of electrolytes (eg potassium, calcium, magnesium) in the blood

Pins and needles (paraesthesia)

Sensation of ringing or other noise in the ears (tinnitus)

Disturbance in the normal numbers of blood cells in the blood

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

Go To Next Page>>
The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use



© Copyright 1998 - 2004 NetDoctor.co.uk - All rights reserved