Frumil (co-amilofruse)

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Amiloride can increase the amount of potassium in the blood. If this medicine is taken with any of the following, which can also raise potassium in the blood, the combination could cause the amount of potassium in the blood to rise too high (hyperkalaemia):

- ACE inhibitors, eg captopril
- angiotensin II receptor antagonists, eg losartan
- ciclosporin
- non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin
- other potassium-sparing diuretics, eg spironolactone, triamterene
- potassium supplements (do not take these while taking this medicine)
- potassium-containing salt substitutes, eg lo-salt (do not use these while taking this medicine)
- tacrolimus.

Furosemide can decrease the amount of potassium in the blood. If this medicine is taken with any of the following medicines, which can also lower potassium in the blood, the combination could cause the amount of potassium in the blood to fall too low (hypokalaemia):

- amphotericin
- corticosteroids, such as hydrocortisone and prednisolone
- beta 2 agonists, eg salbutamol, terbutaline
- other diuretics, such as bendroflumethiazide
- prolonged use of laxatives
- theophylline.

If the level of potassium in your blood falls during treatment, this can increase the risk of adverse effects from digoxin or medicines for abnormal heart rhythms, eg amiodarone.

If this medicine is taken with carbamazepine the combination may cause the amount of sodium in your blood to fall too low (hyponatraemia).

Furosemide decreases blood pressure. If this medicine is used in combination with other medicines that lower blood pressure, either as a side effect, or to treat high blood pressure (antihypertensives), the combination might lower your blood pressure too much. This could make you feel dizzy or faint. If this happens to you tell your doctor, as your doses may need adjusting. Other medicines that decrease blood pressure include the following:

- ACE inhibitors such as enalapril
- alpha-blockers such as prazosin
- angiotensin II receptor antagonists such as losartan
- beta-blockers such as propranolol
- calcium-channel blockers such as verapamil, nifedipine
- clonidine
- nitrates, eg glyceryl trinitrate
- certain antidepressants
- certain antipsychotics
- alprostadil
- baclofen
- benzodiazepines.

If you are due to start treatment with an ACE inhibitor, eg captopril, or an angiotensin II receptor antagonist, eg candesartan, your doctor may ask you to stop taking this medicine temporarily, or reduce your dose for a few days beforehand. This is to avoid your blood pressure falling too low with your first dose of ACE inhibitor/angiotensin II blocker.

This medicine can increase blood glucose levels and people with diabetes may therefore need increases in their dose of insulin or antidiabetic tablets. Your blood sugar level should be monitored.

This medicine may increase the blood level of the medicine lithium. People taking lithium with this medicine should have the level of lithium in their blood closely monitored.

The diuretic effect of this medicine may be reduced by the following medicines:

- non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin, ibuprofen, aspirin
- phenytoin.

There may be an increased risk of side effects on the kidneys if this medicine is used in combination with the following medicines:

- ACE inhibitors, eg captopril
- certain antibiotics, eg aminoglycosides such as gentamicin
- other diuretics
- non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin.

There may be an increased risk of side effects on the ears if this medicine is used in combination with aminoglycoside antibiotics such as gentamicin.

There may be an increased risk of side effects on the kidneys and ears if this medicine is taken by people being treated with platinum-based chemotherapy such as cisplatin.

Other medicines containing the same active ingredients

Froop-co

Fru-co

Co-amilofruse tablets are also available without a brand name, ie as the generic medicine.

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