Medicine Information

Frusin-Plus

Name: Frusin-Plus
Brand: Frusin-Plus
Rating: 4.5 (117 reviews)

TabletFurosemide 40 mg + Amiloride 5 mgDiuretics; Loop Diuretics with Potassium Sparing AgentsATC: C03EB01

Generic Name

Furosemide + Amiloride

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
frusin plus 40 mg tablet	৳ 8.03	৳ 80.30

Description

Overview of the medicine

Frusin-Plus 40 mg Tablet is a combination medicine containing Furosemide, a loop diuretic, and Amiloride, a potassium-sparing diuretic. It is primarily used to treat fluid retention (edema) associated with heart failure, liver disease, kidney disease, and high blood pressure. The combination helps to prevent potassium loss that can occur with Furosemide alone.

Uses & Indications

Treatment of edema associated with congestive heart failure

Treatment of edema associated with liver cirrhosis with ascites

Treatment of edema associated with renal disease (nephrotic syndrome)

Management of mild to moderate hypertension

Dosage

Adults

Initially 1 tablet once daily, adjusted according to patient response. Max 2 tablets daily.

Elderly

Lower initial dose may be considered.

Renal_impairment

Use with caution. Dosage reduction may be necessary. Contraindicated in severe renal failure with anuria.

How to Take

Take orally, preferably in the morning to avoid nocturnal diuresis, with or without food. Swallow the tablet whole with water.

Mechanism of Action

Furosemide acts on the ascending limb of the loop of Henle in the kidney, inhibiting the reabsorption of sodium and chloride, leading to increased excretion of water, sodium, chloride, and potassium. Amiloride acts on the collecting ducts and distal convoluted tubules, inhibiting sodium reabsorption and potassium excretion, thereby conserving potassium.

Pharmacokinetics

Onset

Furosemide oral: 30-60 minutes; Amiloride oral: 2 hours.

Excretion

Furosemide is primarily excreted by the kidneys (60-90% unchanged). Amiloride is excreted unchanged in urine and feces.

Half life

Furosemide: 0.5-2 hours (increased in renal/hepatic impairment). Amiloride: 6-9 hours.

Absorption

Furosemide is absorbed orally (bioavailability 40-70%). Amiloride has about 50% bioavailability.

Metabolism

Furosemide is partially metabolized in the liver. Amiloride is not significantly metabolized.

Side Effects

Contraindications

Anuria or severe renal impairment
Hypersensitivity to Furosemide or Amiloride
Hypokalemia or Hyponatremia refractory to treatment
Hyperkalemia
Hepatic coma or pre-coma
Addison's disease

Drug Interactions

NSAIDs

May reduce diuretic and antihypertensive effects; increased risk of nephrotoxicity.

Digoxin

Increased risk of digoxin toxicity due to electrolyte imbalance.

Lithium

Reduced renal clearance of lithium, leading to increased lithium levels and toxicity.

Corticosteroids

Increased risk of hypokalemia.

ACE Inhibitors/ARBs

Increased risk of hypotension and renal impairment.

Aminoglycoside antibiotics

Increased risk of ototoxicity (with furosemide).

Storage

Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.

Overdose

Symptoms include dehydration, electrolyte imbalance (hypokalemia, hyponatremia, hypochloremia, hyperkalemia), hypotension. Treatment is supportive, focusing on fluid and electrolyte replacement.

Pregnancy & Lactation

Pregnancy Category C. Use only if potential benefit outweighs risk. Furosemide and Amiloride are excreted in breast milk. Caution advised; consider discontinuing nursing or the drug.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets30 tablets50 tablets

Shelf Life

36 months from manufacturing date.

Availability

Pharmacies, Hospitals

Approval Status

Approved by regulatory authorities (e.g., DGDA)

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical data support the efficacy and safety of Furosemide and Amiloride, both individually and in combination, for diuretic and antihypertensive purposes. Specific trials for "Frusin-Plus" would typically be bioequivalence studies for generics.

Lab Monitoring

Serum electrolytes (potassium, sodium, chloride, magnesium)
Kidney function tests (BUN, creatinine)
Liver function tests
Blood pressure
Fluid status and weight

Doctor Notes

Monitor serum electrolytes (especially potassium) regularly, particularly in elderly patients or those with renal impairment.
Advise patients on symptoms of electrolyte imbalance.
Caution advised with NSAIDs and other nephrotoxic drugs.
Important for patients to report any hearing changes.

Patient Guidelines

Take medicine as directed by your doctor.
Do not stop taking the medicine without consulting your doctor.
Report any signs of electrolyte imbalance (e.g., muscle weakness, irregular heartbeat).
Avoid sudden changes in posture to prevent dizziness.

Missed Dose Advice

If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.

Driving Precautions

May cause dizziness or lightheadedness, especially at the start of treatment. Patients should be cautioned against driving or operating machinery until they know how they react to the medicine.