Indications for: SOAANZ
Edema associated with heart failure or renal disease.
Initially 20mg orally once daily. If inadequate, titrate upwards by doubling dose until desired response; max: 200mg/day.
Anuria. Hepatic coma.
Hypotension. Renal impairment. Monitor volume status, renal function, BP, electrolytes, blood glucose. High doses, severe renal impairment, or hypoproteinemia may increase the risk of ototoxicity. Pregnancy. Nursing mothers.
Concomitant NSAIDs may decrease diuretic, natriuretic (eg, indomethacin), and antihypertensive effects; risk of renal impairment. Lithium or salicylate toxicity. Potentiated by concomitant CYP2C9 inhibitors (eg, amiodarone, fluconazole, miconazole, oxandrolone); monitor and adjust dose if needed. Antagonized by concomitant CYP2C9 inducers (eg, rifampin); monitor and adjust dose if needed. May affect sensitive CYP2C9 substrates or substrates with narrow therapeutic range (eg, celecoxib, warfarin, phenytoin); monitor and adjust dose if needed. Give oral dose 1hr before or 4–6hrs after cholestyramine. Antagonized by organic anion drugs (eg, probenecid). Ototoxicity with aminoglycosides (avoid) or ethacrynic acid. Risk of hypotension and/or renal impairment with concomitant ACE inhibitors, ARBs, or nephrotoxic drugs. Increased nephrotoxicity with concomitant radiocontrast agents. Increased risk of hypokalemia with concomitant corticosteroids or ACTH.
Excessive urination; dehydration, volume depletion, hypotension, worsening renal function, electrolyte and metabolic abnormalities, hyperglycemia, hyperuricemia, tinnitus, hearing loss; rare: gout.
Generic Drug Availability: