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Furosemide + Spironolactone

Potassium-sparing diuretics Prescription
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Indications

Hypertension Heart Failure Edema

The combination of Frusemide and Spironolactone is used for these conditions: essential hypertension, chronic congestive heart failure, and hepatic cirrhosis with a collection of fluid in the abdominal cavity (ascites). It is also used for swelling due to excess fluid retention (edema), for hyperaldosteronism, and for resistant edema associated with secondary hyperaldosteronism.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Spironolactone is a potassium-sparing diuretic and Furosemide is a loop diuretic. They work in different ways and at different sites in the kidney, but the two actions complement each other, so together they give an additive or synergistic diuretic effect.

The Furosemide part blocks the Na+/K+/2Cl- co-transporter in the ascending Loop of Henle. This stops the reabsorption of sodium, potassium and chloride ions, so more sodium and a larger volume of water leave in the urine. Loss of potassium is a typical result of this action.

The spironolactone part acts at the distal tubule, where sodium is normally reabsorbed in exchange for potassium. It antagonises the action of aldosterone, which greatly favours sodium excretion and reduces the extra potassium loss caused by Furosemide.

Pregnancy & Breastfeeding

Pregnancy: Spironolactone and its metabolites may cross the placental barrier. If a pregnant woman needs spironolactone, the doctor has to weigh the expected benefit against the possible harm to the mother and the fetus. Animal teratology studies show that Furosemide may cause fetal abnormalities. So Furosemide should be given to women of child bearing age only when suitable contraceptive measures are in place, or when the potential benefits justify the potential risks to the fetus.

Lactation: Metabolites of Spironolactone have been found in breast milk. If spironolactone is considered essential, the baby should be fed by another method instead. Furosemide is also excreted in breast milk, so breast-feeding should be stopped if treatment is essential.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Furosemide 20 mg with spironolactone 50 mg: the dose is 1 to 4 tablets daily, which gives 20 to 80 mg of furosemide and 50 to 200 mg of spironolactone. The exact number depends on how the patient responds. Furosemide 40 mg with spironolactone 50 mg: this tablet is for patients who are already stabilized but need a higher dose of spironolactone and furosemide. It can be used at one to two tablets daily, which gives 40 to 80 mg of furosemide and 50 to 100 mg of spironolactone. Use in children: furosemide and spironolactone is not suitable for children. In the elderly, both furosemide and spironolactone may be excreted more slowly.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.