Edema associated w/ heart failure, including pulmonary edema, & w/ renal & hepatic disorders & may be effective in patients unresponsive to thiazide diuretics. HTN either alone or w/ other antihypertensives. Used in high doses in management of oliguria due to renal failure or insufficiency.
Adult 20-80 mg single daily dose preferably in the morning, may be titrated & given in divided doses every 6-8 hr. Edema Initially 40 mg in the morning. Maintenance: 20-40 mg daily, increased to ≥80 mg daily in resistance edema. HTN 40-80 mg daily either alone or w/ other antihypertensives. Childn Initially 2 mg/kg/dose, increased by 1-2 mg/kg every 6-8 hr if diuretic response is not achieved. After initial dose, max: 6 mg/kg w/ interval of at least 2 hr between doses. Edema Initially 1-3 mg/kg daily. Max: 40 mg daily. Chronic renal impairmentOliguria Initially 250 mg daily, increased if necessary in steps of 250 mg every 4-6 hr to max: 1.5 g in 24 hr.
Not to be given in pre-comatose states associated w/ hepatic cirrhosis. Patients w/ prostatic hypertrophy or impairment of micturition; impaired hearing. 20-mg tab: Contains FD&C yellow #5 (tartrazine) which may cause allergic reaction including bronchial asthma in certain susceptible persons.
May enhance nephrotoxicity of cephalosporins eg, cefalotin. Enhanced ototoxicity of aminoglycosides & other ototoxic drugs. Interactions due to effects on fluids & electrolyte balance are similar to those of hydrochlorothiazide. Diuretic-induced hypokalemia may enhance toxicity of digitalis glycosides & may increase risk or arrhythmias w/ drugs that prolong QT interval eg, astemizole, terfenadine, halofantrine, pimozide & sotalol.
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