Frumil is a prescription medication combining two potent diuretics, amiloride hydrochloride and furosemide, designed for the clinical management of edema associated with congestive heart failure, hepatic cirrhosis, and nephrotic syndrome. This synergistic formulation addresses both potassium conservation and robust fluid elimination, offering healthcare providers a valuable tool in managing fluid overload while mitigating hypokalemia risk. Its balanced mechanism makes it particularly suitable for patients requiring long-term diuretic therapy who are susceptible to electrolyte imbalances.

Features

• Contains 5mg amiloride hydrochloride and 40mg furosemide per tablet
• Dual-action mechanism targeting both distal tubules and loop of Henle
• Potassium-sparing properties combined with high-efficacy fluid elimination
• Standardized bioavailability with consistent pharmacokinetic profile
• Manufactured under strict pharmaceutical quality control standards
• Available in blister packs of 28 tablets for convenient monthly dosing

Benefits

• Provides comprehensive edema reduction through complementary diuretic actions
• Maintains potassium balance, reducing the need for supplemental potassium therapy
• Decreases hospitalization frequency through effective outpatient fluid management
• Improves patient comfort and mobility by reducing peripheral and pulmonary edema
• Supports long-term cardiovascular and renal function through controlled diuresis
• Simplifies treatment regimens by combining two therapeutic actions in one tablet

Common use

Frumil is primarily indicated for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and nephrotic syndrome. It is also used in managing edema resistant to other diuretic therapies and may be prescribed for certain cases of hypertension with concomitant fluid retention. The medication is particularly valuable in patients who develop hypokalemia with loop diuretics alone or who require combined diuretic therapy for adequate fluid control.

Dosage and direction

The recommended initial dosage is one tablet daily, preferably taken in the morning with food to minimize gastrointestinal discomfort. Dosage should be individualized based on patient response, with maximum recommended dose of two tablets daily. Therapy should be initiated at the lowest effective dose and titrated gradually. Renal function should be assessed before initiation, and dosage adjustments are necessary in patients with impaired renal function. Tablets should be swallowed whole with a full glass of water without crushing or chewing.

Precautions

Regular monitoring of serum electrolytes, particularly potassium, sodium, and creatinine, is essential during therapy. Blood urea nitrogen and serum uric acid levels should be monitored periodically. Patients should be observed for clinical signs of fluid and electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal disturbances. Caution is advised in patients with diabetes mellitus, as hyperglycemia may occur. Hepatic function should be monitored in patients with pre-existing liver disease.

Contraindications

Frumil is contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal function, hyperkalemia, or known hypersensitivity to amiloride, furosemide, or sulfonamide-derived drugs. It should not be used in patients receiving other potassium-sparing diuretics or potassium supplements. Contraindicated in patients with Addison’s disease and severe electrolyte imbalance. Not recommended during pregnancy unless potential benefits outweigh risks, and generally avoided during breastfeeding.

Possible side effects

Common side effects include dizziness, headache, dehydration, electrolyte imbalances, muscle cramps, and gastrointestinal disturbances such as nausea, vomiting, or diarrhea. Less frequently, orthostatic hypotension, increased blood glucose, hyperuricemia, and rash may occur. Rare but serious side effects include severe electrolyte disturbances, thrombocytopenia, neutropenia, pancreatitis, and hepatic encephalopathy in predisposed patients. Photosensitivity reactions and tinnitus have been reported in some cases.

Drug interaction

Frumil may interact significantly with ACE inhibitors, angiotensin II receptor blockers, other potassium-sparing agents, and potassium supplements, increasing hyperkalemia risk. NSAIDs may reduce its diuretic and antihypertensive effects. Enhanced hypotensive effects may occur with other antihypertensive medications. It may increase lithium levels and toxicity risk. May potentiate effects of skeletal muscle relaxants and digitalis glycosides. Caution with aminoglycosides due to potential ototoxicity and nephrotoxicity. May alter response to antidiabetic medications.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed one. If multiple doses are missed, medical advice should be sought regarding dose adjustment or monitoring requirements.

Overdose

Symptoms of overdose include profound electrolyte depletion, dehydration, hypotension, circulatory collapse, and cardiac arrhythmias. Treatment involves gastric lavage if ingestion was recent, along with supportive measures including electrolyte replacement and fluid resuscitation. Hemodialysis may be effective for furosemide removal but is less effective for amiloride. Specific attention should be paid to potassium levels, as both hyperkalemia and hypokalemia may occur depending on the circumstances of overdose.

Storage

Store at room temperature (15-30°C) in the original container, protected from light and moisture. Keep tightly closed and out of reach of children. Do not use after the expiration date printed on the packaging. Tablets should be protected from excessive heat and humidity. Do not transfer to other containers as this may affect stability and protection from environmental factors.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Frumil is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual patient responses may vary, and treatment decisions should be based on professional medical judgment considering the patient’s complete medical history and current condition. Always follow the prescribing physician’s instructions and report any adverse effects promptly.

Reviews

Clinical studies demonstrate Frumil’s efficacy in maintaining normokalemia while providing effective diuresis in 85% of patients with congestive heart failure. In a 12-month study of 450 patients, 78% showed improved edema control without requiring additional potassium supplementation. Healthcare providers report high satisfaction with its balanced approach to fluid management, particularly in elderly patients and those with comorbid conditions requiring careful electrolyte monitoring. Patient reviews indicate improved quality of life due to reduced swelling and decreased frequency of dose adjustments compared to single-agent diuretic therapy.