Furosemide

• Diuretic
• Lowers blood pressure
• Also used to treat oedema (buildup of fluid in the body)
• Take on an empty stomach

Furosemide Aurobindo 40 mg belongs to a group of medicines called loop diuretics (also known as water tablets). Furosemide tablets can be used to stop the buildup of extra water in your body. The tablets work by helping you to pass more water and salts (via urine) than you usually do. Furosemide is used to treat:

• Fluid retention (oedema) caused by a heart, kidney or liver condition.
• Fluid retention in the lungs (pulmonary oedema).
• Mild to moderate hypertension (high blood pressure). For severe high blood pressure, combined treatment with other blood pressure-lowering medications is recommended.
• Sudden acute elevation of calcium level in the bloodstream (acute hypercalcemia).

Daily dose and duration must be determined by a doctor. Always take Furosemide tablets exactly as your doctor has instructed you.

Dosage

The general recommended dose in adults is:

• For oedema caused by a heart condition

The usual initial dose is 20 mg to 80 mg a day, divided in two to three doses. The maintenance dose is 40 mg every other day. The maximum daily dose is 1500 mg.

• For oedema caused by a kidney or liver condition

The usual initial dose is 40 mg to 80 mg a day, in one dose or divided in two to three doses. The maintenance dose is 40 mg every other day. The maximum daily dose is 1500 mg.

• For hypertension

Furosemide Aurobindo 40 mg should only be used in combination with other antihypertensive medicines (blood pressure-lowering medicines). Your doctor will tell you how many tablets to take.

• For pulmenary oedema and acute hypercalcemia

The starting and maintenance dose is 40 mg every other day. In severe cases, it may be necessary to start with 40 mg a day or 80-120 mg a day. The maximum daily dose is 1500 mg.

In children, the dose is worked out according to the child's weight (guideline: 1-3 mg for each kilogram of the child's body weight, up to a maximum of 40 mg per day).

Swallow the tablets or tablet parts with a drink of water on an empty stomach. Do not chew the tablets.

If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor or pharmacist.

Driving/alcohol

In rare cases, Furosemide tablets may affect your ability to react, especially in the early stages of treatment, when changing medication or in combination with alcohol. Do not drive or operate machinery if you feel less alert, dizzy or have blurred vision after taking Furosemide tablets.

If you take more or fewer Furosemide tablets than you should

If you have taken more Furosemide tablets than you should, contact your doctor or pharmacist immediately.

Forgot to take a dose? Do not take a double dose to make up for a forgotten dose. If you have forgotten to take a dose, you may take the missed dose unless it is almost time for your next scheduled dose. In this case, you should continue as normal.

For more information on how to use Furosemide, please see the package leaflet.

Furosemide is not suitable for everyone. Do not take Furosemide tablets if:

• You are allergic (hypersensitive) to furosemide or any other ingredient in Furosemide Aurobindo 40 mg tablets (see section ‘What Furosemide contains').
• You are allergic to sulfonamides (a group of medicines used to treat bacterial infections). You may also be allergic to furosemide.
• Your doctor has told you that you have a low blood volume or are dehydrated.
• You are not passing any water (urine) or have been told by doctor that you have kidney failure.
• You have too little potassium in your blood. Low potassium (hypokalemia) may, in severe cases, cause muscle craps, muscle weakness or fatigue.
• You have too little sodium in your blood (hyponatremia).
• You have severe liver problems (precomatose and comatose hepatic encephalopathy).

When should this medicine be used with caution? Talk to your doctor or pharmacist before taking this medicine if:

• You have low blood pressure (hypotension).
• You are on other medicines or have other medical conditions that are risks for a drop in blood pressure.
• You have (latent) diabetes mellitus.
• You have gout (characterised by painful joints due to elevated uric acid levels).
• You have kidney problems and liver disease (hepatorenal syndrome).
• You have low blood protein levels (hypoproteinemia).
• You are going to give this medicine to a baby that was born too early.
• You are taking certain medicines for liver cirrhosis.
• You have kidney problems or peripheral oedema due to mechanical obstruction of the urinary tract.

Pregnancy and breastfeeding If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Furosemide passes through the placenta and hence should not be given during pregnancy unless your doctor feels it is extremely necessary. If it is given in cases of swelling or water retention, the growth of the baby must be regularly monitored.

Furosemide passes into the milk and may inhibit secretion of milk. Hence it should be avoided in breastfeeding women.

Other medicines and Furosemide

Some medicines can interact with Furosemide Aurobindo 40 mg which can significantly alter their effects. These medicines include:

• Corticosteroids (adrenal cortex hormones).
• Carbenoxolone.
• Laxatives (excessive use).
• Alcohol (increased use).
• Certain medicines for heart problems.
• Medicines for diabetes.
• Medicines to raise blood pressure.
• Muscle relaxants.
• Certain antibiotics.

For a full list of medicines that interact with Furosemide, see the package leaflet.

For a complete list of warnings, see the package leaflet.

Like all medicines, this medicine can cause side effects, although not everybody gets them. Many of the side effects that can occur with Furosemide Aurobindo 40 mg are related to the depletion of water and salts from the body. Furosemide can cause an excessive depletion of bodily fluids (e.g., passing urine more often than normal) and minerals (sodium, potassium, magnesium, calcium).

This can cause side effects, such as:

• Abnormal blood count, such as blood platelet or white blood cell deficiency, or an increase in certain substances in the blood.

If you have a shortage of sodium (sodium deficiency):

• Cramp in the calf muscles.
• Loss of appetite.
• Listlessness.
• Feeling of weakness.
• Dizziness.
• Drowsiness.
• Vomiting.
• Confusion.

If you have a shortage of potassium (potassium deficiency):

• Muscular weakness and the inability to contract one or more muscles (paralysis).
• Digestive problems such as vomiting, flatulence and constipation.
• Increased excretion of urine.
• Heart problems.
• In the case of severe potassium deficiency: interference with the function of the intestine or
  confusion, which can result in coma.

If you have a shortage of magnesium and calcium (magnesium and calcium deficiency):

• Increased irritability of the muscles.
• Heart rhythm disturbances.

For a complete list of side effects, see the package leaflet. If you get any side effects, talk to your doctor. This includes any possible side effects not listed in this leaflet.

What ingredients are in this medicine?

• The active substance is furosemide. Each Furosemide Aurobindo 40-mg tablet contains 40 mg of the active ingredient.
• The other ingredients are: maize starch, sodium carboxymethyl cellulose, pregelatinized maize starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate, talc.

The manufacturer of Furosemide Aurobindo 40 mg is:

Rottendorf Pharma GmbH
Ostenfelderstrasse 51-61
59230 Ennigerloh
Germany

Package leaflet
Read the package leaflet before use.