Furantril 40 mg. 12 tablets

WHAT furantril AND WHAT IT IS USED
Furantril increases the excretion of accumulated overtime liquids at
diseases associated with keeping them in tissues such as heart
failure, impaired liver function and kidney during treatment with certain medicines. Reduces high blood pressure, reducing the amount of sodium, chlorine and fluids in the body, by increasing the excretion with the urine.

Furantril used for treatment of:
Swellings, which are caused by:
congestive heart failure;
liver failure and cirrhosis:
kidney disease (including nephrotic syndrome):
burns;
swelling when treated with certain agents (hormones from the adrenal gland Adrenal Corticotropin hormone, oral contraceptives, etc.);
High blood pressure - hypertension (alone or in combination with other medicines that lower blood pressure) in patients substandard treatment with another type of diuretic (thiazide diuretics).

2. BEFORE YOU TAKE furantril
Do not take furantril at:
Allergy or hypersensitivity to the active substance or to any of the ingredients of furantril;
Allergy or hypersensitivity to sulfonamides (sulfonamide antibiotics or sulfonylureas antidiabetic agents) because of possible cross allergy furantril;
Severe hypovolemia, dehydration and / or hypotension (low blood volume depletion, loss of fluids or low blood pressure);
Anuria (production of urine) or renal failure with anuria, which is not affected by furantril;
Prekomatozni or comatose states associated with hepatic encephalopathy (severe impairment of brain function due to liver failure);
Digitalis toxicity (poisoning with drugs affecting heart function);
Renal failure due to poisoning by substances harmful to the kidneys and liver;
Acute poisoning with salicylates;
Expressed violation of the electrolyte composition of blood by reducing sodium and potassium (hypokalemia, hyponatremia);
Pregnancy and lactation.
Take special care with furantril
There is a risk of hearing damage, especially when high doses furantril simultaneously with other medications affecting hearing (eg. Aminoglycoside antibiotics), and in patients with renal, cardiac and hepatic insufficiency.

It requires careful monitoring during therapy with furantril in the following patients:
Patients with low blood pressure;
Patients in whom significant reduction in blood pressure is a significant risk - patients with marked narrowing of the vessels of the heart or blood vessels brain;
Patients with renal failure associated with severe liver disease;
Patients with reduced amount of protein in the blood (eg in connection with nephrotic syndrome) who may weaken the effect of furantril and to enhance the likelihood of hearing damage). This requires careful dose titration;
In premature babies have an increased risk of developing urinary stones. It is necessary to monitor renal function and to monitor renal ultrasound;
There is an increased risk of acute attacks of porphyria (an inherited liver disease in which the body does not produce enough hemoglobin) in the use of furantril.
Furantril should be used with caution in patients with advanced liver failure, cirrhosis and ascites (free flowing liquid in the abdominal cavity) due to the risk of sudden changes in water and electrolyte balance and development of azotemia (increased residual nitrogen bodies in the blood) and hepatic coma.
Excessive urine can cause dehydration and hypovolemia with cardiovascular collapse (sharp fall in blood pressure with transient impairment of consciousness).
It is recommended that regular monitoring of serum sodium, potassium and creatinine during the adoption of furantril. This is particularly important in patients at risk of developing electrolyte disturbances, and in case of loss of fluid (prolonged vomiting, diarrhea or sweating). Hypovolemia or dehydration, which are expressed disturbances in electrolyte and acid balance should be corrected, which can lead to temporary discontinuation of furantril. Treatment should be conducted against the background of a potassium rich diet, if necessary appoint concomitant use of potassium-sparing diuretics and / or potassium replacement therapy.
With longer treatment furantril should be regularly monitored and serum electrolyte concentration of uric acid, urea and blood sugar. Caution should be used furantril in patients with hypokalemia (low blood potassium), particularly with concomitant therapy with digitalis (medications to treat heart failure) due to the risk of developing arrhythmias.
Older patients are more prone to electrolyte disturbances. They have a greater risk of developing cardiovascular collapse or thromboembolism, often have kidney damage and should be treated conform doses and timing of administration.
In patients with congestive heart failure may develop hyponatremia (low sodium content in the blood).
It can manifest the development of latent diabetes and gout. In the treatment of diabetic patients need strict control of blood sugar because of the possibility of its increase.
It is possible exacerbation of symptoms of systemic lupus erythematosus (autoimmune disease).
Caution furantril should be used in patients with hypertrophy (enlargement) of the prostate and urination disorders (increased risk of urinary retention).
The normal urine output should be maintained, particularly in patients with partial obstruction of the urinary tract. We need close monitoring and regular monitoring of serum potassium, especially early in treatment.

Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

food:
It is recommended furantril be taken on an empty stomach.

Combinations not recommended:
Co-administration of furosemide and chloral hydrate is not recommended.
Furosemide may increase the risk of hearing damage when administered with aminoglycosides, ethacrynic acid and other toxic hearing drugs, especially in the presence of impaired renal function. These combinations should be avoided unless absolutely necessary.

Caution is required in the following cases:
In the case of concurrent administration of cisplatin and furosemide risk of damage to hearing.
Sucralfate decreases the effect of furosemide. Two drugs must be taken at intervals of at least two hours.
Furosemide reduces excretion of lithium salts by increased serum concentrations of lithium, may enhance the toxic effects of lithium on the heart and nervous system.
With the concomitant use of certain drugs to treat high blood pressure (ACE inhibitors or angiotensin II receptor blockers) with furosemide, may develop excessive fall in blood pressure and impairment of renal function, especially in patients with a low amount of sodium, and reduced fluid in the blood, or if antihypertensive medication administered for the first time. Treatment with furosemide, if necessary, should be suspended or its dosage should be reduced at least three days before the start of therapy with ACE inhibitors or angiotensin II receptor blockers, or before increasing their dose.
Hypokalaemia (low blood potassium) accompanying treatment with furosemide, increases sensitivity to certain drugs (digitalis glycosides and non-depolarizing neuromuscular blocking agents).

Other important interactions:
Nonsteroidal anti-inflammatory drugs, including acetylsalicylic acid may reduce the effect of furosemide. In patients with dehydration, NSAIDs can cause acute renal failure.
High doses of salicylates with furosemide may cause salicylic intoxication.
Cholestyramine and colestipol bind furosemide, with the result that the efficiency of furosemide belongs.
The diuretic activity of furosemide reduced in a combination therapy with medications such as phenobarbital, phenytoin and the like.
Furosemide may enhance the toxic effect of cephalosporins and other antibiotics on the kidneys, particularly in renal insufficiency and in high doses. Monitoring is indispensable renal function.
Corticosteroids, carbenoxolone, high doses of the herb "Licorice" and prolonged use of laxatives, taken together with furosemide lead to an increased risk of hypokalemia due to increased excretion of potassium. Any breach in the electrolyte balance (hypokalemia, hypomagnesemia) increases the risk of toxic effects of certain medications (eg. Digitalis glycosides and drugs that cause changes in the electrocardiogram).
Furosemide may potentiate the effect of antihypertensive products and other drugs with blood pressure lowering effect.
Probenecid, methotrexate and other drugs may reduce the effect of furosemide. On the other hand, furosemide may decrease renal elimination of these drugs. In use of higher doses of these drugs and furosemide, their serum levels may rise, which increases the risk of adverse reactions.
The effect of antidiabetic agents and vasopressors sympathomimetic (adrenaline and noradrenaline) can be reduced when co-administered with furosemide. The effect of curare-like muscle relaxants and of theophylline may be increased.
Coadministration of cyclosporin A with furosemide leads to an increased risk of developing gout.
Patients who received furosemide before introducing a contrast agent can receive renal impairment.
Hypotension, which causes furosemide may be enhanced by alcohol, barbiturates, opioids.

Taking furantril with food and drink
Best effect is obtained when the tablet furantril morning on an empty stomach.
It is recommended that treatment be conducted against the background of a potassium rich diet as necessary to appoint additional use of potassium-containing products.
The use of alcohol may increase the effect of furantril in terms of lowering blood pressure.

Pregnancy and lactation
Ask your doctor or pharmacist before taking any medicine.

pregnancy
Furantril crosses the placenta and should not be used during pregnancy unless absolutely necessary. In conducting such treatment is necessary to follow the development of the fetus.

breastfeeding
Furantril passes into breast milk and also inhibits the process of formation of milk, which makes it unsuitable for use in lactating women.

Driving and using machines
At the beginning of treatment furantril may be a temporary occurrence of fatigue, dizziness and decreased alertness, which affect the ability to drive and use machines.

Important information about some of the ingredients of furantril
Furantril contain lactose as an excipient, which makes it unsuitable for patients with lactose intolerance.
Due to its composition of wheat starch can not be used in patients with allergy to wheat.

3. HOW TO TAKE furantril
Always take furantril just as you have been told your doctor. If you're not sure, ask your doctor or pharmacist.
The best effect is obtained when taking the tablets in the morning on an empty stomach (at least 1/2 hour before or 2 hours after a meal). The dosage is determined by the doctor depending on the individual response, aiming to achieve maximum therapeutic effect and finding the minimum dose required to maintain the effect.

Treatment of edema
Adults: The usual starting dose is 20-80 mg once daily. If necessary, the dose may be increased to 160 mg / day, divided into 1 to 3 doses, to achieve the desired effect. The dose may be cautiously increased to maximum 600 mg / day in patients with severe edematous events. The usual maintenance dose is 40-120 mg / day. A more complete and safer influence of swelling can be achieved by intermittent administration of furantril (alternating days with drug intake for days without reception). With more prolonged use of doses above 80 mg / day should be carefully monitored clinical and laboratory parameters of patients.
Children: initial dose is typically 1-2 mg / kg body weight, once a day. If the response is unsatisfactory, the dose may be increased to 3 mg / kg body weight per day, divided into 1 to 3 doses. Not recommended daily doses higher than 40 mg / day. For maintenance treatment using the lowest effective dose.
Hypertension
Adults: The dose is determined strictly individually by seeking the minimum maintenance dose providing the desired effect. The usual starting dose is 80 mg / day in two divided doses. The dose is further determined by the progress response. At insufficient effect add other antihypertensive agents. In this case it is necessary doses of other medicines will be reduced by 50% and be carefully monitored blood pressure.
The duration of treatment is determined by the condition of the patient and periodically monitored for the development of hypokalemia and dehydration. If necessary, additional potassium is administered therapy.

Impaired renal function:
When furantril be used for treating patients with renal failure, may require the use of higher doses to achieve the desired diuresis. The total daily dose usually does not exceed 1500-2000 mg (usually administered intravenously). We need dose adjustment in the treatment of patients undergoing dialysis.

If you take more than the amount furantril
symptoms:
The clinical picture of acute or chronic overdose furantril depends mainly on the electrolyte disorders (decrease in potassium, sodium and chlorine in the blood) and the severity and consequences of dehydration due to diuresis (dry mouth, thirst, weakness, lethargy, restlessness, drowsiness, muscle pain or cramps, nausea, vomiting, confusion).
Symptoms of these disorders include reduction in circulating blood volume, blood thickening and cardiac arrhythmias, including life-threatening heart rhythm disturbances, severe decrease in blood pressure, progressing to shock, acute renal failure, thrombosis, delirious states, subdued paralysis, apathy, confusion.
In children, symptoms may include mental status changes, headache, muscle weakness and seizures.

treatment:
Treatment is symptomatic and supportive. We need to take measures to reduce absorption and elimination of the product (to induce vomiting, gastric lavage with charcoal, magnesium sulphate). It is correct dehydration, electrolyte disturbances, low blood pressure. Is not removed by dialysis. There is no specific antidote.

If you forget to take furantril
If you miss a dose, take it at the next regular intake.

4. POSSIBLE SIDE EFFECTS
Like all medicines, furantril can cause side effects, although not everybody gets them.
Most side effects occur during treatment with high doses furantril and approximately 95% were dose-dependent. The most common side effects include electrolyte disturbances (about 5%), mainly in patients with impaired renal function and in patients with renal failure receiving high dosages. Frequently observed and nephrocalcinosis (kidney stones) in the long term treatment of full-term children with structural heart disease. In patients receiving furantril more than 3 months, it can be observed a decrease of the magnesium in the blood.

Described below adverse reactions are classified according to frequency of occurrence as follows:
Very common (affecting more than 1 in 10 people);
common (affecting less than 1 in 10 but more than 1 in 100 people);
Uncommon (affecting less than 1 in 100 but more than 1 in 1,000 people);
rare (affecting less than 1 in 1,000 but more than 1 in 10 000);
very rare (affecting less than 1 in 10 000;
Not known / available data can not be estimated /.
Infections and infestations:
Not known - Fever.
Blood and lymphatic system disorders:
Uncommon - Thrombocytopenia (decreased platelet count, which increases the risk of bleeding or bruising);