P - Contraindicated in pregnancy
L - Contraindicated in lactation
LI - Lab *
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Volume depletion& electrolyte imbalance, dry mouth, thirst, lethargy, drowsiness, muscle pain, & cramps, hypotension, hypersensitivity reactions e.g. rashes, photosensitivity, thrombocytopenia, jaundice, pancreatitis, fatigue, weakness may preciptate an attack of gout; impotence, hyperglycaemia, anorxia, gastric irritation, nausea, vomiting, constiption, diarrhoea, sialadenitis, dizziness, raised Ca concentration. Hypersensitivity reactions.
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Existing electrolyte disturbances, hepatic cirrhosis, severe heart failure, oedema, elderly, renal impairment. Monitor for signs or fluid & electrolyte disturbance. Hepatic impairment, DM, gout, hyperlipidaemia, hypercalcae,ia, hyperuricaemia, ECG; LVH (Extrasystoles). May axacerbate or activate SLE in susecptible patients.
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May cause hyponatraemia when used with carbamazepine. May increase risk of toxicity when used with allopurinol or tetracyclines. Potentiates hypotensive effect of <!-- @page { margin: 0.79in } P { margin-bottom: 0.08in } --> <!-- @page { margin: 0.79in } P { margin-bottom: 0.08in } -->α blockers & ACE inhinbitors. Diuretic- induced hypokalaemia may increase the toxicity of digitalis glycosides and risk of arrhythmias when used with drugs that prolong QT inteval. May increase serum concentrations of lithium when used together. Concurrent use with alcohol, barbiturates & opoids may enhance diuertic - enhanced orthostatic hypotension. Antihypertensive effect may be reduced by corticosteriods, NSAIDs or carbenoxolone. May enhance the nephrotoxicity of NSAIDs. Enhnaces neuromuscular blocking action of competitive muscle relaxants. Impaired control of diabetics by oral hypoglycaemic agents.
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Oral
Oedema associated with heart failure:
Adult: Usual dosage: 25-100 mg dialy in the morning, may reduce to 25-50mg daily or intermittently. Up to 200 mg daily may be used as initial doses in severe cases.
Nephrogenic diabetes Insipidus
Adult: Initial dose: up to 100mg daily.
Child: Initially, 1-2 mg/kg/day in 1-2 divided doses; <6 months; up to 3 mg/kg/day.
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Contraindicated in pregnancy
Contraindicated in lactation
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Severe hepatic & renal impairment, Addison's disease, preexisting hypercalcaemia, anuria, sulphonamide allaergy. Pregnancy & lactation.
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