Aquanil 40 mg Tablet

Loop diuretic ("water tablet") for:

• Fluid retention (oedema) in heart failure, liver cirrhosis, kidney disease (including nephrotic syndrome)
• Acute pulmonary oedema (injection)
• High blood pressure (usually when kidney function is reduced)
• Promoting urine output in some kidney conditions (specialist)

Oedema (adults): 20–40 mg once daily in the morning, adjusted to response; up to 80–120 mg daily (higher doses in kidney failure, specialist).

Hypertension: 20–40 mg twice daily.

Injection (hospital): 20–40 mg slowly IV/IM; acute pulmonary oedema 40–80 mg slowly IV.

Children: 1–2 mg/kg (maximum 6 mg/kg/day) orally in 1–2 doses.

• Take in the morning (second dose early afternoon) to avoid night-time urination.
• Elderly: start with lower doses.

• No urine output (anuria), severe dehydration, low blood volume
• Severe low sodium or potassium
• Hepatic pre-coma/coma
• Allergy to furosemide or sulphonamides
• Addison's disease, digitalis toxicity

Common: passing more urine, dehydration, dizziness, low blood pressure on standing, low potassium, sodium, magnesium, raised uric acid (gout), raised blood sugar and cholesterol, muscle cramps.

Less common: nausea, rash, sun sensitivity, urinary retention in enlarged prostate.

Rare but serious: hearing loss/tinnitus (high-dose or rapid IV, especially with kidney failure), pancreatitis, severe skin reactions, low blood counts, kidney injury.

• Check potassium, sodium and kidney function regularly; potassium supplements or a potassium-sparing diuretic may be needed.
• Weigh daily in heart failure; report dizziness, cramps or very little urine.
• Diabetes, gout, prostate enlargement, liver cirrhosis: caution.
• Avoid excessive sun exposure.

Avoid in pregnancy unless clearly needed (may reduce placental blood flow). May reduce milk supply; use with caution while breastfeeding.

• Aminoglycosides, vancomycin, cisplatin (ear and kidney damage)
• Lithium (toxicity)
• Digoxin, sotalol, amiodarone (arrhythmias if potassium falls)
• NSAIDs (reduced effect, kidney injury)
• Corticosteroids, salbutamol, laxatives (more potassium loss)
• ACE inhibitors, ARBs (first-dose low blood pressure)
• Antidiabetic drugs (raised sugar)

Severe dehydration, low blood pressure, electrolyte loss, confusion, collapse. Emergency care.

Store below 30°C, protected from light (injection discolours in light — do not use if yellow).