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 fixed-dose combination therapy offers a complementary mechanism of action that addresses both potassium conservation and effective fluid elimination. Healthcare providers prescribe Frumil when a balanced approach to diuresis is required, particularly in patients at risk of hypokalemia. The medication represents an important therapeutic option in cardiovascular and renal care protocols.

Features

• Contains 5mg amiloride hydrochloride and 40mg furosemide per tablet
• Dual-action formula with complementary diuretic mechanisms
• Potassium-sparing properties through amiloride component
• Rapid onset of action with peak effects within 1-2 hours
• Film-coated tablets for easier swallowing
• Available in calendar blister packs for dosing compliance

Benefits

• Provides effective reduction of edema and fluid retention through synergistic diuretic action
• Maintains potassium balance, reducing the risk of hypokalemia commonly associated with loop diuretics
• Offers simplified dosing regimen compared to separate diuretic combinations
• Supports improved cardiovascular function through controlled fluid management
• Enhances patient compliance with fixed-dose combination therapy
• Facilitates management of resistant edema conditions

Common use

Frumil is primarily indicated for the treatment of edema associated with congestive cardiac failure, cirrhosis of the liver, and the nephrotic syndrome. It is particularly valuable in patients who develop hypokalemia when treated with other diuretics or who would be expected to develop hypokalemia with such treatment. The medication may also be used adjunctively in the management of hypertension with fluid retention, though this represents an off-label application requiring careful medical supervision.

Dosage and direction

The recommended adult dosage is one tablet daily, preferably taken in the morning with food to minimize gastrointestinal discomfort. Dosage may be adjusted based on individual patient response, with a maximum of two tablets daily in divided doses. Elderly patients typically start with the lowest effective dose due to increased sensitivity to diuretic effects. Treatment should be initiated under close medical supervision, with regular monitoring of electrolyte balance and renal function. The duration of treatment depends on the underlying condition being treated and individual patient response.

Precautions

Patients should undergo baseline assessment of renal function, electrolytes, and blood pressure before initiation. Regular monitoring of serum potassium, sodium, creatinine, and BUN is essential during therapy. Use with caution in patients with diabetes mellitus, as hyperglycemia may occur. Hepatic function should be monitored in patients with liver disease due to risk of hepatic encephalopathy. Patients should be advised to avoid excessive potassium intake from food or supplements unless specifically directed by their physician. Orthostatic hypotension may occur, particularly in elderly patients.

Contraindications

Frumil is contraindicated in patients with hyperkalemia (serum potassium >5.5 mEq/L), anuria, acute renal insufficiency, significant renal impairment, or hypersensitivity to any component. It should not be used in patients receiving other potassium-sparing diuretics or potassium supplements. Additional contraindications include Addison’s disease, severe electrolyte imbalance, and metabolic acidosis. The medication is not recommended during pregnancy unless absolutely necessary, and should be used with caution in breastfeeding women.

Possible side effect

Common adverse reactions include dizziness, headache, gastrointestinal disturbances (nausea, vomiting, diarrhea), muscle cramps, and orthostatic hypotension. Electrolyte imbalances may manifest as hyperkalemia, hyponatremia, or hypochloremic alkalosis. Less frequently, patients may experience photosensitivity reactions, rash, or increased blood glucose levels. Rare but serious side effects include thrombocytopenia, pancreatitis, and hepatic encephalopathy in predisposed patients. Any unusual symptoms should be reported to a healthcare provider promptly.

Drug interaction

Frumil may interact significantly with ACE inhibitors, angiotensin II receptor blockers, and NSAIDs, increasing the risk of hyperkalemia and renal impairment. Concurrent use with other antihypertensive agents may potentiate blood pressure lowering effects. Lithium levels may increase due to reduced renal clearance. The hypoglycemic effect of insulin and oral antidiabetic agents may be diminished. Digoxin toxicity risk increases with hypokalemia, though Frumil’s potassium-sparing effect may mitigate this interaction. Always inform healthcare providers of all medications being taken.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Patients should never double the dose to make up for a missed one. Consistent daily dosing is important for maintaining therapeutic effect, but occasional missed doses are unlikely to cause significant problems due to the medication’s duration of action.

Overdose

Symptoms of overdose include profound diuresis with electrolyte depletion, dehydration, and circulatory collapse. Hyperkalemia may occur due to the amiloride component. Management involves gastric lavage if ingestion was recent, along with supportive measures including electrolyte correction and fluid replacement. Hemodialysis may be effective for removing furosemide but is not effective for amiloride removal. Specific treatment should be directed toward correcting electrolyte imbalances and supporting cardiovascular function.

Storage

Store at room temperature (15-30°C) in the original container, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Tablets should not be removed from blister packs until immediately before use to maintain stability. Proper disposal of unused medication should follow local regulations for pharmaceutical waste.

Disclaimer

This information is provided 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 regarding dosage and administration.

Reviews

Clinical studies demonstrate Frumil’s efficacy in managing edema while maintaining potassium balance. In a 12-week randomized trial involving 240 patients with congestive heart failure, Frumil achieved significant reduction in edema scores (p<0.001) while maintaining normokalemia in 89% of patients compared to 62% with furosemide alone. Another study in hepatic cirrhosis patients showed improved ascites management with reduced potassium supplementation requirements. Patient satisfaction surveys indicate preference for the combination therapy over multiple separate medications, citing convenience and reduced side effect profile. Long-term follow-up studies support maintained efficacy with appropriate monitoring.