Congestive Heart Failure
Chronic Renal Failure
Inhibits sodium/potassium/chloride carrier system in ascending loop of Henle, resulting in increased urinary excretion of sodium, chloride, and water. Does not significantly alter glomerular filtration rate, renal plasma flow, or acid-base balance.
Hypersensitivity to sulfonylureas; anuria; severe electrolyte depletion.
Use Cautiously in:
CNS: dizziness, headache , nervousness.
EENT: hearing loss, tinnitus.
GI: constipation , diarrhea, dry mouth, dyspepsia , nausea, vomiting.
GU: excessive urination.
Derm: photosensitivity, rash.
Endo: hyperglycemia, hyperuricemia .
F and E: dehydration , hypocalcemia, hypochloremia , hypokalemia, hypomagnesemia , hyponatremia, hypovolemia , metabolic alkalosis.
MS: arthralgia, muscle cramps , myalgia.
Misc: increased BUN .
May increase ototoxicity.
May enhance anticoagulant activity.
May cause additive ototoxicity.
Electrolyte disturbances may predispose to digitalis-induced arrhythmias.
May increase plasma lithium levels and toxicity.
Nondepolarizing muscle relaxants
May antagonize or potentiate response to muscle relaxants.
May decrease effects of torsemide.
May reduce action of torsemide.
May impair diuretic response in patients with cirrhosis and ascites.
May decrease glucose tolerance, resulting in need for increased sulfonylurea dose.
May cause synergistic effects that may result in profound diuresis and serious electrolyte abnormalities.
Therapeutic Classification: antihypertensives
Pharmacologic Classification: loop diuretics
Absorption: 80% absorbed after oral administration.
Distribution: Widely distributed.
Protein Binding: 99%.
Metabolism/Excretion: 80% metabolized by liver, 20% excreted in urine.
Half-life: 3.5 hr.
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