Uremide 20

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NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia.

frusemide

Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about UREMIDE 20. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking UREMIDE 20 against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine.

You may need to read it again.

What UREMIDE 20 is used for

UREMIDE 20 contains the active ingredient frusemide.

Frusemide belongs to a family of drugs called diuretics. A diuretic helps reduce the amount of excess fluid in the body by increasing the amount of urine produced.

Frusemide used to treat swelling of the ankles, feet, legs or even the brain or lungs. This swelling is called oedema and can occur in some heart, lung, liver or kidney conditions.

Frusemide may be used in some patients with more serious kidney problems who may have some fluid retention.

Frusemide may also be used to lower high blood pressure (which is also called hypertension).

Everyone has blood pressure. This pressure helps move your blood around your body. Your blood pressure may be different at different times of the day, depending on how busy or worried you are. You have hypertension (high blood pressure) when your blood pressure stays higher than is needed, even when you are calm and relaxed.

If high blood pressure is not treated it can lead to serious health problems, including stroke, heart disease and kidney failure.

Frusemide may be taken alone or in combination with other medicines to treat your condition.

Ask your doctor if you have any questions about why this medicine has been prescribed for you.

Your doctor may have prescribed it for another reason.

This medicine is not addictive.

This medicine is available only with a doctor's prescription.

Before you take UREMIDE 20

When you must not take it

Do not take UREMIDE 20 if you have:

certain kidney problems

no production or no passing of urine

low blood pressure (hypotension)

low sodium levels in your blood

low potassium levels in your blood

dehydration.

Do not take UREMIDE 20 if you have an allergy to:

any medicine containing furosemide

any of the ingredients listed at the end of this leaflet

medicines called sulfonamides (e.g. some types of antibiotics which are also referred to as 'sulfur antibiotics') or sulfonylureas which are medicines which can be used to treat diabetes.

Some of the symptoms of an allergic reaction may include skin rash, itching, shortness of breath or swelling of the face, lips or tongue, which may cause difficulty in swallowing or breathing.

Do not take UREMIDE 20 if you are pregnant.

Do not take UREMIDE 20 if you are breastfeeding or planning to breast-feed.

The active drug, frusemide, passes into breast milk and there is a possibility your baby may be affected.

Do not take this medicine after the expiry date printed on the pack.

If you take it after the expiry date has passed, it may not work as well.

Do not take frusemide if the packaging is torn or shows signs of tampering.

If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start taking this medicine, talk to your doctor.

Before you start to take it

Tell your doctor if you have allergies to:

any of the ingredients listed at the end of this leaflet

any other medicines called sulfonamides or sulfonylureas

any other medicines, foods, preservatives or dyes.

Tell your doctor if you have or have had any of the following medical conditions:

liver problems

kidney problems

heart problems

high cholesterol levels

asthma

diabetes

gout, a disease with painful, swollen joints

passing less urine than is normal for you

difficulty passing urine

no production or no passing of urine

prostate problems

SLE (Systemic Lupus Erythematosus), a disease affecting the skin, joints and kidneys.

Tell your doctor if you are pregnant or plan to become pregnant.

Like most medicines of this kind, UREMIDE 20 is not recommended to be used during pregnancy. If there is a need to consider UREMIDE 20 during your pregnancy, your doctor will discuss the risks and benefits of taking it if you are pregnant.

Tell your doctor if you are breastfeeding or planning to breast-feed.

UREMIDE 20 passes into breast milk and there is a possibility your baby may be affected. Your doctor will discuss the risks and benefits of taking it if you are breast-feeding or planning to breast-feed.

Tell your doctor if you are on a salt restricted diet.

If you have not told your doctor about any of the above, tell them before you start taking UREMIDE 20.

Taking other medicines

Tell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.

Some medicines should not be taken with frusemide. This includes large amounts of laxatives.

Some medicines and UREMIDE 20 may interfere with each other. These include:

certain other fluid tablets or diuretic medicines

medicines used to treat high blood pressure and some other heart conditions, especially ACE inhibitors or angiotensin receptor antagonists

digoxin and other medicines used to treat heart failure

NSAIDs (non-steroidal anti-inflammatory drugs) and aspirin, medicines used to relieve pain, swelling and other symptoms of inflammation, including arthritis

medicines used to relax muscles before or during surgery

lithium, a medicine used to treat mood swings and some types of depression

medicines used in emergency situations such as adrenaline and noradrenaline

cisplatin, a medicine used to treat cancer

theophylline, a medicine used to treat asthma

certain antibiotics, especially cephalosporins

amphotericin, a medicine used to treat fungal infections

barbiturates, medicine used to treat epilepsy, to produce calmness, or to help you sleep

narcotic/strong pain killers such as codeine and morphine

insulin and tablets used to treat diabetes

sucralfate, a medicine used to treat stomach ulcers

anticonvulsant medicines such as chloral hydrate or phenytoin

corticosteroids such as cortisone, prednisone or dexamethasone

medicines used during scans to see the images of your body.

These medicines may be affected by UREMIDE 20 or may affect how well it works. You may need different amounts of your medicines or take different medicines.

You should not eat large amounts of liquorice when you are taking UREMIDE 20.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine.

How to take UREMIDE 20

How much to take

Follow all directions given to you by your doctor or pharmacist carefully.

They may differ from the information contained in this leaflet.

Ask your doctor or pharmacist if you are unsure of the correct dose for you.

They will tell you exactly how much to take.

Follow the instructions they give you. If you take the wrong dose, frusemide may not work as well and your problem may not improve.

How to take it

Take the tablets with a glass of water.

When to take it

UREMIDE 20 tablets are usually taken once or twice a day.

Take UREMIDE 20 tablets on an empty stomach. For example, one hour before food or two hours after food.

Food can interfere with the absorption of frusemide tablets.

Take your medicine at about the same time each day unless your doctor tells you otherwise.

Taking it at the same time each day will have the best effect. It will also help you remember when to take it.

If your doctor prescribes UREMIDE 20 tablets to be taken once a day, it is best done in the morning, for example, before breakfast.

If you are taking UREMIDE 20 tablets more than once a day, take your first dose immediately before breakfast and take your last dose around 2:00 pm (on an empty stomach), unless your doctor tells you otherwise.

Frusemide may increase the amount of urine you pass; it will also increase the number of times you need to go to the toilet. By taking your last dose around 2:00 pm, there may be less chance that your sleep is disturbed.

How long to take it

Oedema:

Continue taking your medicine for as long as your doctor tells you.

The medicine helps control your condition and lowers the fluid buildup in your body.

Hypertension:

Continue taking your medicine for as long as your doctor tells you.

The medicine helps control your blood pressure, but it does not cure it. Continue taking the medicine until your doctor tells you to stop.

Ask your doctor or pharmacist if you are not sure how long to take the medicine for.

If you forget to take it

Do not try to make up for missed doses by taking more than one dose at a time.

This may increase the chance of getting an unwanted side effect.

If it is almost time for your next dose, skip the dose you missed and take the next dose when you are meant to.

If there is still a long time to go before your next dose, take it as soon as you remember, and then go back to taking it as you would normally.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering when to take your medicine, ask your pharmacist for hints.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre (Australia telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much UREMIDE 20. Do this even if there are no signs of discomfort or poisoning.

You may need urgent medical attention.

If you take too much frusemide, you may feel confused, dehydrated, dizzy or you may pass excessive urine.

While you are using UREMIDE 20

Things you must do

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking UREMIDE 20.

Tell any other doctors, dentists and pharmacists who treat you that you are taking this medicine.

If you are going to have surgery, tell the surgeon or anaesthetist that you are taking this medicine.

Your blood pressure may drop suddenly.

If you become pregnant while taking this medicine, tell your doctor or pharmacist immediately.

Tell your doctor if you have excessive vomiting or diarrhea while taking frusemide or if you experience any of the following symptoms:

dry mouth or thirst

fainting

weakness, tiredness or drowsiness

muscle pain or cramps

fast heart beat

passing less urine than normal.

If you experience these symptoms, you may be dehydrated because you are losing too much water.

Make sure you drink enough water during any exercise and during hot weather when you are taking frusemide, especially if you sweat a lot.

If you do not drink enough water while taking frusemide, you may feel faint or light-headed or sick. This is because your blood pressure is dropping suddenly and you are dehydrating. If you continue to feel unwell, tell your doctor.

If you are about to have any blood tests, tell your doctor that you are taking this medicine.

It may interfere with the results of some tests.

If you are taking frusemide to treat high blood pressure, make sure you have your blood pressure checked when your doctor says to make sure frusemide is working properly.

Things you must not do

Do not take UREMIDE 20 to treat any other complaints unless your doctor tells you to.

Do not give your medicine to anyone else, even if they have the same condition as you.

Do not stop taking your medicine or change the dosage without checking with your doctor.

Things to be careful of

If you feel light-headed, dizzy or faint, get up slowly when getting out of bed or standing up.

You may feel light-headed or dizzy when you begin to take frusemide. This is because your blood pressure is falling suddenly. Standing up slowly, especially when you get up from beds or chairs, will help your body get used to the change in position and blood pressure. If this problem continues or gets worse, talk to your doctor.

Be careful driving or operating machinery until you know how UREMIDE 20 affects you.

Diuretic medicines may cause dizziness or light-headedness in some people. Make sure you know how you react to your medicine before you drive a car, operate machinery, or do anything else that could be dangerous if you are dizzy or lightheaded.

If this occurs do not drive.

If you drink alcohol or take strong painkillers, dizziness or light-headedness may be worse.

The effects of alcohol could be made worse while taking frusemide. It is not recommended that you drink alcohol while taking frusemide.

If you are taking frusemide for a long period of time, you should check with your doctor to determine whether or not you should eat more potassium-containing foods or take potassium supplements. However, increasing the amount of potassium in your diet may not be necessary and could be harmful. Check with your doctor.

Frusemide may cause your skin to become more sensitive to the sun. If this happens you should take care to wear protective clothing including a hat and sun block when you are outside.

Things that may help your condition

Some self-help measures suggested below may help your condition.

alcohol - your doctor may advise you to limit your alcohol intake.

diet - eat a healthy diet which includes plenty of fresh vegetables, fruit, bread, cereals and fish. Also eat less fat and sugar.

exercise - regular exercise helps reduce blood pressure and helps the heart get fitter, but it is important not to overdo it.

Walking is a good exercise, but try to find a route that is fairly flat. Before starting any exercise, ask your doctor about the best kind of program for you.

salt - if you have high blood pressure, your doctor may advise you to watch the amount of salt in your diet. To reduce your salt intake you should avoid using salt in cooking or at the table.

smoking - your doctor may advise you to stop smoking or at least to cut it down.

weight - your doctor may suggest that you lose some weight to help lower your blood pressure and help lessen the amount of work your heart has to do. Some people may need a dietician's help to lose weight.

Talk to your doctor or pharmacist about these measures and for more information.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking UREMIDE 20.

This medicine helps most people with high blood pressure or fluid retention, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. Your doctor has weighed the risks of using this medicine against the benefits they expect it will have for you.

You may need medical attention if you get some of the side effects.

Do not be alarmed by the following lists of side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

very dry mouth or unusual thirst

weight loss

weakness or tiredness

numbness or tingling in the hands and/or feet

calf muscle spasms

muscle pains or cramps

restlessness

drowsiness or a lack of energy

dizziness or light-headedness

headache

fever

vomiting or nausea

diarrhoea

blurred or impaired vision

unusual bleeding or bruising under the skin

ringing or buzzing in the ears

confusion.

These are more common side effects of frusemide. Mostly they are mild or short-lived.

Tell your doctor as soon as possible if you notice any of the following:

irregular or fast heart beat

passing less urine than is normal for you

severe stomach pain, often with nausea or vomiting

severe dizziness or a spinning sensation

increased sensitivity to sunlight

flaking or peeling of the skin

symptoms of anaemia such as tiredness, being short of breath when exercising, dizziness and looking pale

frequent infections such as fever, severe chills, sore throat or mouth ulcers

bleeding or bruising more easily than normal, nose bleeds

loss of control of your bladder or bowels (incontinence)

gout, a disease with painful, swollen joints

deafness or ringing in the ears.

These may be serious side effects of frusemide. You may need urgent medical attention. Serious side effects are uncommon.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

sudden signs of allergy such as rash, itching or hives (pinkish, itchy raised areas) on the skin, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble breathing

chest pain

fainting or having a rapid, weak pulse

lockjaw

red, often itchy spots similar to the rash seen with measles which starts on the limbs and sometimes on the face and body. The spots may blister and may progress to form raised red, pale-centred marks. Those affected may have fever, sore throat, headache with or without diarrhoea.

yellowing of the skin and/or eyes (jaundice).

These are serious side effects. You may need urgent medical attention or hospitalisation. These side effects are very rare.

Tell your doctor or pharmacist if you notice anything that is making you feel unwell.

Other side effects not listed above may also occur in some people.

Ask your doctor or pharmacist to answer any questions you may have.

After using UREMIDE 20

Storage

Keep your tablets in the bottle until it is time to take them.

If you store your frusemide tablets out of the container they may not keep well.

Keep your frusemide tablets in a cool dry place where the temperature stays below 25°C.

Do not store frusemide tablets or any other medicine in the bathroom, near a sink, or on a window sill.

Do not leave it in the car.

Heat, sunlight and dampness can destroy some medicines.

Keep it where children cannot reach it.

A locked cupboard at least one-and a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.