Indications & Dose: ACUTE PULMONARY EDEMA IV Adult 40mg over 1-2min, increase to 80mg if no response within 1h Elderly Initially 20mg/day, increase slowly to desired response | EDEMA PO Adult Initially 20-80mg/dose; increase by 20-40mg/dose q6-8h if no response, max 600mg/day with severe edematous states Child Initially 2mg/kg/dose increase by 1-2mg/kg/dose with each succeeding dose q6-8h until satisfactory response is achieved max 6mg/kg/dose Elderly Initially 20mg/day, increase slowly to desired response | IV/IM Adult Initially 20-40mg/dose, increase by 20mg/dose if no response & administer 1-2h after previous dose, max 200mg/dose. Continuous inf: Initially 20-40mg over 1-2 min as bolus dose followed by continuous inf 10-40mg/h. If urine output is <1mL/kg/h increase to 80-160 mg/h Child Initially 1mg/kg/dose; increase by 1mg/kg/dose if no response & administer not sooner than 2h after previous dose, until a satisfactory response is achieved, administer MD at intervals of q6-12h, max 6mg/kg/dose Elderly Initially 20mg/day, increase slowly to desired response | HEART FAILURE PO Adult Initially 20-80mg/dose; increase by 20-40mg/dose q6-8h if no response, max 600mg/day with severe edematous states Child Initially 2mg/kg/dose increase by 1-2mg/kg/dose with each succeeding dose q6-8h until satisfactory response is achieved max 6mg/kg/dose Elderly Initially 20mg/day, increase slowly to desired response | IV/IM Adult Initially 20-40mg/dose, increase by 20mg/dose if no response & administer 1-2h after previous dose, max 200mg/dose. Continuous inf: Initially 20-40mg over 1-2 min as bolus dose followed by continuous inf 10-40mg/h. If urine output is <1mL/kg/h increase to 80-160 mg/h Child Initially 1mg/kg/dose; increase by 1mg/kg/dose if no response & administer not sooner than 2h after previous dose, until a satisfactory response is achieved, administer MD at intervals of q6-12h, max 6mg/kg/dose Elderly Initially 20mg/day, increase slowly to desired response | REFRACTORY HEART FAILURE PO/IV Adult Up to 8g/day Elderly Initially 20mg/day, increase slowly to desired response | RESISTANT HYPERTENSION PO Adult 20-80mg/day in 2 divided doses Elderly Initially 20mg/day, increase slowly to desired response

Precautions: DM, elderly, prostatic hyperplasia or impairment of micturition, renal/hepatic impairment

ADR: Serious: Necrotizing angiitis, acute pancreatitis, interstitial nephritis, SJS, TEN, thrombophlebitis, blurred vision, bone marrow depression, tinnitus & deafness, fluid & electrolyte imbalances, hyperuricemia, Others: hypovolemia & dehydration, muscle cramps, dry mouth, thirst, weakness, lethargy, drowsiness, GI disturbances, dizziness

DDI: Serious Sevelamer abolishes the drug efficacy in hemodialysis patients, Probenecid decreases drug renal clearance, Ranitidine/Cimetidine increases drug bioavailability, Aminoglycosides nephrotoxicity & ototoxicity, NSAIDs reduces antihypertensive & diuretic effects of drug, Colestyramine/Colestipol reduces drug absorption & its diuretic effects, Aspirin/Aliskiren/Phenytoin reduces drug plasma levels

Diet: With food

Monitor: Weight, BP, orthostasis, serum electrolytes, RFT