Frumil is a prescription medication combining two potent diuretics, amiloride hydrochloride and furosemide, designed for the effective treatment of edema associated with congestive heart failure, liver cirrhosis, and certain kidney disorders. This synergistic formulation addresses fluid retention by targeting different parts of the nephron, promoting a balanced electrolyte excretion and reducing the risk of hypokalemia. It is indicated for use when other diuretics have proven insufficient or when potassium conservation is a clinical priority. Frumil should only be used under strict medical supervision to ensure appropriate dosing and monitoring.

Features

• Contains a fixed-dose combination of amiloride hydrochloride (5 mg) and furosemide (40 mg)
• Dual mechanism of action: amiloride acts as a potassium-sparing diuretic in the distal tubule, while furosemide acts as a loop diuretic
• Available in tablet form for oral administration
• Manufactured under strict pharmaceutical quality control standards
• Requires a prescription to ensure appropriate patient selection and monitoring

Benefits

• Effectively reduces edema and fluid overload in conditions such as congestive heart failure
• Lowers the risk of hypokalemia due to the potassium-sparing action of amiloride
• May reduce the need for additional potassium supplementation in many patients
• Can help improve symptoms like shortness of breath and swelling, enhancing quality of life
• Provides a convenient, fixed-dose combination to support adherence to treatment regimens
• Suitable for patients who have not responded adequately to single-agent diuretic therapy

Common use

Frumil is commonly prescribed for the management of edema where conservation of potassium is clinically important. This includes edema associated with congestive heart failure, hepatic cirrhosis (with ascites), and nephrotic syndrome. It may also be used in some cases of idiopathic edema or edema due to chronic kidney disease, particularly when hypokalemia is a concern with other diuretics. Frumil is not typically used as a first-line treatment but is reserved for cases where the combination therapy offers a specific advantage.

Dosage and direction

The usual adult dosage is one tablet daily, taken orally, preferably in the morning to avoid nocturia. Dosage may be adjusted based on individual patient response, electrolyte levels, and renal function. In some cases, a healthcare provider may recommend taking the tablet on alternate days. Tablets should be swallowed whole with a glass of water, with or without food, though taking with food may help reduce gastrointestinal upset. Dosage in elderly patients or those with impaired renal function should be carefully individualized and monitored.

Precautions

Patients taking Frumil should have regular monitoring of electrolytes (particularly potassium and sodium), renal function, and blood pressure. Caution is advised in patients with diabetes, as hyperglycemia may occur. Use with care in those with a history of gout, as furosemide can increase uric acid levels. Frumil may cause dizziness or lightheadedness, especially during the initial phase of therapy; patients should avoid driving or operating machinery until they know how the medication affects them. Dehydration should be avoided, and adequate fluid intake is generally recommended unless otherwise directed by a physician.

Contraindications

Frumil is contraindicated in patients with anuria, severe renal impairment (eGFR <30 mL/min), hyperkalemia, or known hypersensitivity to amiloride, furosemide, or sulfonamide-derived drugs. It should not be used in patients receiving other potassium-sparing diuretics or potassium supplements, due to the increased risk of hyperkalemia. Use is also contraindicated in cases of Addison’s disease or pre-existing elevated serum potassium levels. Frumil is not recommended during pregnancy or breastfeeding unless the potential benefit justifies the potential risk.

Possible side effect

Common side effects may include dizziness, headache, nausea, vomiting, diarrhea, or muscle cramps. Electrolyte imbalances such as hypokalemia (though less common due to amiloride), hyponatremia, or hypochloremia may occur. Hyperkalemia is a risk, particularly in patients with renal impairment or those consuming high-potassium diets. Other potential side effects include increased blood glucose, elevated uric acid, rash, photosensitivity, and orthostatic hypotension. Rare but serious side effects can include pancreatitis, tinnitus, hearing loss, or severe skin reactions.

Drug interaction

Frumil may interact with several medications, including other diuretics, ACE inhibitors, angiotensin II receptor blockers, NSAIDs, lithium, digoxin, and antihypertensive drugs, potentially increasing the risk of electrolyte disturbances or reducing efficacy. Concomitant use with other potassium-sparing agents or potassium supplements is not recommended. Caution is advised with drugs that prolong the QT interval, as electrolyte imbalances may exacerbate this risk. Always inform your healthcare provider of all medications, including over-the-counter products and herbal supplements.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not double the dose to make up for a missed one. If unsure, patients should contact their healthcare provider or pharmacist for guidance.

Overdose

Symptoms of overdose may include profound dehydration, electrolyte imbalances (such as hypokalemia or hyperkalemia), circulatory collapse, or renal failure. Treatment is supportive and includes correction of fluid and electrolyte abnormalities. Hemodialysis may not be effective for removing significant amounts of amiloride but can remove furosemide. In cases of suspected overdose, seek immediate medical attention or contact a poison control center.

Storage

Store Frumil tablets at room temperature (15–30°C), in a dry place, protected from light and moisture. Keep the medication in its original container, tightly closed, and out of reach of children and pets. Do not use Frumil beyond the expiration date printed on the packaging.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions regarding a medical condition or medication. Do not disregard professional medical advice or delay seeking it based on information provided here.

Reviews

Clinical studies and patient reports generally indicate that Frumil is effective in reducing edema while helping to maintain potassium balance. Many healthcare providers appreciate its dual-action mechanism for patients at risk of hypokalemia. Some patients note improved symptom control compared to single-agent diuretics, though individual experiences with side effects can vary. Always discuss your specific situation with your doctor to determine if Frumil is appropriate for you.