Frumil is a prescription medication combining two potent diuretic agents, 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 robust fluid elimination. Healthcare providers prescribe Frumil when comprehensive edema control requires balancing effective diuresis with electrolyte stability, particularly in patients at risk of hypokalemia.

Features

• Contains 5mg amiloride hydrochloride and 40mg furosemide per tablet
• Potassium-sparing and loop diuretic combination therapy
• Film-coated tablets for oral administration
• Typically prescribed as once-daily or twice-daily regimen
• Manufactured under strict pharmaceutical quality standards
• Available in calendar blister packs for dosing compliance

Benefits

• Provides effective reduction of fluid retention and edema through dual diuretic action
• Helps maintain potassium balance, reducing the risk of hypokalemia compared to furosemide monotherapy
• Supports management of underlying conditions contributing to fluid overload
• May reduce the need for separate potassium supplementation in many patients
• Can improve symptoms of breathlessness and swelling associated with fluid overload
• Offers convenient combination therapy in a single tablet formulation

Common use

Frumil is primarily indicated for the treatment of edema (fluid retention) where potassium conservation is desirable. This includes edema associated with congestive cardiac failure, cirrhosis of the liver, and the nephrotic syndrome. It may also be used in other clinical situations where both potent diuresis and potassium conservation are required, as determined by a healthcare professional. The medication is typically prescribed when patients have demonstrated a need for diuretic therapy but have experienced or are at risk of developing low potassium levels with other diuretics.

Dosage and direction

The dosage of Frumil must be individualized based on the patient’s clinical response and electrolyte status. The usual starting dose is one tablet daily, preferably taken in the morning with food to minimize gastrointestinal discomfort. Depending on therapeutic response, the dosage may be increased to two tablets daily, taken as a single morning dose or divided into two doses (morning and early afternoon). Higher doses require careful medical supervision. Patients should be advised to take Frumil at approximately the same time each day to maintain consistent therapeutic effects. Dosage adjustments may be necessary for elderly patients or those with renal impairment.

Precautions

Patients taking Frumil should undergo regular monitoring of electrolytes, particularly potassium, sodium, and magnesium, especially during initial therapy and after dosage adjustments. Blood urea nitrogen and serum creatinine should be monitored periodically to detect any deterioration in renal function. Caution is advised in patients with diabetes, as hyperglycemia and glycosuria may occur. Patients should be advised to avoid excessive potassium intake from food or supplements unless specifically directed by their physician. Adequate hydration should be maintained, but excessive fluid intake should be avoided. Alcohol, sedatives, and narcotics may potentiate orthostatic hypotension.

Contraindications

Frumil is contraindicated in patients with hyperkalemia (serum potassium levels greater than 5.5 mEq/L), anuria, acute renal insufficiency, significant renal impairment, hypersensitivity to amiloride, furosemide, or sulfonamide-derived drugs, and in patients receiving other potassium-sparing diuretics or potassium supplements. It should not be used in patients with Addison’s disease or severe hepatic failure. The combination is contraindicated in pregnancy unless the potential benefit justifies the potential risk to the fetus, and generally should be avoided during breastfeeding.

Possible side effects

Common side effects may include dizziness, headache, dry mouth, gastrointestinal disturbances (nausea, vomiting, diarrhea, or constipation), muscle cramps, and fatigue. Less frequently, patients may experience orthostatic hypotension, increased blood glucose levels, electrolyte imbalances (including hyperkalemia, hyponatremia, or hypochloremia), rash, photosensitivity, or changes in liver function tests. Rare but serious adverse effects include severe allergic reactions, pancreatitis, blood dyscrasias, and tinnitus or hearing loss (usually reversible). Patients should report any unusual symptoms to their healthcare provider promptly.

Drug interaction

Frumil may interact with several medications including other antihypertensive agents (potentiating hypotensive effects), lithium (increased lithium toxicity risk), nonsteroidal anti-inflammatory drugs (may reduce diuretic efficacy), digoxin (altered electrolyte balance may affect toxicity), diabetes medications (may alter glucose control), and other potassium-affecting drugs. Concomitant use with angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or cyclosporine may increase the risk of hyperkalemia. Always inform healthcare providers of all medications, including over-the-counter drugs and supplements.

Missed dose

If a dose of Frumil is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one. If multiple doses are missed or uncertainty exists about dosing, patients should contact their healthcare provider for guidance. Consistent dosing is important for maintaining therapeutic effect while minimizing side effects.

Overdose

Symptoms of Frumil overdose may include profound diuresis with electrolyte depletion (particularly dehydration, hyponatremia, hypokalemia, or hyperkalemia), circulatory collapse, cardiac arrhythmias, and gastrointestinal disturbances. In case of suspected overdose, immediate medical attention should be sought. Treatment is supportive and symptomatic, focusing on electrolyte correction and fluid replacement. Gastric lavage or activated charcoal may be considered if ingestion was recent. Hemodialysis may not be effective for removing significant amounts of either component due to high protein binding.

Storage

Store Frumil tablets at room temperature (15-30°C or 59-86°F) in their original container, protected from light and moisture. Keep the medication out of reach of children and pets. Do not use Frumil beyond the expiration date printed on the packaging. Properly discard any unused medication that is no longer needed or has expired according to local guidelines for medication disposal, typically through medication take-back programs rather than flushing down toilets or throwing in household trash.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Frumil is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual patient needs may vary, and only a healthcare provider can determine the appropriate treatment based on a complete medical assessment. Patients should not initiate, discontinue, or change their dosage of Frumil without consulting their physician. The complete prescribing information should be consulted before initiating therapy.

Reviews

Clinical studies and patient experiences generally indicate that Frumil is effective in managing edema while helping to maintain potassium balance. Many healthcare providers appreciate the combination therapy for reducing pill burden and improving adherence compared to separate prescriptions. Patients often report significant improvement in edema-related symptoms, though some note the need for careful monitoring of side effects. The medication has been used clinically for decades with a well-established safety profile when used appropriately under medical supervision. Individual responses may vary, and ongoing physician assessment is essential for optimal outcomes.