Piretanide

Oral
Hypertension

Oral
Oedema associated with heart failure

Severe hepatic or renal impairment; anuria; Addison's disease; hypercalcaemia.

Fluid and electrolyte disturbances; hepatic cirrhosis; gout; diabetes mellitus. Elderly; severe heart failure; renal or hepatic impairment. Monitor blood glucose concentrations in patients taking antidiabetics. Monitor for signs of fluid and electrolyte imbalance. May exacerbate or unmask SLE. Pregnancy and lactation.

Hyponatraemia, hypokalaemia, hypomagnesaemia, hypochloraemic alkalosis, increased Ca excretion, hypotension; nausea, GI disturbances, hyperuricaemia, gout; hyperglycaemia; temporary increase in plasma cholesterol and TG concentrations; rarely, rashes, photosensitivity, bone marrow depression (withdraw treatment), pancreatitis (with large parenteral doses), tinnitus and deafness (usually with large parenteral doses and rapid admin and in renal impairment); muscle cramps (high doses).

May increase the nephrotoxicity of cephalosporins and ototoxicity of aminoglycosides and other ototoxic drugs. Severe electrolyte disturbances may occur when used with metolazone. May increase the plasma concentrations of lithium. NSAIDs may reduce the efficacy of piretanide. Decreased natriuretic effect when used with probenecid.

Description: Piretanide inhibits the reabsorption of electrolytes primarily in the thick ascending limb of the loop of Henle and also in the distal renal tubules. It may also have a direct effect in the proximal tubules. Excretion of sodium, potassium, Ca and chloride ions is increased and water excretion enhanced.
Pharmacokinetics:
Absorption: Almost completely absorbed after oral doses.
Distribution: Extensively bound to plasma proteins.

Diuretics