Acuren 50

Introduction
Acuren 50 is a diuretic (water pill) medicine used to treat hypertension (high blood pressure). This medicine reduces excess fluid levels in the body and treats edema (fluid overload) associated with heart, liver, kidney, or lung disease. Acuren 50 makes you lose excess water through urine. It may be used alone or in combination with other medicines. This medicine should be taken only during day time to avoid frequent urination at night. You must take this medicine in the dose and duration as advised by the doctor and never stop it abruptly without consulting the doctor. Most people with high blood pressure do not feel ill, but if you stop taking this medicine, your condition could get worse. This may lead to your blood pressure rising up again and increase your risk of heart disease and stroke. It is important to have your blood pressure checked regularly. This medicine is only one part of a treatment program which should also include a healthy diet, regular exercise, smoking cessation, moderation of alcohol intake and weight reduction. You can eat normally while taking this medicine, but try to reduce your salt intake. Common side effects of this medicine include headache, nausea, and dizziness. Consult your doctor if these side effects bother you. Before taking this medicine, its better to let your doctor know if you are suffering from any kidney or liver disease. Also, pregnant women and breastfeeding mothers should consult doctor before taking it. You must inform doctor about all the other medicines that you are taking apart from this medicine. Regular monitoring of kidney function and electrolytes is important while using this medicine.

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Uses of Acuren 50
Hypertension (high blood pressure)
Side effects of Acuren 50
Common
Headache
Nausea
Increased blood uric acid
Decreased potassium level in blood
Glucose intolerance
Altered blood lipid level
How to use Acuren 50
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Acuren 50 is to be taken with food.
How Acuren 50 works
Acuren 50 is a diuretic which lowers blood pressure by removing extra water and certain electrolytes from the body. Over time it also relaxes blood vessels and improves blood flow.
What if you forget to take Acuren 50?
If you miss a dose of Acuren 50, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
Acuren 50 helps lower blood pressure and also removes excess water from your body.
Take it in the morning with breakfast to avoid getting up at night to urinate.
It makes you feel dizzy. Avoid driving and attention requiring activity until you know how it affects you.
Avoid alcohol intake while taking Acuren 50 as it may increase the dizziness.
It may cause a sudden drop of sodium level in blood. Avoid low sodium diet while you are taking this medication.
Monitor your blood pressure after starting Acuren 50, and notify your doctor if it does not lower down.
Notify your doctor if you experience dizziness, tiredness, or muscle weakness that does not go away.
Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
Brief Description
Indication
Hypertension, Congestive heart failure, Oedema, Diabetes insipidus, Renal tubular acidosis
Administration
Should be taken with food.
Adult Dose
Oral Hypertension Adult: Initially, 12.5 mg, may increase to 25-50 mg once daily as necessary either alone or w/ other antihypertensives. Elderly: 12.5-25 mg once daily, titrate as necessary in increments of 12.5 mg. Oedema Adult: 25-100 mg daily in 1-2 divided doses or intermittently on alternate days or on 3-5 days a wk. Elderly: 12.5-25 mg once daily, titrate as necessary in increments of 12.5 mg.

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Child Dose
Oral Hypertension Child: <6 mth 1-3 mg/kg/day in 1-2 divided doses. Max: 37.5 mg daily; 6 mth to 2 yr 1-2 mg/kg/day in 1-2 divided doses. Max: 37.5 mg daily; >2-12 yr 1-2 mg/kg/day in 1-2 divided doses Max: 100 mg daily. Oedema Child: <6 mth 1-3 mg/kg/day in 1-2 divided doses. Max: 37.5 mg daily; 6 mth to 2 yr 1-2 mg/kg/day in 1-2 divided doses. Max: 37.5 mg daily; >2-12 yr 1-2 mg/kg/day in 1-2 divided doses Max: 100 mg daily.

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Renal Dose
Renal impairment CrCl <10 mL/min: Avoid use CrCl >10 mL/min: Dose adjustment not necessary; not effective with CrCl <30 mL/min unless used in combination with loop diuretic

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Contraindication
Hypersensitivity to sulfonamide-derived drugs, anuria, severe renal impairment.
Mode of Action
Hydrochlorothiazide inhibits the reabsorption of Na and chloride in the distal tubules causing increased excretion of Na and water K and hydrogen ions.
Precaution
Patients w/ electrolyte disturbances, history of gout, allergy or bronchial asthma, DM, parathyroid disease, hypercholesterolaemia. May exacerbate SLE. Hepatic and mild to moderate renal impairment. Pregnancy and lactation. Monitoring Parameters Assess wt, input and output reports daily to determine fluid loss, BP, serum electrolytes, BUN, creatinine. Lactation: Drug excreted in breast milk; use with caution (American Academy of Pediatrics states that it is “compatible with nursing”)

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Side Effect
Electrolyte disturbances, weakness, hypotension, pancreatitis, jaundice, diarrhoea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia, aplastic anaemia, agranulocytosis, leukopenia, haemolytic anaemia, thrombocytopenia, anaphylactic reactions, necrotising angiitis, resp distress, photosensitivity, fever, urticaria, rash, purpura, hyperglycaemia, glycosuria, hyperuricaemia., muscle spasm, vertigo, paraesthesias, dizziness, headache, restlessness, renal failure, renal dysfunction, interstitial nephritis, erythema multiforme, exfoliative dermatitis, alopecia, transient blurred vision, xanthopsia, impotence. Potentially Fatal: Hypersensitivity reactions.

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Interaction
Increases toxicity of lithium. May potentiate orthostatic hypotension w/ barbiturates and narcotics. Enhanced neuromuscular blocking action of competitive neuromuscular blockers (e.g. atracurium). Increased hypokalaemic effect w/ corticosteroids, corticotropin, beta2 agonists (e.g. salbutamol). Additive effect w/ other antihypertensives. Potentiation of orthostatic hypotension w/ barbiturates or opioids. Reduced antihypertensive effect by drugs that cause fluid retention (e.g. corticosteroids, NSAIDs, carbenoxolone). Enhanced nephrotoxicity of NSAIDs. Reduced therapeutic effect of antidiabetics.