Lasilactone (Furosemide, spironolactone)
How does it work?
Lasilactone capsules contain two active ingredients, spironolactone which is a type of medicine called a potassium-sparing diuretic and furosemide is a type of medicine called a loop diuretic.
Diuretics act in the kidneys. They work by causing the kidneys to increase the amount of salts, such as potassium and sodium, which are filtered out of the blood and into the urine. When these salts are filtered out of the blood by the kidneys, they draw water alongside them. As diuretics increase the removal of salts from the blood, they also cause more water to be drawn out of the blood and into the urine.
Removing water from the blood decreases the volume of fluid circulating through the blood vessels. This subsequently decreases the pressure within the blood vessels. Diuretics such as spironolactone and furosemide can therefore be used to lower high blood pressure.
Loop diuretics like furosemide are strong diuretics that cause lots of potassium to be filtered out of the blood. This can sometimes cause the level of potassium in the blood to fall too low. A low blood potassium level is called hypokalaemia and can sometimes be dangerous, particularly for people with heart disease or liver disease.
Spironolactone works by blocking the actions of a hormone in the body called aldosterone. This hormone is produced by glands found above the kidneys called the adrenal glands. Aldosterone acts in the kidneys, where it is involved in controlling the balance of salt and water in the body.
This medicine is used in heart failure, where the pumping mechanism of the heart is less effective. It is used to relieve the symptoms of heart failure, such as the shortness of breath seen with fluid on the lungs. It can also be used to remove excess fluid that can accumulate in the body in people with cirrhosis of the liver. This fluid may accumulate in the abdomen (ascites) or in the legs (oedema).
What is it used for?
- Congestive heart failure.
- Fluid retention (ascites and oedema) in liver cirrhosis.
- Overproduction of aldosterone, a steroid hormone which regulates the salt and water balance in the body (hyperaldosteronism).
- To treat excess fluid retention causing swelling (oedema).
How do I take it?
- Lasilactone capsules should be taken with food.
- Lasilactone capsules should be swallowed with a drink of water. The number of capsules to be taken daily will vary depending on your symptoms, but all the capsules should be taken once daily, preferably in the morning.
- As diuretics cause your kidneys to produce more urine, you may find that if you take a dose too late in the day that you need to get up in the night to visit the toilet. For this reason, it is recommended that you take this medicine in the morning. Seek further advice from your doctor or pharmacist.
- This medicine may cause fatigue and dizziness. You should take care when performing potentially hazardous activities, such as driving or operating machinery, until you know how this medicine affects you and are sure you can perform such activities safely.
- While taking this medicine you may need to have regular blood tests to monitor your kidney function and the levels of salts such as potassium and sodium in your blood.
- If you experience any of the following symptoms while taking this medicine you should inform your doctor promptly, so that the amount of fluids and salts in your body can be checked: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting.
Use with caution in
- Elderly people.
- Decreased liver function.
- Decreased kidney function.
- Enlarged prostate gland (prostatic hypertrophy).
- Low blood pressure (hypotension).
- Low volume of circulating blood (hypovolaemia).
Not to be used in
- Allergy to furosemide or spironolactone.
- Allergy to medicines from the sulphonamide group, eg the antibiotic sulfamethoxazole.
- People with a low volume of fluid in their blood (hypovolaemia), eg due to blood loss or dehydration.
- High levels of potassium in the blood (hyperkalaemia).
- Very low levels of potassium in the blood (hypokalaemia).
- Very low levels of sodium in the blood (hyponatraemia).
- Kidney failure caused by poisoning with agents that have damaged the kidney or liver.
- Kidney failure that is preventing the production of urine (anuria).
- People who are losing consciousness due to liver cirrhosis that is affecting the brain.
- Inadequate production of natural steroid hormones by the adrenal glands (Addison's disease).
- Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Lasilactone capsules contain lactose).
This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.
- There is no information available about the safety of this medicine during breastfeeding. Furosemide passes into breast milk and may decrease the production of breast milk. For this reason, the manufacturer states that this medicine should not be used by women who are breastfeeding. Seek medical advice from your doctor.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Increased production of urine.
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.
- Decrease in blood pressure.
- Dry mouth.
- Visual disturbances.
- Muscle cramps.
- Skin rashes.
- Increased blood sugar level.
- Increased level of uric acid in the blood (hyperuricaemia) which may cause gout.
- Disturbances in the levels of electrolytes (eg potassium, calcium, magnesium) in the blood.
- Pins and needles (paraesthesia).
- Sensation of ringing or other noise in the ears (tinnitus).
- Abnormal enlargement of breasts in men (gynaecomastia).
- Changes in libido.
- Disturbance in the normal numbers of blood cells in the blood.
- Severe blistering skin reactions, eg Stevens-Johnson Syndrome.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.
This medicine is likely to have an additive effect with other medicines that decrease blood pressure, particularly medicines that are used to treat high blood pressure (antihypertensives). This may cause dizziness, which can usually be relieved by lying down until the symptoms pass. If you feel dizzy while taking this medicine in combination with other medicines that can lower blood pressure you should let your doctor know, as your doses may need adjusting. Other medicines that decrease blood pressure include the following:
- ACE inhibitors, eg enalapril
- alpha-blockers such as prazosin
- angiotensin II receptor antagonists such as losartan
- antipsychotics such as chlorpromazine
- benzodiazepines, eg temazepam, diazepam
- other beta-blockers such as propranolol
- calcium channel blockers such as verapamil, nifedipine.
- diuretics, eg furosemide
- dopamine agonists, eg bromocriptine, apomorphine
- MAOI antidepressants, eg phenelzine
- nitrates, eg glyceryl trinitrate
Furosemide can decrease the amount of potassium in the blood. If it is used in combination with any of the following medicines, which can also lower potassium in the blood, the risk of a low blood potassium level (hypokalaemia) is increased:
- corticosteroids, such as hydrocortisone and prednisolone
- beta 2 agonists, eg salbutamol, terbutaline
- other diuretics, eg bendroflumethiazide
If the level of potassium in your blood falls during treatment, this can increase the risk of side effects on the heart from various other medicines, including digoxin, certain antipsychotics and medicines for abnormal heart rhythms (anti-arrhythmics), eg amiodarone.
Furosemide reduces the ability of the body to remove the medicine lithium, which can cause the level of lithium in the blood to rise too high. If you are taking lithium your lithium level should be checked after you start and stop treatment with this medicine, as well as after any dose changes. Your lithium dose may need adjusting.
Spironolactone may increase the level of potassium in your blood. If this medicine is taken with other medicines that can increase blood potassium levels, this effect may be enhanced. Your doctor may want to monitor your blood potassium levels if you take any of these medicines in combination with Lasilactone capsules:
- ACE inhibitors, eg enalapril
- angiotensin II receptor antagonists, eg losartan
- non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin, diclofenac, ibuprofen
- potassium-containing salt substitutes such as Lo-Salt
- potassium salts, eg potassium citrate for cystitis
- other potassium-sparing diuretics eg spironolactone (these should not usually be taken in combination with Lasilactone)
- potassium supplements (these should not usually be taken in combination with Lasilactone)
Other medicines containing the same active ingredients
There are currently no other medicines available in the UK that contain both spironolactone and furosemide.