BUMETANIDE AND FRUSEMIDE AMILORIDE IN THE TREATMENT OF CONGESTIVE CARDIAC-FAILURE

The consequences of changing diuretic therapy were determined in 58 patients with cardiac failure receiving bumetanide. Bumetanide was replaced by frusemide/amiloride, at a fixed ratio of 1 mg bumetanide to 40 mg frusemide + 5 mg amiloride, and continued for eight weeks. The combination of frusemide/amiloride was significantly less effective than bumetanide alone and resulted in increased dyspnoea (P < 0.001), pulmonary crepitations (P < 0.02), body weight (P < 0.001), and heart rate (P < 0.001). Treatment with frusemide/amiloride was associated with an increased coronary risk status, as indicated by a decrease in high density lipoprotein (HDL) cholesterol (P < 0.01) and a corresponding increase in the total cholesterol/HDL cholesterol ratio (P < 0.01). Urate (P < 0.01) and creatinine (P < 0.02) also increased during treatment with frusemide/amiloride.