Effects of this medicine

Before using this medicine, be sure to tell your doctor and pharmacist

• If you have previously experienced any allergic reactions (itch, rash, etc.) to any medicines.
  If you are unable to sense thirst or have anuria, impaired fluid intake, hypernatremia, hepatic encephalopathy, coronary artery disease, cerebrovascular disease, hyperkalemia, or renal disorder.

• If you are pregnant, possibly pregnant or breastfeeding.

• If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.)

Dosing schedule (How to take this medicine)

• Your dosing schedule prescribed by your doctor is <<        to be written by a healthcare professional>>

• Volume overload in heart failure when adequate response is not obtained with other diuretics (e.g., loop diuretics): In general, for adults, take 2 tablets (15 mg of active ingredient), once daily. In order to avoid nocturnal urination, it is desirable to take the medicine in the morning. Your doctor may decide to start the medicine at 1 tablet (7.5 mg of active ingredient) or to later reduce the dose to half according to your symptoms.
  Body fluid retention in hepatic cirrhosis when adequate response is not obtained with other diuretics (e.g., loop diuretics): In general, for adults, take 1 tablet (7.5 mg of active ingredient), once daily. In order to avoid nocturnal urination, it is desirable to take the medicine in the morning. Your doctor may decide to start the medicine at half dose (3.75 mg of active ingredient) or to later reduce the dose to half according to your symptoms.
  In each case, strictly follow the instructions.

• If you miss a dose, take the missed dose as soon as you remember it. However, if it is close to the time for the next dose, skip the missed dose and continue your regular dosing schedule. You should never take two doses at one time.

• If you accidentally take more than your prescribed dose, consult with your doctor or pharmacist.

• Do not stop taking this medicine unless your doctor instructs you to do so.

Precautions while taking this medicine

• If you feel thirst, drink an appropriate amount of water to prevent dehydration but be careful not to drink an excessive amount.
• This medicine increases both urine volume and urination frequency and should therefore be used with caution as directed.
• Women of childbearing potential should use contraception to avoid pregnancy while taking this medicine. Contact your doctor immediately if you discover that you are pregnant while on this medicine.
• This medicine may cause dizziness and caution is therefore required to avoid falling accidents. In particular, you should pay sufficient attention when working in high places or operating potentially hazardous machinery, including motor vehicles, while on this medicine.
• Avoid drinking grapefruit juice since it may enhance the effects of this medicine.
• Avoid taking health foods containing hypericum perforatum (St. John's wort) since it may reduce the therapeutic effect of this medicine.

Possible adverse reactions to this medicine

• decrease of urine output, swelling, thirst [renal failure]
• localized pain, pressured pain, erythema [thromboembolism]
• mental confusion and hyperventilation, dehydration symptoms such as thirst, decreased consciousness (in serious cases, coma) [hypernatraemia]
• general malaise, loss of appetite, yellowing in skin and white of eyes [liver dysfunction]
• decreased blood pressure, hives, respiratory distress [shock, anaphylaxis]

Storage conditions and other information

• Keep out of the reach of children. Store away from direct sunlight, heat and moisture.
•  If there is a remainder, this is to be discarded. Do not store it. Ask your pharmacist or medical institution about how to discard it.