Dytor Plus 20 Tablet

• Dytor Plus 20 Tablet is used to treat fluid retention and swelling caused by heart failure, liver cirrhosis, and kidney disease.
• Dytor Plus 20 Tablet is also used for high blood pressure that has not responded adequately to other treatment, particularly where fluid overload is contributing.

• If you are allergic to torsemide, spironolactone or any other components of Dytor Plus 20 tablet.
• If you are unable to pass urine
• If you have any liver or kidney disease
• If you have low blood pressure
• If you are pregnant think you may be pregnant or are breastfeeding
• If you have a heart-related disorder
• If you have a condition of hepatic coma or pre-coma
• If you are currently on antibiotics like Streptomycin, Gentamicin or one of the cephalosporin class of medicines
• If your kidneys are damaged due to some medication in past
• If you are diagnosed with high potassium levels in the blood or are already taking a water pill (medicine like Eplerenone) that retains potassium
• If you have Addison’s disease (symptoms are stomach pain, weakness, weight loss, darkening of the skin for a long time with episodes of low blood pressure, vomiting, lower back pain and loss of consciousness)
• If your child has moderate to severe kidney damage

• Dizziness
• Headache
• Drowsiness
• Nausea
• Vomiting
• Constipation
• Diarrhoea
• Indigestion
• Weakness

Other General Warnings

• You have problems with your liver or kidneys.
• You have any heart-related problems.
• You have diabetes.
• You may experience a ringing sensation in your ears, with or without loss of hearing.
• You have heart disease with high levels of potassium in the blood.
• You should be cautious about electrolyte imbalance, which can cause symptoms such as an irregular or fast heartbeat, tiredness, lack of energy, fits, nausea, vomiting, diarrhoea, constipation, stomach or muscle cramps, weakness, irritability, confusion, headache, numbness, dry mouth, thirst, drowsiness, and restlessness.
• You are above 65 years of age, as this medicine should be used with caution, as the risk of having severe adverse effects may be increased,
• Dytor Plus 20 tablets may increase blood potassium levels.
• Male patients may develop breast swelling when taking this medicine.
• Dytor Plus 20 tablet is not recommended for children, as there is no information on its safety or efficacy.

• Take Dytor Plus 20 Tablet exactly as prescribed by your doctor.
• Swallow the tablet whole with a glass of water.
• Take it with food in the morning.
• Avoid late afternoon or evening doses to avoid disturbing your sleep.
• Do not use potassium supplements or salt substitutes unless your doctor approves.
• Attend all blood tests arranged for potassium, sodium, and kidney function.

• Dytor Plus 20 Tablet combines a strong fluid-removing diuretic with another that helps protect your potassium levels.
• Take it in the morning with food; evening doses may cause you to pass urine during the night.
• Weigh yourself every morning after urinating and report a change of two kilograms or more over two to three days.
• Never use low-sodium salt substitutes; they are potassium-based and could be dangerous with this medication.
• Attend all scheduled blood tests for potassium, sodium, and kidney function.
• Report muscle cramps, weakness, numbness, irregular heartbeat, or confusion immediately.
• Stand up slowly, especially during the first few weeks and in hot weather.
• Men should report breast swelling or tenderness; women should report menstrual changes.
• Notify your doctor if you develop a sudden, painful, swollen joint, as this may be gout.
• Avoid ibuprofen and similar painkillers unless approved by your doctor.
• Reduce salt intake, limit alcohol, and follow any fluid restrictions given to you.
• Report vomiting or diarrhea, as body salt levels can shift quickly during illness.

Overdose

Missed a Dose

Interactions with other medicines

• Concomitant use of Dytor Plus 20 tablets along with Cholestyramine, (used to lower blood cholesterol), painkillers (Probenecid and Indomethacin) or Carbenoxolone (to treat stomach ulcer), should be avoided as it will reduce the effect of this tablet.
• Concomitant use of this tablet along with Lithium (to treat psychiatric diseases) should be avoided as it may lead to lithium toxicity
• This medicine, when taken along with blood pressure tablets like Captopril and lisinopril, may lower the blood pressure excessively and you may feel giddy, thus should be used with caution.
• Concomitant use of this tablet along with blood thinners like Heparin, Cotrimoxazole (antibiotic), Indomethacin, etc. (NSAIDs) can cause an increase in the blood potassium levels.
• Concomitant use of Dytor Plus 20 tablet with barbiturates like butabarbital or narcotics like morphine may cause a sudden drop in blood pressure causing unconsciousness.
• Concomitant use of this medicine with a high dose of salicylates like aspirin may lead to salicylate toxicity and may also cause damage to the kidneys.
• Concomitant use of this tablet with Digoxin, (used in case of heart failure), should be avoided as it may result in increased levels of it in blood and may make the heart more sensitive to the medication. You should inform your treating physician if you are already taking Digoxin.
• Antidiabetic medicine when taken along with this tablet, the action of antidiabetic medications may be reduced
• Concomitant use of this tablet with antibiotics like Amikacin, Neomycin, one of the cephalosporin class of drugs or anticancer medications like Cisplatin should be avoided as you may experience hearing loss, ringing in ears and difficulty in urination.
• Other medicines like Tubocurarine, Atracurium, Prednisone and Betamethasone should be used with caution along with Dytor Plus 20 tablet.

Interactions with food items

• Take Dytor Plus 20 Tablet with food in the morning. Food reduces stomach upset and improves absorption of the spironolactone component, and morning dosing avoids being woken repeatedly at night.
• Do not use potassium-based low-sodium salt substitutes. Because one component holds potassium in the body, these can push your level dangerously high.
• Reduce ordinary salt intake as well, since sodium directly counteracts the diuretic and worsens fluid retention. Limit pickles, papads, packaged snacks, processed meats, and restaurant food.
• Do not take potassium supplements unless prescribed. Your doctor will advise individually on potassium-rich foods such as coconut water, bananas, oranges and tomatoes, since the right advice depends on your blood results.
• Follow any daily fluid limit your doctor has set, and weigh yourself each morning after passing urine to catch fluid changes early.
• Avoid liquorice, which disturbs body salts and counteracts the potassium-sparing effect, and avoid alcohol, which dehydrates and can worsen dizziness.