Availability & Expiry
INTRODUCTION
NALES PLUS TABLET is a fixed-dose combination of Spironolactone and Torsemide which belongs to the group of medicines called Diuretics. It is used to reduce fluid accumulation (oedema) in the body that is caused due to severe liver, kidney or heart problems. It can also be used to treat hyperaldosteronism (excessive secretion of aldosterone in the body) and resistant hypertension (high blood pressure that is not controlled by other medicines).
Before taking NALES PLUS TABLET inform your doctor if you have any liver, kidney or heart problems. Avoid consumption of alcohol while taking NALES PLUS TABLET as it may make you feel dizzy or faint even while changing posture.
Avoid consuming potassium rich diet or potassium supplements while taking NALES PLUS TABLET, as it may further increase the levels of potassium in your body. NALES PLUS TABLET is not recommended for use in pregnant or breastfeeding women due to increased risk of side effects.
NALES PLUS TABLET may alters the levels of electrolytes in your body and may make you feel dizzy or tired very easily. To avoid this, your doctor would regularly monitor your serum electrolyte levels and may increase or decrease the dose of this medicine accordingly.
The most common side effects of [GBKEYWORD] are headache, dizziness, nausea, vomiting, tiredness, increased urination and impotence. Consult your doctor if any of the side effect bothers you.
USES OF NALES PLUS TABLET
It is used to treat:
- oedema caused due to severe liver, kidney or heart problems
- hyperaldosteronism (excessive secretion of aldosterone in the body)
- resistant hypertension (high blood pressure that is not controlled by other medicines)
HOW NALES PLUS TABLET WORKS
NALES PLUS TABLET contains two medicines namely spironolactone and torsemide. Both spironolactone and torsemide acts by removing the excess water and electrolytes (sodium and chloride) from the body in the form of urine which helps in reducing blood pressure. Additionally, spironolactone can prevent the loss of potassium via urine and can block the release of certain chemicals in the kidneys (aldosterone) that causes endocrine problems.
DIRECTIONS FOR USE
Take NALES PLUS TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.
Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition. Do not stop taking NALES PLUS TABLET unless your doctor tells you to stop.
SIDE EFFECTS OF NALES PLUS TABLET
COMMON
- headache, dizziness
- nausea, vomiting
- general weakness
- increased urination
- excessive thirst
- impotence
- indigestion
RARE
Stop taking NALES PLUS TABLET and contact your doctor immediately if you experience any of the following side effects:
- irregular heartbeat, chest pain
- bleeding from the gut or diarrhoea
- hyperglycaemia (increased blood glucose levels causing excessive urination and thirst, fatigue, headache)
- hyperuricemia (increased uric acid levels in blood causing joint pain, redness, swelling and of joints)
- hypokalaemia (low blood potassium levels causing constipation, tiredness, muscle weakness, tingling and numbness)
- hypotension (low blood pressure causing fainting, tiredness, blurred vision, nausea)
- hypovolemia (loss of body fluids causing headache, dizziness, low blood pressure, weakness, drowsiness, confusion, loss of appetite and cramps)
- blood clot formation in the body
- skin rash
- rectal bleeding
- feeling faint
HOW TO MANAGE SIDE EFFECTS
Dizziness Or Drowsiness
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely if you feel dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
Nausea And Vomiting
Take NALES PLUS TABLET with or just after meals. Stick to simple meals. Avoid eating oil rich or spicy foods. Consult your doctor if your nausea worsens.
Headache
Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
WARNING & PRECAUTIONS
PREGNANCY
ContraindicatedNALES PLUS TABLET is not recommended for use in pregnant women. Therefore, consult your doctor before taking it.
BREASTFEEDING
ContraindicatedNALES PLUS TABLET is not recommended for use in breast-feeding women. Therefore, consult your doctor before taking it.
DRIVING AND USING MACHINES
Use with CautionDo not drive or handle any heavy tools or machines if you experience dizziness, drowsiness, or blurred vision after taking NALES PLUS TABLET.
ALCOHOL
Consult your doctorAvoid consumption of alcohol while taking NALES PLUS TABLET as it might make you feel dizzy or faint even when you change posture.
KIDNEY
ContraindicatedNALES PLUS TABLET is not recommended for use in patients with moderate to severe kidney diseases (such as difficulty in passing urine or acute renal failure). Therefore, consult your doctor before taking it.
LIVER
Consult your doctorNALES PLUS TABLET is not recommended for use in patients liver diseases. It should be used with caution in patients with other liver problems. Therefore, consult your doctor before taking it.
ALLERGY
ContraindicatedDo not take NALES PLUS TABLET if you are allergic to Torsemide, Spironolactone or sulfonylureas (Ex. glimepiride, glipizide).
HEART DISEASE
ContraindicatedNALES PLUS TABLET is not recommended for use in patients with heart diseases (such as low blood pressure or abnormal heart rate). Therefore, consult your doctor before taking it.
OTHERS
NALES PLUS TABLET is not recommended for use if you:
- have high levels of potassium in your blood (hyperkalaemia)
- have Addison’s disease (deficiency of cortisol and aldosterone)
Use in paediatrics:
There is no proper information regarding the use of NALES PLUS TABLET in children and adolescents (below 18 years). Therefore, consult your doctor before taking it.
Use in geriatrics:
NALES PLUS TABLET should be used with caution in elderly patients. Therefore, consult your doctor before taking it.
INTERACTIONS
A. Drug - Drug interactions:
Before taking NALES PLUS TABLET, inform your doctor if you are taking any of the following medicines such as:
- cholestyramine (a medicine used to control blood cholesterol levels)
- medicines that exert effects on heart function during emergency conditions (Ex. adrenaline, noradrenaline)
- probenecid (a medicine used to treat gout)
- lithium (a medicine used to treat mental illness)
- medicines used to reduce anxiety and to induce sleep (Ex. phenobarbital)
- corticosteroids (used to treat inflammation) Ex. methylprednisolone
- adrenocorticotropic hormone (used to treat cortisol deficiency)
- medicines used to relax muscles (Ex. tubocurarine)
- medicines used for pain relief (Ex. indomethacin, aspirin, morphine, fentanyl, codeine)
- cardiac glycosides (used to treat cardiac failure) Ex. digoxin
- carbenoxolone (a medicine used to treat ulcers)
- medicines used to treat bacterial infections Ex. trimethoprim, sulfamethoxazole, ceftriaxone, cefazolin, gentamycin, streptomycin
- cotrimoxazole (a medicine used to treat fungal infections)
- cisplatin (used to treat cancer)
- other potassium-sparing diuretics (used to treat fluid accumulation) Ex. eplerenone
- heparin and low molecular weight heparin (used to prevent blood clots)
- potassium supplements (used to treat potassium deficiency) Ex. potassium chloride
- medicines used to treat high blood pressure such as ACE inhibitors, angiotensin II blockers or beta-blockers (Ex. enalapril, telmisartan, valsartan, propranolol)
- medicines used to treat diabetes (Ex. metformin, glimepiride)
B. Drug-Food interactions
Avoid foods rich in potassium such as bananas, dry fruits, lentils, dairy products, and salt substitutes such as potassium chloride.
Overdosage:
If you or anyone else accidentally took more NALES PLUS TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose might include dehydration,
low blood pressure, decreased body fluids and electrolytes levels, low blood sodium levels, abnormal blood potassium levels, increased RBC count, drowsiness, mental confusion, erythematous rash, nausea, vomiting, dizziness, diarrhoea, or liver problems.
SYNOPSIS
| Drug | : | Spironolactone, torsemide |
| Pharmacological Category | : | Potassium sparing diuretics, Loop diuretics |
| Therapeutic Indication | : | Oedema, hypertension, Hyperaldosteronism |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep NALES PLUS TABLET out of reach of children
- Store NALES PLUS TABLET at room temperature
FAQs ABOUT NALES PLUS TABLET
Q: What is the use of NALES PLUS TABLET?
A: NALES PLUS TABLET is used to reduce fluid accumulation (oedema) in the body that is caused due to severe liver, kidney or heart problems. It can also be used to treat hyperaldosteronism (excessive secretion of aldosterone in the body) and resistant hypertension (high blood pressure that is not controlled by other medicines).
Q: Can I take NALES PLUS TABLET daily?
A: Take NALES PLUS TABLET as advised by your physician. Your doctor will evaluate your health condition and suggests you the number of doses that needs to be taken per day.
Q: What are the possible side effects of NALES PLUS TABLET?
A: The most common side effects of [GBKEYWORD] are headache, dizziness, nausea, vomiting, tiredness, and increased urination. It may also cause impotence in men. Consult your doctor if any of the side effect bothers you. Also inform your doctor immediately if you experience irregular heartbeat, joint pain, muscle pain, extreme dizziness or fainting or rectal bleeding after taking NALES PLUS TABLET.
Q: What is the best time to take NALES PLUS TABLET?
A: It is advisable to take NALES PLUS TABLET in the morning preferably after meals. This may avoid frequent urination at the night. However, consult your doctor regarding the time of administration of NALES PLUS TABLET.
Q: How long does it take for NALES PLUS TABLET to show the results?
A: It may take a few weeks for NALES PLUS TABLET to show the results, and so take NALES PLUS TABLET regularly as advised by your physician to see the optimum results.
Q: Can NALES PLUS TABLET cause dizziness?
A: Yes, NALES PLUS TABLET may cause dizziness due to the loss of fluids from the body. To avoid this, keep yourself hydrated by drinking plenty of fluids. Avoid driving or operating any tools or machines if you feel dizzy. Consult your doctor if you experience extreme dizziness.
Q: Can I consume alcohol while taking NALES PLUS TABLET?
A: Avoid consumption of alcohol while taking NALES PLUS TABLET as it might make you feel dizzy or faint even when you change posture.
Q: Do I have any food restrictions while taking NALES PLUS TABLET?
A: Avoid food rich in potassium such as bananas, dry fruits, lentils, dairy products, and salt substitutes containing potassium while taking NALES PLUS TABLET. It is because NALES PLUS TABLET can reabsorb potassium in the kidneys, and so additionally consumption of potassium rich foods or supplements may further increase the levels of potassium in the blood.
Q: Do we need any laboratory investigations while taking NALES PLUS TABLET?
A: Yes. NALES PLUS TABLET may alter the electrolyte balance in your body, and make you feel tired or dehydrated very easily. To avoid this, your doctor would regularly monitor your serum electrolyte levels and increase or decrease the dose of this medicine accordingly.
Q: Can NALES PLUS TABLET reduce my weight?
A: NALES PLUS TABLET does not have any impact on reducing your weight. But, due to removal of excess water from the body, you may experience a slight reduction in body weight.
Q: Can I take NALES PLUS TABLET to reduce my postpartum belly?
A: No. NALES PLUS TABLET is not indicated for use in postpartum women. Do not take NALES PLUS TABLET unless your doctor has prescribed it. It is not advisable to breastfeed while taking NALES PLUS TABLET. Consult your doctor before taking NALES PLUS TABLET.
Q: Can NALES PLUS TABLET cause cancer?
A: No. Research does not suggest any risk of cancer while taking [GBNEYWORD]. If you are doubtful consult your doctor for advice.
Q: Can I take NALES PLUS TABLET on my own?
A: No. NALES PLUS TABLET is a prescription medicine. It should be used only when prescribed by a physician. Do not take NALES PLUS TABLET on your own without consulting your doctor.
Q: Can NALES PLUS TABLET affect sense of hearing?
A: Yes, some rare cases of hearing loss have been reported with the use of NALES PLUS TABLET. This condition is often reversible after discontinuing the therapy. However, consult your doctor immediately if you experience any disturbances in the sense of hearing.
Q: Can the use of NALES PLUS TABLET cause frequent urination?
A: Yes. NALES PLUS TABLET may cause frequent urination. It tends to excrete the accumulated fluid from the body in the form of urine. As a result, you may experience an increase in tendency to urinate. If this bothers you, contact your doctor.
Q: Can the use of [GNKEYWORD] make me more tired?
A: Yes. NALES PLUS TABLET may make you feel tired easily because it removes the excess fluids from the body. This reduces your energy levels and make you feel very tired. To avoid this, keep yourself hydrated by drinking plenty of fluids. If you experience extreme tiredness that hinders your daily activities, consult your doctor for advice.
REFERENCES
1. K.D. Tripathi. Diuretics Essentials of pharmacology seventh edition, 2013 Page no – 581 and 587.
2. Juan Tamargo 1, Julian Segura, Luis M Ruilope. Diuretics in the treatment of hypertension. Part 2: loop diuretics and potassium-sparing agents. NIH. National Library of Medicine. National Centre for biotechnology information. Pubmed.gov. April 2014. [Accessed on 4th February 2023] https://pubmed.ncbi.nlm.nih.gov/24456327/
3. Cipla Ltd. Spironolactone/torsemide. Ciplamed.com. [Revised in April 2015]. [Accessed on 4th February 2023] https://www.ciplamed.com/content/dytor-plus-tablets
4. Torrent Pharmaceuticals Ltd. Spironolactone/torsemide [Revised in July 2016]. [Accessed on 4th February 2023] https://www.torrentian.com/pisheet/Upload/PI_Sheet/1818.pdf
5. La Renon Healthcare Pvt Ltd. Torvigress Plus. [Accessed on 4th February 2023] https://www.larenon.com/wp-content/uploads/2022/06/Torvigress-Torvigress-Plus-copy.pdf
6. Leeford Healthcare Pvt Ltd. Durite Plus 10. [Accessed on 4th February 2023] https://www.leeford.in/product/648/durite-plus-10
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