Dytor E 20 Combikit (10 + 10 Tab)

DYTOR E 20 COMBIKIT (10 + 10 TAB) by CIPLA LTD.

This combikit is a combination medication primarily used for managing fluid retention and high blood pressure.

• Name: Dytor E 20 Combikit

• Manufacturer: Cipla Ltd.

• Composition:

  • Eplerenone (25 mg)
  • Torsemide (20 mg)

• Uses: Dytor E 20 Combikit is prescribed for various conditions involving fluid overload and hypertension. It helps the body eliminate excess fluid and salt while striving to maintain balanced potassium levels.

  • Management of high blood pressure (hypertension).
  • Treatment of fluid retention (oedema) associated with:
    • Heart failure, including congestive heart failure post-myocardial infarction (heart attack).
    • Liver cirrhosis.
    • Kidney disorders, such as nephrotic syndrome.
  • Reducing strain on the heart and improving survival chances after a heart attack.

• Dosage and Administration:

  • Take the tablets as directed by your doctor.
  • Swallow the tablet whole with a glass of water; do not crush, break, or chew it.
  • It is generally recommended to take this medicine in the morning, preferably with food, to minimize the need for nighttime urination.
  • For optimal results, take it at the same time each day.

• Side Effects: Common side effects may include:

  • Dizziness.
  • Fatigue.
  • Dehydration.
  • Diarrhea, constipation, abdominal pain.
  • Itching, cough, flu-like symptoms.
  • Electrolyte imbalances such as hyponatraemia (abnormally low sodium levels) and hypokalaemia (low potassium levels).
  • Increased uric acid levels in the blood, abnormal lipid profile, and increased liver enzymes.

• Precautions:

  • Contraindications: Do not take if allergic to eplerenone, torsemide, or any other ingredients. It is contraindicated in conditions like anuria (inability to produce urine), severe kidney impairment, severe liver injury (hepatic coma), hyperkalaemia (high potassium levels), low blood pressure (hypotension), cardiogenic shock, and aortic stenosis.
  • Pregnancy and Breastfeeding: Caution is advised. Consult your doctor if you are pregnant, planning pregnancy, or breastfeeding, as the effect on the baby is unknown.
  • Alcohol: Alcohol consumption may increase the risk of dehydration and dizziness.
  • Liver and Kidney Impairment: Use with caution. Regular monitoring of kidney function and electrolyte levels may be necessary. Not recommended in severe cases.
  • Driving and Machinery: May cause dizziness or fatigue; exercise caution before driving or operating machinery until you know how the medicine affects you.
  • Drug Interactions: Inform your doctor about all medications, including:
    • Potassium supplements or potassium-rich foods, as this may increase blood potassium levels (hyperkalemia).
    • Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole) which can increase eplerenone levels.
    • Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, diclofenac, which may reduce effectiveness and increase kidney problems.
    • Lithium, as it can increase lithium levels in the blood.
  • Monitoring: Regular monitoring of serum potassium, sodium, creatinine levels, and blood pressure is recommended during treatment.

• Storage:

  • Store at room temperature, ideally between 20-25°C.
  • Protect from moisture and direct sunlight.
  • Keep out of the sight and reach of children.

What is DYTOR E 20 COMBIKIT used for?

DYTOR E 20 COMBIKIT is primarily used to treat resistant edema (fluid overload) associated with conditions such as pulmonary hypertension (high blood pressure in the lungs), heart failure, and hepatic cirrhosis (chronic liver damage). It also helps manage high blood pressure (hypertension) and can improve survival chances after a heart attack in patients with congestive heart failure.

How does DYTOR E 20 COMBIKIT work?

This medicine is a combination of two active ingredients: Eplerenone and Torsemide, both of which are diuretics (water pills).

• Torsemide is a loop diuretic that increases the amount of urine produced by the kidneys, helping the body get rid of excess water and salts.
• Eplerenone is a selective aldosterone receptor antagonist that blocks the action of aldosterone, a hormone that regulates blood pressure and fluid balance. This helps to reduce sodium reabsorption and increase water removal, while also helping to retain potassium in the body. Together, they reduce fluid levels, lower the heart's workload, and make it more efficient at pumping blood, thereby lowering high blood pressure.

What is the usual dosage for DYTOR E 20 COMBIKIT?

The dosage of DYTOR E 20 COMBIKIT is determined by your doctor based on your specific condition and individual response. It is typically taken orally once a day, with or without food. It is advisable to take it in the morning to avoid frequent urination at night. The tablets should be swallowed whole and not crushed, chewed, or broken.

What are the possible side effects of DYTOR E 20 COMBIKIT?

Common side effects may include dehydration, electrolyte disturbances (such as changes in calcium, magnesium, or sodium levels), constipation, increased uric acid, itching, dizziness, headache, fatigue, frequent urination, diarrhea, and abdominal pain. More serious side effects can include high potassium levels (hyperkalemia), low blood pressure (hypotension), allergic reactions, worsening kidney function, and hearing loss. Dizziness or lightheadedness may occur due to a sudden drop in blood pressure when standing up (orthostatic hypotension).

Is DYTOR E 20 COMBIKIT safe during pregnancy or breastfeeding?

Pregnancy: DYTOR E 20 COMBIKIT is generally not recommended during pregnancy unless it is absolutely necessary and the potential benefits outweigh the risks. It is crucial to consult your doctor if you are pregnant or planning to become pregnant.

Breastfeeding: This medicine is generally not advised during breastfeeding. Eplerenone passes into breast milk in very small amounts, and the effect on the baby is not fully known. Torsemide may potentially suppress lactation. Your doctor may suggest an alternative medication.

Can DYTOR E 20 COMBIKIT be taken with other medications?

DYTOR E 20 COMBIKIT can interact with several other medications. It may interact with other blood pressure-lowering drugs (such as ACE inhibitors, angiotensin receptor blockers, and other diuretics), blood thinners (like aspirin and warfarin), certain antibiotics, antifungals (e.g., ketoconazole, itraconazole), nonsteroidal anti-inflammatory drugs (NSAIDs like ibuprofen), lithium, and digoxin. It is important to avoid taking potassium supplements or consuming potassium-rich foods, as this medication can increase potassium levels in the blood. Always inform your doctor about all medications, supplements, and vitamins you are taking.

What precautions should be taken while using DYTOR E 20 COMBIKIT?

Do not stop taking DYTOR E 20 COMBIKIT suddenly, as this can worsen your condition or lead to a spike in blood pressure. Your doctor will regularly monitor your potassium levels due to the risk of hyperkalemia (high potassium). Use with caution if you have kidney disease, liver disease, diabetes, low blood pressure, or a history of heart attack or heart valve problems. Avoid alcohol, as it may lead to serious side effects. If you experience dizziness, avoid driving or operating machinery. It's also recommended to correct any dehydration or electrolyte imbalances before starting this medication and to reduce your salt intake.

What happens if a dose of DYTOR E 20 COMBIKIT is missed?

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

How should DYTOR E 20 COMBIKIT be stored?

Store DYTOR E 20 COMBIKIT at room temperature, ideally not exceeding 30°C. Keep it in a cool, dry, and dark place, protected from moisture and light. Always ensure it is kept out of reach of children.