Furosemide

Generic name: Furosemide (oral/injection)
Drug class: Loop diuretics

Usage of Furosemide

Furosemide is a loop diuretic used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. Furosemide is also used to treat high blood pressure (hypertension).

Furosemide works by increasing the amount of urine the body makes, which helps reduce swelling and symptoms of fluid retention and helps lower high blood pressure. Furosemide tablets are sometimes called water pills as they increase how much you urinate.

Furosemide is also known as frusemide in some countries. Furosemide became an FDA-approved medicine on July 1, 1966, and is available as tablets (Lasix), oral liquid, injection, and intravenous solution.

Furosemide side effects

Common furosemide side effects may include:

diarrhea, constipation, loss of appetite;

numbness or tingling;

headache, dizziness; or

blurred vision.

Serious furosemide side effects

Get emergency medical help if you have signs of an allergic reaction to furosemide (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Furosemide may cause other serious side effects. Call your doctor at once if you have:

a light-headed feeling, like you might pass out;

ringing in your ears, hearing loss;

muscle spasms or contractions;

pale skin, easy bruising, unusual bleeding;

high blood sugar - increased thirst, increased urination, dry mouth, fruity breath odor;

kidney problems - swelling, urinating less, feeling tired or short of breath

signs of liver or pancreas problems - loss of appetite, upper stomach pain (that may spread to your back), nausea or vomiting, dark urine, jaundice (yellowing of the skin or eyes); or

signs of an electrolyte imbalance - increased thirst or urination, constipation, muscle weakness, leg cramps, numbness or tingling, feeling jittery, fluttering in your chest.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Furosemide

You should not use furosemide if you are allergic to it, if you are unable to urinate or have hepatic cirrhosis.

To make sure furosemide is safe for you, tell your doctor if you have ever had:

an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

enlarged prostate, bladder obstruction, or other urination problems;

gout;

lupus;

diabetes;

an allergy to sulfa drugs;

kidney disease; or

cirrhosis or other liver disease.

Tell your doctor if you have an MRI (magnetic resonance imaging) or any type of scan using a radioactive dye that is injected into a vein. Contrast dyes and furosemide can harm your kidneys.

Furosemide on-body infusor (Furoscix) can only be used for congestion due to fluid overload in adults with NYHA Class II/III chronic heart failure, and is not not indicated for emergency situations or in patients with acute pulmonary edema.

Pregnancy

It is not known if furosemide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Breastfeeding

It may not be safe to breastfeed while using furosemide. Ask your doctor about any risk. Furosemide may slow breast milk production.

Relate drugs

How to use Furosemide

Usual Adult Dose for Edema associated with Congestive Heart Failure, Cirrhosis of the Liver, and Renal Disease (including Nephrotic Syndrome):

Oral: Initial dose: 20 to 80 mg orally once; may repeat with the same dose or increase by 20 or 40 mg no sooner than 6 to 8 hours after the previous dose until the desired diuretic effect has been obtained. Maintenance dose: Administer the dose that provided the desired diuretic effect once or twice a day (e.g., at 8 am and 2 pm). Comments:Edema may be most efficiently and safely mobilized by giving this drug on 2 to 4 consecutive days each week. When doses greater than 80 mg/day are given for prolonged periods of time, careful clinical observation and laboratory monitoring are particularly advisable.

Usual Adult Dose for Pulmonary Edema:

IV: 40 mg IV slowly over 1 to 2 minutes; if a satisfactory response doesn't occur within one hour, may increase to 80 mg IV slowly over 1 to 2 minutes. Use: Adjunctive therapy in acute pulmonary edema. IV administration of this drug is indicated when a rapid onset of diuresis is desired (e.g., in acute pulmonary edema).

Usual Adult Dose for Hypertension:

Oral: Initial dose: 80 mg/day, usually divided into 40 mg orally twice a day Use: Treatment of hypertension alone or in combination with other antihypertensive agents.

Usual Pediatric Oral Dose for Edema:

Initial dose: 2 mg/kg orally once; if the diuretic response to the initial dose is not satisfactory, may increase by 1 or 2 mg/kg and administer no sooner than 6 to 8 hours after the previous dose. Maintenance dose: Adjust to minimum effective dose. Use: Treatment of edema associated with congestive heart failure, cirrhosis of the liver and renal disease, including the nephrotic syndrome, especially when an agent with greater diuretic potential is desired.

Warnings

You should not use furosemide if you are unable to urinate.

Using more than your recommended dose will not make this medicine more effective. High doses of tis medicine may cause irreversible hearing loss.

Before using this medicine, tell your doctor if you have kidney disease, enlarged prostate, urination problems, cirrhosis or other liver disease, an electrolyte imbalance, high cholesterol, gout, lupus, diabetes, or an allergy to sulfa drugs.

Tell your doctor if you have recently had an MRI (magnetic resonance imaging) or any type of scan using a radioactive dye that is injected into your veins. Do not take more of this medication than is recommended.

If you are being treated for high blood pressure, keep using this medicine even if you feel fine. High blood pressure often has no symptoms.

Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dose schedule must be adjusted to the individual patient’s needs

Tell your doctor about all your other medicines. Some drugs should not be used with furosemide.

What other drugs will affect Furosemide

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective

If you also take sucralfate, take your furosemide dose 2 hours before or 2 hours after you take sucralfate.

Tell your doctor about all your other medicines, especially:

another diuretic, especially ethacrynic acid;

methotrexate;

chloral hydrate;

lithium;

phenytoin;

an antibiotic;

cancer medicine, such as cisplatin;

heart or blood pressure medicine; or

NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with furosemide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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