Kenzamide

Furosemide

Oedema associated w/ heart failure, pulmonary oedema, & w/ renal & hepatic disorders. Patients unresponsive to thiazide diuretics & management of oliguria due to renal failure or insufficiency & HTN.

Tab Oedema Initially 40 mg once daily adjust as necessary according to response. Mild cases: 20 mg daily or 40 mg on alternate days. May require doses of ≥80 mg daily given as 1 or 2 doses daily, or intermittently. Severe cases: Gradual titration up to 600 mg daily. HTN 40-80 mg daily, either alone, or w/ other antihypertensives. Childn 1-3 mg/kg daily. Max: 40 mg daily. Inj Adult 20-50 mg by slow IV inj or may be given by IM but not for acute conditions. Increase by 20 mg not given more than every 2 hr. Increase initial dose to 80 mg if not satisfactory. Childn 0.5-1.5 mg/kg daily. Max: 20 mg daily.

Should be taken on an empty stomach.

Tab: Renal failure caused by nephrotoxic or hepatotoxic drugs, & associated w/ hepatic coma (high doses). Inj: Hypersensitivity. Pregnancy & lactation.

Tab: Not to be given in anuria or renal failure caused by nephrotoxic or hepatotoxic drugs nor in renal failure associated w/ hepatic coma; in precomatoses states associated w/ hepatic cirrhosis. Patients w/ prostatic hyperplasia or impairment of micturition since acute urinary retention can be precipitated. Risk of ototoxicity. Pregnancy & lactation. Infants & neonates. Inj: Regularly check serum electrolytes when higher doses are given over prolonged periods. Supplement K-rich diet or K drugs. Normalize BP & circulating blood vol before treatment of patients in shock. Hypertrophy of prostate & dysuria, diabetic patients, liver cirrhosis associated w/ ascites, disturbed uric acid metabolism. Elderly.

Tab: Fluid & electrolyte imbalance including hyponatraemia, hypokalaemia & hypochloraemic alkalosis, particularly after large doses or prolonged administration. Nephrocalcinosis (preterm infants). Hyperglycaemia & glycosuria. Hyperuricaemia & precipitate attacks of gout in some patients. Signs of electrolyte imbalance include headaches, hypotension, muscle cramps, dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, oliguria, cardiac arrhythmias & GI disturbances. Inj: Nausea, vomiting, diarrhea, indigestion, visual disturbance, tinnitus, transient hearing impairment, muscle spasm, paresthesia, orthostatic hypotension, pancreatitis, hepatic dysfunction, photosensitivity, dizziness, fatigue, muscular weakness, increased thirst & impulse to urinate, rarely skin rash, myelopathy (eg, leukopenia, thrombocytopenia). Disturbance of electrolyte & fluid balance, particularly hypokalemia.

Tab: Diuretic-induced hypokalaemia may enhance toxicity of digitalis glycosides & may also increase risk of arrhythmias w/ drugs that prolong QT interval eg, astemizole, terfenadine, halofantrine, pimozide, & sotalol. May enhance neuromuscular blocking action of competitive neuromuscular blockers eg, atracurium. Enhanced K-depleting effect w/ corticosteroids, corticotropin, β2 agonists eg, salbutamol, carbenoxolone, amphotericin B, or reboxetine. May enhance effect of other antihypertensives, particularly the 1st-dose hypotension that occurs w/ α blockers or ACE inhibitors. Enhanced orthostatic hypotension associated w/ diuretics w/ alcohol, barbiturates, or opioids. Antagonised antihypertensive effects of diuretics w/ drugs that cause fluid retention eg, corticosteroids, NSAIDs, or carbenoxolone; may enhance nephrotoxicity of NSAIDs. May diminish response of pressor amines eg, noradrenaline. Not to be used w/ lithium since may lead to toxic blood conc of lithium. Increased toxicity of allopurinol & tetracyclines. May alter requirements for hypoglycaemics in diabetic patients. May enhance nephrotoxicity of cephalosporins eg, cefalotin & ototoxicity of aminoglycosides & other ototoxic drugs. Inj: May aggravate orthostatic hypotension w/ alcohol, barbiturate & narcotics. May intensify electrolyte imbalance (eg, hypokalemia) w/ corticotropin or corticosteroid. Increased potential for ototoxicity & nephrotoxicity w/ aminoglycosides. Increased potential for nephrotoxicity w/ cephaloridine or cephalothin. May provoke lithium toxicity of lithium salts.

Diuretics

C03CA01 - furosemide ; Belongs to the class of high-ceiling sulfonamide diuretics.

Rx