Lasix

Furosemide

Fluid retention associated w/ chronic CHF & nephrotic syndrome (if diuretic treatment is required); acute CHF; chronic renal failure; liver disease (if necessary to supplement treatment w/ aldosterone antagonists). Maintenance of fluid excretion in acute renal failure, including that due to pregnancy or burns. HTN. Supportive measure for hypertensive crisis. Support of forced diuresis.

Adult Recommended max daily dose: 1,500 mg. Use lowest dose sufficient to achieve desired effect. Give IV only when PO is not feasible or ineffective (eg, impaired intestinal absorption) or if a rapid effect is required. Transfer to PO therapy as soon as possible if IV is used. Tab Hepatic impairment Fluid retention associated w/ liver disease Initially, 20-80 mg daily as a single dose or divided doses. Renal impairment Fluid retention associated w/ chronic renal failure Initially, 40-80 mg daily as a single dose or 2 divided doses. Maintenance: 250-1,500 mg daily in dialysis patients. Renal impairment Fluid retention associated w/ nephrotic syndrome Initially, 40-80 mg daily as a single dose or several divided doses. Fluid retention associated w/ chronic congestive cardiac failure Initially, 20-80 mg daily in 2 or 3 divided doses. HTN Maintenance: 20-40 mg daily alone or in combination w/ other antihypertensives. Higher dose may be required if HTN is associated w/ chronic renal failure. Childn 2 mg/kg. Max: 40 mg daily. IV Adult Hepatic impairment Fluid retention associated w/ liver disease Initially, 20-40 mg as a single dose. Renal impairment Fluid retention associated w/ chronic renal failure Initially, 0.1 mg/min continuous IV infusion, gradually increasing the rate every ½ hr according to response. Maintenance of fluid excretion in acute renal failure Initially, 40 mg inj, may be given as continuous IV infusion w/ a rate of 50-100 mg/hr if desired increase in fluid excretion is not attained. Fluid retention associated w/ acute congestive cardiac failure, hypertensive crisis Initially, 20-40 mg as IV bolus inj. Support of forced diuresis in poisoning Initially, 20-40 mg, in addition to infusions of electrolyte soln. Childn 1 mg/kg. Max: 20 mg daily.

Tab: Should be taken on an empty stomach: Do not chew.

Hypersensitivity to furosemide, sulfonamides or to any of the excipients. Hypovolemia or dehydration; anuric renal failure not responding to furosemide; severe hypokalemia & hyponatremia; pre-comatose & comatose states associated w/ hepatic encephalopathy. Lactation.

Partial obstruction of urinary outflow (eg, in patients w/ bladder-emptying disorders, prostatic hyperplasia or narrowing of urethra). Hypotension, latent or manifest DM, gout. SLE; patients w/ risk from pronounced fall in BP eg, patients w/ significant stenoses of coronary arteries or of blood vessels supplying the brain. Patients at high risk of developing electrolyte imbalances or significant additional fluid loss (eg, due to vomiting, diarrhea or intense sweating); regularly monitor serum Na, K & creatinine during therapy. Hypoproteinemia eg, associated w/ nephrotic syndrome. Hepatorenal syndrome ie, functional renal failure associated w/ severe liver disease. Concomitant use of risperidone. May impair ability to drive & use machines. Not recommended during pregnancy unless there are compelling medical reasons; monitor fetal growth during treatment. Monitor renal function & perform renal ultrasound in premature infants.

Electrolyte disturbances (including symptomatic), dehydration & hypovolemia especially in the elderly, increased blood creatinine & blood triglyceride; hypotension including orthostatic hypotension (for IV infusion). Hyponatremia, hypochloremia, hypokalaemia, increased blood cholesterol & blood uric acid, attacks of gout; increased urine vol; hepatic encephalopathy in patients w/ hepatocellular insufficiency; hemoconcentration.

Flushing, sweating attacks, restlessness, nausea, BP increase & tachycardia w/ chloral hydrate. Potentiates ototoxicity of aminoglycosides & other ototoxic drugs. Enhanced nephrotoxicity of cisplatin if furosemide is not given in low doses. Decreased absorption w/ sucralfate. Decreases excretion, increases serum conc, increases risk of toxicity including cardiotoxic & neurotoxic effects of lithium. Severe hypotension & deterioration in renal function w/ ACE inhibitors or AIIAs. Increased mortality in elderly patients w/ dementia w/ risperidone. Inhibits binding of thyroid hormones to carrier proteins leading to an initial transient increase, followed by an overall decrease in total thyroid hormone levels w/ levothyroxine. Reduced effects w/ NSAIDs including aspirin; acute renal failure in patients w/ dehydration or hypovolaemia w/ NSAIDs; increased salicylate toxicity. Attenuated effects w/ phenytoin. Increased risk of developing hypokalaemia w/ corticosteroids, carbenoxolone, liquorice in large amounts & prolonged use of laxatives. Increased toxicity of digitalis prep & other drugs inducing QT interval prolongation syndrome w/ electrolyte disturbances eg, hypokalaemia & hypomagnesaemia. More pronounced fall in BP w/ antihypertensives, diuretics or other drugs w/ BP-lowering potential. May reduce effect w/ probenecid, MTX & other drugs which undergo significant renal tubular secretion. May decrease renal elimination of probenecid, MTX & other drugs which undergo significant renal tubular secretion. Reduced effects of antidiabetics & BP-increasing sympathomimetics (eg, epinephrine, norepinephrine). Increased effects of curare-type muscle relaxants or theophylline. Increased harmful effects of nephrotoxic drugs on the kidney. Impairment of renal function w/ high doses of certain cephalosporin. Increased risk of gouty arthritis w/ cyclosporine A. Deterioration in renal function w/ radiocontrast in patients at high risk of radiocontrast nephropathy.

Diuretics

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

Rx