Furosemide: functions, dosage, side effects, how to use it

What Drug Furosemide?

What drug Furosemide?

Furosemide is a drug to reduce excess fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidneys. This drug is also used to treat high blood pressure. Furosemide is a diuretic drug that causes you to urinate more frequently to help flush excess water and salt from your body.

This drug can also be used to reduce high calcium levels in the blood (hypercalcemia).

The furosemide dosage and the side effects of furosemide are detailed below.

How do you use Furosemide?

Take Furosemide with or without food, usually once or twice a day. You should not use this medicine within 4 hours before bedtime so as not to wake up to urinate.

The dose of this medication is based on your health condition, age, and response to therapy. For children, the dosage is also based on body weight. Seniors usually start with a lower dose to lower their risk of side effects. Do not increase your dose or use it more often than recommended.

Use this remedy regularly for maximum benefits. To help you, use it every day at the same time. Continue treatment even though you feel well. Most people with high blood pressure don't feel sick.

Sucralfate, cholestyramine, and colestipol can decrease the absorption of Furosemide. If you are using the drug, give the interval of administration of Furosemide at least 2 hours.

Tell your doctor if your condition does not improve or gets worse (for example, your blood pressure remains high or increases).

Follow the rules given by your doctor or pharmacist before starting treatment. If you have any questions, consult your doctor or pharmacist.

How to store Furosemide?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Furosemide dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dosage of Furosemide for adults?

Furosemide dose for ascites
Oral

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After a repeat dose, if there is still no response within 2 hours, the last IV dose can be increased by 20-40 mg until a diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg with a bolus initial dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Dosage of furosemide for congestive heart failure

Oral:

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After a repeat dose, if there is still no response within 2 hours, the last IV dose can be increased by 20-40 mg until a diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg as the initial bolus dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Furosemide dose for edema

Oral:

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion:

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After repeated doses, if there is still no response within 2 hours, the last IV dose may be increased by 20-40 mg until diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg with a bolus initial dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Furosemide dosage for nonobstructive oliguria

Oral:

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion:

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After a repeat dose, if there is still no response within 2 hours, the last IV dose can be increased by 20-40 mg until a diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg with a bolus initial dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Furosemide dose for pulmonary edema

Oral:

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion:

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After repeated doses, if there is still no response within 2 hours, the last IV dose may be increased by 20-40 mg until diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg with a bolus initial dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Furosemide dose for renal failure

Oral:

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion:

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After a repeat dose, if there is still no response within 2 hours, the last IV dose can be increased by 20-40 mg until a diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg with a bolus initial dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Dosage of urosemide for kidney transplantation

Oral:

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion:

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After a repeat dose, if there is still no response within 2 hours, the last IV dose can be increased by 20-40 mg until a diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg with a bolus initial dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Furosemide dosage for oliguria

Initial: 20-80 mg per dose.

Maintenance: Increase 20-40 mg / dose every 6-8 hours for the desired effect. The dose interval is usually 1 or 2 times a day, with a maximum daily dose of 600 mg.

Infusion:

10-20 mg once for 1-2 minutes. A repeat dose which is the same as the initial dose can be given within 2 hours if there is no response. After repeated doses, if there is still no response within 2 hours, the last IV dose may be increased by 20-40 mg until diuresis occurs. A single dose exceeding 200 mg is rarely needed.

Continuous IV infusion: 0.1 mg / kg with a bolus initial dose, followed by 0.1 mg / kg / hour doubled every 2 hours to a maximum of 0.4 mg / kg / hour.

Furosemide dose for hypercalcemia

• Oral: 10-40 mg 4 times a day.
• IV: 20-100 mg every 1-2 hours for 1-2 minutes

What is the dosage of Furosemide for children?

Children's furosemide dose for edema
Neonatal:

Oral: Bioavailability of about 20%; a dose of 1 mg / kg / dose 1-2 times / day has been used

IM or IV: Oxygenation (ECMO) circuit; do not give directly to this circuit; high doses are required for adequate diuretic effect.

Gestational age less than 31 weeks:

1 mg / kg / dose every 24 hours; accumulation and increased risk of toxicity may occur with doses of more than 2 mg / kg or doses of 1 mg / kg given more frequently than every 24 hours.

Gestational age ≥31 weeks

1-2 mg / kg / dose every 12-24 hours

Continuous IV infusion: 0.2 mg / kg / hour, increased by 0.1 mg / kg / hour every 12-24 hours to a maximum infusion rate of 0.4 mg / kg / hour

Pulmonary edema

Inhalation: 1-2 mg / kg / dose diluted in 2 mL NS as a single dose

Infants and Children:

Oral: 2 mg / kg once a day; if not effective, it can be increased by 1-2 mg / kg / dose every 6-8 hours; not more than 6 mg / kg / dose. In most cases, a dose of more than 4 mg / kg or a frequency of once or twice a day is not required.

IM or IV: 1-2 mg / kg / dose every 6-12 hours

Continuous IV infusion: 0.05 mg / kg / hour; dose titration for clinical effect.

In what dosage is Furosemide available?

Furosemide is available in the following dosages.

• Solution, injection: 10 mg / mL (2 mL, 4 mL, 10 mL)
• Solution, Injection 10 mg / mL (10 mL)
• Solution, Oral: 8 mg / mL (5 mL, 500 mL), 10 mg / mL (60 mL, 120 mL)
• Tablet, Oral: 20 mg, 40 mg, 80 mg

Furosemide side effects

What side effects can be experienced due to Furosemide?

Stop using Furosemide and call your doctor if you experience serious side effects such as:

• Ear ringing, deaf
• Itching, no appetite, dark urine, putty, jaundice (yellowing of the skin or eyes)
• Severe pain in the upper abdomen spreading to the back, nausea and vomiting
• Weight loss, body aches, numbness
• Swelling, rapid weight gain, less or no urination
• Chest pain, new or worsening cough with fever, breathing problems
• Pale skin, bruises, unusual bleeding, feeling like floating, fast heart rate, difficulty concentrating
• Low potassium (confusion, irregular heartbeat, discomfort in the legs, muscle weakness or limping)
• Low calcium (tingling around the mouth, tight or contracted muscles, exaggerated reflexes)
• Headache, lightheadedness, weakness or difficulty swallowing
• Severe skin reaction - fever, sore throat, swelling of the face or tongue, burning in your eyes, skin pain, followed by a red or purple rash that spreads (especially on the face or upper body) and causes blisters and peeling

The milder side effects of furosemide include:

• Diarrhea, constipation, abdominal pain
• Dizziness, spinning sensation
• Mild itching or rash

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Furosemide Drug Warnings and Cautions

What should be known before using Furosemide?

Before using Furosemide,

• Tell your doctor and pharmacist if you are allergic to Furosemide, sulfa drugs, or other drugs
• Tell your doctor and pharmacist what prescription and nonprescription drugs you are taking, especially other drugs for high blood pressure, aspirin, corticosteroids (eg prednisone), digoxin (Lanoxin), indomethacin (Indocin), lithium (Eskalith, Lithobid), medications anti diabetes, probenecid (Benemid), and vitamins. If you are also taking cholestyramine or colestipol, take it at least 1 hour before Furosemide
• Tell your doctor if you have or have ever had diabetes, gout, or kidney or liver disease
• Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Do not breastfeed while using this medicine. If you are pregnant and are taking Furosemide, contact your doctor
• If you are going to have surgery, such as dental surgery, tell your doctor or dentist that you are using Furosemide
• Avoid unnecessary or prolonged exposure to the sun and wear protective clothing, sunglasses, and sunscreen

Furosemide can make your skin sensitive to sunlight.

Is Furosemide safe for pregnant and lactating women?

There are no adequate studies regarding the risks of furosemide use in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C (possibly risky) according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

Furosemide Drug Interactions

What medicines may interact with Furosemide?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

If you are taking sucralfate (Carafate), take it at least 2 hours before or after you use Furosemide.

Tell your doctor all the drugs you use, in particular:

• Cisplatin (Platinol)
• Cyclosporine (Neoral, Gengraf, Sandimmune)
• Ethacrynic acid (Edecrin)
• Lithium (Eskalith, Lithobid)
• Methotrexate (Rheumatrex, Trexall)
• Phenytoin (Dilantin)
• Antibiotics such as amikacin (Amikin), cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Mycifradin), Neo Fradin, Neo Tab tobramycin (Nebcin, Tobi)
• Heart or blood pressure medications such as amiodarone (Cordarone, Pacerone), benazepril (Lotensin), candesartan (Atacand), eprosartan (Teveten), enalapril (Vasotec), irbesartan (Avapro, Avalide), lisinopril (Prinivil, Zestrilza), losartan , Hyzaar), olmesartan (Benicar), quinapril (Accupril), ramipril (Altace), telmisartan (Micardis), valsartan (Diovan), and others
• Laxatives (Metamucil, Milk of Magnesia, Colace, Dulcolax, Epsom salts, senna, etc.)
• Salicylates such as aspirin, Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others or
• Steroids (prednisone and others)

This list is not complete and other drugs may interact with Furosemide. Tell your doctor all the drugs you use. This includes prescription, non-prescription drugs, vitamins, and herbal products. Do not initiate new medications without the doctor's knowledge.

Can food or alcohol interact with Furosemide?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions may interact with Furosemide?

The presence of other health problems in your body may affect the use of this medicine. Tell your doctor if you have other health problems, in particular:

• Sulfa drug allergy (eg sulfamethoxazole, sulfasalazine, sulfisoxazole, Azulfidine®, Bactrim®, Gantrisin®, or Septra®)
• Anemia
• BAK problem
• Dehdrasi
• Diabetes mellitus
• Uric acid
• Hearing problems
• Hyperuricemia (high uric acid in the blood)
• Hypocalcemia (low calcium level in the blood)
• Hypochloremic alkalosis (low chlorine levels in the blood)
• Hypokalemia (low potassium levels in the blood)
• Hypomagnesemia (low magnesium levels in the blood)
• Hyponatremia (low sodium level in the blood)
• Hypotension (low blood pressure)
• Hypovolemia (low blood volume)
• Low liver disease (eg cirrhosis)
• Systemic lupus erythematosus (SLE)
• Tinnitus (ringing in the ears)
• Difficulty urinating (caused by abnormal emptying of the bladder, enlarged prostate, squeezing urethra) - use with caution as it can make the condition worse
• Anuria (unable to urinate) - Should not be used in patients with this condition
• Hypoproteinemia (low protein levels in the blood) from kidney problems
• Radiocontrast nephropathy (kidney problems) —may worsen side effects
• Severe kidney disease — use with caution, as side effects can increase by slowing down the removal of the drug from the body

Furosemide overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.