Furosemide

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Furosemide

What is Furosemide?

Furosemide is a loop diuretic used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a chronic 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, a subcutaneous injection (Furoscix), and an 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

Before taking this medicine

You should not use furosemide if you are allergic to it, 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) may be used to treat congestion due to fluid overload in adults with chronic heart failure (HF) or chronic kidney disease, including the nephrotic syndrome. Furoscix should not be used for emergencies 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.

How should I use furosemide?

Take or administer furosemide exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Furosemide oral tablets and liquid are taken by mouth. Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Furosemide injection is given in a muscle, under the skin, or in a vein. A healthcare provider will give you this injection if you are unable to take the medicine by mouth.

Furosemide subcutaneous infusion (Furoscix) is administered via the On-body infusor and will take about 5 hours.

Do not get the On-body infusor wet. Do not bathe, shower, swim or exercise while wearing the infusor.
Also, do not apply any products such as lotions or creams in the area where the infusor is placed.
Furoscix is not for chronic use and should be replaced with oral diuretics as soon as practical.
It is not recommended to travel by car or airplane while using Furoscix. Also do not use the infusor within 12 inches of mobile phones, tablets, computers, or wireless accessories such as remote control, or Bluetooth devices.

General furosemide dosing information.

Do not use more than your recommended dose. High doses of furosemide may cause irreversible hearing loss.

Doses are based on weight in children and teenagers. Your child’s dose may change if the child gains or loses weight.

This medicine will make you urinate more often and you may get dehydrated easily. Follow your doctor’s instructions about using potassium supplements or getting enough salt and potassium in your diet.

Your blood pressure will need to be checked often and you may need other medical tests.

If you have high blood pressure, keep using furosemide even if you feel well. High blood pressure often has no symptoms.

Dosing Information

Usual Adult Dose for Edema associated with Congestive Heart Failure, Cirrhosis of the Liver, and Chronic 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.

Subcutaneous: Furoscix 30 mg over the first hour, then 12.5 mg per hour for the subsequent 4 hours.

This dose is automatically delivered by the Furoscix On-Body Infusor
Furoscix is not for chronic use and should be replaced with oral diuretics as soon as practical.

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.

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