What are the primary uses of furosemide 40 mg. How does furosemide work as a diuretic. What are the common side effects of furosemide. How should furosemide be taken for optimal effectiveness. What precautions should be considered when using furosemide.

Understanding Furosemide: A Powerful Diuretic Medication

Furosemide, commonly prescribed in a 40 mg dosage, is a potent diuretic medication used to address various medical conditions. This “water pill” works by increasing urine production, helping the body eliminate excess fluid and salt. However, its potency necessitates careful monitoring and proper usage to avoid potential complications.

How Does Furosemide Work?

Furosemide acts on the kidneys to promote the excretion of water and electrolytes. By inhibiting the reabsorption of sodium and chloride in the loop of Henle and distal renal tubule, it increases urine output. This mechanism of action makes it effective in treating conditions associated with fluid retention and high blood pressure.

Primary Uses of Furosemide 40 mg

Furosemide is prescribed for various medical conditions, primarily those involving fluid retention or edema. Its versatility makes it a valuable tool in managing several health issues:

• Reducing edema caused by heart failure, liver disease, or kidney disease
• Treating high blood pressure (hypertension)
• Alleviating symptoms such as shortness of breath and swelling in arms, legs, and abdomen
• Managing fluid buildup in the lungs (pulmonary edema)

Can furosemide be used for conditions other than edema and hypertension? While its primary uses focus on fluid retention and blood pressure management, furosemide may occasionally be prescribed off-label for other conditions. However, such uses should always be under the guidance of a healthcare professional.

Proper Administration of Furosemide

Taking furosemide correctly is crucial for its effectiveness and to minimize potential side effects. Here are the key points to remember:

1. Follow your doctor’s instructions precisely
2. Take the medication orally, with or without food
3. Dosing is typically once or twice daily
4. Avoid taking it within 4 hours of bedtime to prevent nighttime urination
5. Maintain a consistent schedule for optimal results

Is the timing of furosemide intake important? Indeed, the timing can significantly impact its effectiveness and your quality of life. Taking it early in the day can help prevent frequent nighttime urination, while consistent timing helps maintain steady blood levels of the medication.

Potential Side Effects and Precautions

While furosemide is generally well-tolerated, it can cause various side effects. Being aware of these potential issues can help you identify and address them promptly:

Common Side Effects

• Dizziness and lightheadedness
• Headache
• Blurred vision
• Increased urination

Serious Side Effects Requiring Immediate Attention

• Severe dizziness or fainting
• Unusual dry mouth or extreme thirst
• Muscle cramps or weakness
• Irregular heartbeat
• Signs of dehydration or electrolyte imbalance

How can one minimize the risk of side effects when taking furosemide? Staying well-hydrated, following dosage instructions carefully, and regularly monitoring your health with your healthcare provider can help reduce the risk of adverse effects. It’s also crucial to report any unusual symptoms promptly.

Interactions and Precautions with Furosemide

Furosemide can interact with various medications and medical conditions. Being aware of these interactions is crucial for safe and effective treatment:

Drug Interactions

• Sucralfate, cholestyramine, and colestipol can decrease furosemide absorption
• Certain antibiotics may increase the risk of hearing damage when combined with furosemide
• NSAIDs can reduce the effectiveness of furosemide

Medical Conditions Requiring Caution

• Kidney disease
• Liver disease
• Gout
• Diabetes
• Lupus

Why is it essential to inform your healthcare provider about all medications and medical conditions before starting furosemide? Full disclosure allows your doctor to assess potential risks, adjust dosages, or choose alternative treatments if necessary, ensuring your safety and the medication’s effectiveness.

Monitoring and Follow-up While on Furosemide

Regular monitoring is crucial when taking furosemide to ensure its effectiveness and minimize risks:

• Regular blood pressure checks
• Blood tests to monitor electrolyte levels and kidney function
• Weighing yourself daily to track fluid retention
• Reporting any unusual symptoms to your healthcare provider

How often should one have follow-up appointments when taking furosemide? The frequency of follow-ups can vary based on individual health status and response to the medication. Initially, more frequent visits may be necessary, followed by regular check-ups as determined by your healthcare provider.

Special Considerations for Furosemide Use

Certain groups may require special attention when using furosemide:

Elderly Patients

Older adults may be more sensitive to the effects of furosemide and may require lower initial doses to reduce the risk of side effects.

Pregnant and Breastfeeding Women

Furosemide should be used during pregnancy only if clearly needed, as it may harm the unborn baby. It’s also known to pass into breast milk, potentially affecting nursing infants.

Patients with Diabetes

Furosemide can affect blood sugar levels, necessitating careful monitoring and possible adjustments to diabetes medications.

Are there alternative medications for those who cannot take furosemide? Yes, other diuretics like thiazides or potassium-sparing diuretics may be suitable alternatives, depending on the specific medical condition and individual health factors. Your healthcare provider can recommend the most appropriate option based on your unique situation.

Long-term Management and Lifestyle Considerations

Successfully managing conditions treated with furosemide often involves more than just taking the medication. Lifestyle modifications can play a crucial role in overall treatment success:

Dietary Adjustments

• Limiting sodium intake to enhance the medication’s effectiveness
• Maintaining adequate potassium levels through diet or supplements as advised by your doctor
• Staying well-hydrated while being mindful of fluid restrictions if applicable

Exercise and Physical Activity

Regular physical activity, as approved by your healthcare provider, can complement the effects of furosemide in managing conditions like hypertension and heart failure.

Stress Management

Chronic stress can exacerbate conditions like hypertension. Incorporating stress-reduction techniques such as meditation, yoga, or deep breathing exercises can be beneficial.

How can patients effectively incorporate these lifestyle changes while taking furosemide? Gradual implementation of changes, regular communication with healthcare providers, and joining support groups or educational programs can help patients successfully integrate lifestyle modifications into their treatment plan.

Understanding Potential Complications of Long-term Furosemide Use

While furosemide is generally safe and effective, long-term use may lead to certain complications that require attention:

Electrolyte Imbalances

Prolonged use of furosemide can lead to imbalances in electrolytes such as potassium, sodium, and magnesium. Regular blood tests and possible supplementation may be necessary.

Kidney Function Changes

Long-term use may affect kidney function, particularly in elderly patients or those with pre-existing kidney issues. Monitoring renal function is crucial.

Metabolic Alkalosis

This condition, characterized by an increase in blood pH, can occur with prolonged furosemide use and may require dose adjustment or additional treatment.

Hearing Impairment

In rare cases, high doses or long-term use of furosemide may lead to hearing problems. Any changes in hearing should be reported immediately.

Can the risk of these complications be minimized while continuing necessary treatment with furosemide? Yes, through regular monitoring, dose adjustments when needed, and addressing any emerging issues promptly, many of these potential complications can be managed effectively. Your healthcare provider will work with you to balance the benefits of furosemide against any potential risks.

Furosemide in Comparison to Other Diuretics

Understanding how furosemide compares to other diuretics can provide insight into why it might be prescribed in certain situations:

Loop Diuretics vs. Thiazide Diuretics

Furosemide is a loop diuretic, which tends to be more potent than thiazide diuretics like hydrochlorothiazide. Loop diuretics are often preferred in cases of severe edema or when rapid diuresis is needed.

Potassium-Sparing Diuretics

Unlike furosemide, which can lead to potassium loss, medications like spironolactone spare potassium. They may be used in combination with furosemide to balance electrolyte levels.

Carbonic Anhydrase Inhibitors

These diuretics, such as acetazolamide, work differently from furosemide and are typically used for specific conditions like glaucoma or altitude sickness.

Why might a healthcare provider choose furosemide over other diuretics? The choice often depends on the specific medical condition, severity of symptoms, patient’s kidney function, and potential side effects. Furosemide’s potency makes it particularly useful in situations requiring significant fluid removal, such as severe heart failure or advanced kidney disease.

Patient Education and Self-Management with Furosemide

Empowering patients with knowledge about furosemide can lead to better treatment outcomes and improved quality of life:

Understanding Medication Effects

• Recognizing the importance of consistent medication intake
• Being aware of expected effects, such as increased urination
• Knowing the signs of potential side effects or complications

Self-Monitoring Techniques

• Daily weight measurements to track fluid retention
• Blood pressure monitoring at home, if advised by a healthcare provider
• Keeping a symptom diary to share with healthcare providers

Emergency Preparedness

• Knowing when to seek immediate medical attention
• Having a plan for managing missed doses
• Understanding potential drug interactions with over-the-counter medications

How can patients effectively communicate their experiences and concerns about furosemide to their healthcare providers? Maintaining open and honest communication, preparing questions before appointments, and sharing detailed information about symptoms, side effects, and any challenges in following the treatment plan can greatly enhance the quality of care and treatment outcomes.

Future Directions and Research in Diuretic Therapy

While furosemide has been a mainstay in diuretic therapy for decades, ongoing research continues to explore new avenues for improvement:

Novel Formulations

Researchers are investigating new delivery methods for furosemide, such as extended-release formulations or transdermal patches, which could provide more consistent drug levels and potentially reduce side effects.

Combination Therapies

Studies are exploring the effectiveness of combining furosemide with other medications to enhance its diuretic effect while minimizing adverse reactions.

Personalized Medicine Approaches

Advances in genetic research may lead to more tailored diuretic therapies, allowing healthcare providers to select the most effective and least problematic treatments based on individual patient profiles.

Alternative Diuretic Agents

Scientists are continuously searching for new diuretic compounds that could offer improved efficacy or reduced side effect profiles compared to current options like furosemide.

What potential benefits could these research directions bring to patients requiring diuretic therapy? Future developments may lead to more effective fluid management with fewer side effects, improved quality of life for patients on long-term diuretic therapy, and potentially better outcomes in conditions like heart failure and hypertension where diuretics play a crucial role.

As research progresses, patients currently using furosemide can look forward to potential improvements in their treatment options. However, it’s important to continue following current treatment plans as prescribed by healthcare providers, while staying informed about new developments that may become available in the future.

Furosemide Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Furosemide is a very potent medication. Using too much of this drug can lead to serious water and salt/mineral loss. It is important that you are closely monitored by your doctor while taking this medication. Tell your doctor right away if you become very thirsty or confused, or develop muscle cramps/weakness. See also Side Effects section.

Warnings:

Furosemide is a very potent medication. Using too much of this drug can lead to serious water and salt/mineral loss. It is important that you are closely monitored by your doctor while taking this medication. Tell your doctor right away if you become very thirsty or confused, or develop muscle cramps/weakness. See also Side Effects section.

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Uses

Furosemide is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen.This drug is also used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.Furosemide is a “water pill” (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt.

How to use furosemide oral

Read the Patient Information Leaflet if available from your pharmacist before you start taking furosemide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, with or without food, usually once or twice daily. It is best to avoid taking this medication within 4 hours of your bedtime to prevent having to get up to urinate.

Dosage is based on your medical condition, age, and response to treatment. For children, the dose is also based on weight. Older adults usually start with a lower dose to decrease the risk of side effects. Do not increase your dose or take it more often than directed.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) of the day as directed. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

Sucralfate, cholestyramine, and colestipol can decrease the absorption of furosemide. If you are taking any of these drugs, separate the timing of each dose from furosemide by at least 2 hours.

Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase).

Side Effects

Dizziness, lightheadedness, headache, or blurred vision may occur as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may cause dehydration and electrolyte imbalance. Tell your doctor right away if you have any of these unlikely but serious side effects: muscle cramps, weakness, unusual tiredness, confusion, severe dizziness, fainting, drowsiness, unusual dry mouth/thirst, nausea, vomiting, fast/irregular heartbeat.

Tell your doctor right away if you have any serious side effects, including: signs of kidney problems (such as change in the amount of urine), numbness/tingling/pain/redness/swelling of the arms/legs, hearing changes (such as ringing in the ears, temporary or permanent decreased hearing/deafness), stomach/abdominal pain, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking furosemide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, inability to make urine, gout, lupus.

If you have diabetes, furosemide may make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor.

Furosemide may reduce the potassium level in your blood. Your doctor may instruct you to add potassium-rich foods to your diet (such as bananas, orange juice) or prescribe potassium supplements to prevent potassium loss. Ask your doctor for more details.

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

This drug may make you dizzy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Severe sweating, diarrhea, or vomiting can increase the risk of dehydration. Report prolonged diarrhea or vomiting to your doctor. Follow your doctor’s instructions about the amount of fluids you can drink.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Babies born early (premature infants) and children may be more sensitive to certain effects of this drug, such as kidney stones.

Older adults may be more sensitive to the effects of this drug, especially dizziness and water/mineral loss.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk and may affect milk production. Consult your doctor before breast-feeding.

Interactions

See also the How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: desmopressin, ethacrynic acid, lithium.

Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

This medication may interfere with certain lab tests (such as thyroid hormone levels), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Does furosemide oral interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fainting, severe weakness, a severe decrease in the amount of urine.

Do not share this medication with others.

Lifestyle changes that may help this medication work better include exercising, stopping smoking, reducing stress, and changing your diet. Consult your doctor for more details.

Lab and/or medical tests (such as kidney function, blood mineral levels such as potassium) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

furosemide 40 mg tablet

Color: whiteShape: roundImprint: EP 117 40

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 40 mg tablet

Color: whiteShape: roundImprint: 3170 and logo

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 40 mg tablet

Color: whiteShape: roundImprint: RE 23

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 20 mg tablet

Color: whiteShape: roundImprint: RE 22

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 20 mg tablet

Color: whiteShape: roundImprint: EP 116

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 20 mg tablet

Color: whiteShape: ovalImprint: 3169 logo

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 20 mg tablet

Color: whiteShape: roundImprint: M2

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 80 mg tablet

Color: whiteShape: roundImprint: 3171 and Logo

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 20 mg tablet

Color: whiteShape: roundImprint: 54 840

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 80 mg tablet

Color: whiteShape: roundImprint: RE 24

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 80 mg tablet

Color: whiteShape: roundImprint: EP 118 80

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 40 mg tablet

Color: whiteShape: roundImprint: MYLAN 216 40

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 40 mg tablet

Color: whiteShape: roundImprint: 54 583

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 80 mg tablet

Color: whiteShape: roundImprint: 54 533

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 80 mg tablet

Color: whiteShape: roundImprint: MYLAN 232 80

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 40 mg tablet

Color: whiteShape: roundImprint: GG 201

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

furosemide 80 mg tablet

Color: whiteShape: roundImprint: GG 80

This medicine is a white, round, scored, tablet imprinted with “EP 117” and “40”.

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Drug Survey

Are you currently using furosemide oral?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Side effects, dosage, uses, and more

1. Furosemide oral tablet is available as both a generic and a brand-name drug. Brand name: Lasix.
2. Furosemide also comes in an oral solution that you take by mouth and an injectable solution that is given by a healthcare professional.
3. It is used to treat high blood pressure in adults. It’s also used to treat edema in adults and some children, which is swelling caused by fluid buildup in your body.

FDA warning: Dehydration risk

• This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients to drug effects that may be dangerous.
• Furosemide is a strong diuretic (water pill) that helps your body get rid of excess water. It does this by increasing the amount of urine your body makes. If you take too much of this drug, it can lead to very low amounts of water and electrolytes in your body. This can cause dehydration. Your doctor will monitor your fluid levels and may change your dosage based on those levels.

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• Low blood pressure warning: This drug can cause low blood pressure. Symptoms include feeling dizzy and faint after standing up. If this occurs, move slowly when changing positions after sitting or lying down. If this problem continues, call your doctor.
• Low potassium levels warning: This drug can cause low potassium levels. (Potassium is a mineral that helps your nerves, muscles, and organs work normally.) Symptoms include tiredness, muscle weakness, and nausea or vomiting. Call your doctor if you have these symptoms.
• Low thyroid levels warning: High doses (over 80 mg) of furosemide can cause low levels of thyroid hormones. If you’re taking high doses of this drug and have symptoms of thyroid problems, call your doctor. These symptoms can include:
  • tiredness
  • weakness
  • weight gain
  • dry hair and skin
  • increased feelings of being cold

Furosemide oral tablet is a prescription drug that’s available as the brand-name drug Lasix. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Why it’s used

Furosemide is used to treat hypertension (high blood pressure). It is also used to treat edema. This is swelling due to fluid buildup in the body. Edema can be caused by other medical conditions such as heart failure, cirrhosis of the liver, or kidney disease.

Furosemide may be used as part of combination therapy to treat high blood pressure. This means you may need to take it with other medications.

How it works

Furosemide belongs to a class of drugs called diuretics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Furosemide works by helping your body get rid of excess salt and water. It does this by increasing the amount of urine your body makes. This helps lower your blood pressure as well as reduce swelling.

Furosemide oral tablets may cause certain side effects.

More common side effects

The more common side effects that can occur with furosemide include:

• nausea or vomiting
• diarrhea
• constipation
• stomach cramping
• feeling like you or the room is spinning (vertigo)
• dizziness
• headache
• blurred vision
• itching or rash
• increased urination

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Excessive loss of water and electrolytes. Symptoms can include:
  • dry mouth
  • feeling of thirst
  • weakness
  • drowsiness
  • restlessness
  • muscle pains or cramps
  • urinating less
  • fast or abnormal heartbeat
  • severe nausea or vomiting
• Low levels of thyroid hormones. Symptoms can include:
  • tiredness
  • weakness
  • weight gain
  • dry hair and skin
  • increased feelings of being cold
• Pancreatitis (inflammation of the pancreas). Symptoms can include:
  • pain when you eat or drink
  • severe nausea or vomiting
  • fever
• Liver damage. Symptoms can include:
  • yellowing of your skin
  • yellowing of the whites of your eyes
• Hearing loss or ringing in your ears (can be temporary or permanent)
• Blistering or peeling skin
• Orthostatic hypotension (low blood pressure that happens when you stand up)
• Allergic reaction

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

Furosemide oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Examples of drugs that can cause interactions with furosemide are listed below.

Antibiotics

Antibiotics can increase your risk of hearing damage or loss when taken with furosemide. These drugs include:

• amikacin
• gentamicin
• neomycin
• paromomycin
• tobramycin

Antiseizure drug

Taking this drug with furosemide can decrease the effects of furosemide:

• phenytoin

Cancer drug

Taking this cancer drug with furosemide can increase your risk of kidney problems and hearing damage or loss:

• cisplatin

Taking this cancer drug with furosemide can decrease the effects of furosemide. Also, furosemide may increase the amount of this drug in your body, which can increase side effects:

• methotrexate

Immunosuppressant

Taking this drug with furosemide can increase your risk of gouty arthritis:

• cyclosporine

Mood stabilizers (lithium)

Taking lithium with furosemide can increase the levels of lithium in your body. This raises your risk of side effects from lithium.

Muscle relaxers

Taking certain muscle relaxers with furosemide can increase the effects of these drugs. This raises your risk of side effects. These drugs include:

• succinylcholine

Other blood pressure drugs

Taking furosemide with other blood pressure drugs can cause your blood pressure to drop to a dangerously low level. These drugs include:

• benazepril
• captopril
• enalapril
• fosinopril
• lisinopril
• moexipril
• perindopril
• quinapril
• ramipril
• trandolapril

Pain and inflammation drugs (NSAIDs)

Taking NSAIDs (nonsteroidal anti-inflammatory drugs) with furosemide can increase the levels of these drugs in your body. This raises your risk of dangerous side effects. NSAIDs include:

• aspirin
• diflunisal
• indomethacin
• magnesium salicylate
• salsalate

Thyroid drugs

Taking high doses of furosemide with levothyroxine can make levothyroxine less effective. This means it won’t work as well to treat your thyroid condition.

Ulcer drugs

Taking sucralfate with furosemide can make furosemide less effective. This means it won’t work as well to control your symptoms.

Don’t take sucralfate within 2 hours of taking furosemide.

Water pills (diuretics)

Taking other diuretics with furosemide can increase your risk of hearing damage or loss. These drugs include:

• ethacrynic acid

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Furosemide oral tablet comes with several warnings.

Allergy warning

If you have an allergy to sulfonamides (sulfa drugs), you may also be allergic to furosemide. Taking this drug can cause a severe allergic reaction, causing symptoms such as:

• trouble breathing or swallowing
• swelling of your throat or tongue
• hives

If you have these symptoms, call 911 or go to the nearest emergency room right away.

Don’t take this drug again if you have ever had an allergic reaction to it or sulfonamides before. Taking it a second time after any allergic reaction to it could be fatal (cause death).

Alcohol interaction

Having drinks that contain alcohol while taking furosemide can make the drug’s side effects worse. For instance, it can worsen a sudden drop in blood pressure when you stand up after sitting or lying down. It can also make you feel dizzier or more lightheaded.

Warnings for people with certain health conditions

For people living with kidney problems: Furosemide is removed from your body by your kidneys. If you have kidney problems, more of the drug may stay in your body longer. This could lead to dangerous side effects, including very low blood pressure. Your doctor may start you on a lower dose of this drug. Your doctor may also monitor how well your kidneys are working to make sure furosemide is safe for you to take.

For people living with liver problems: If you have liver problems such as cirrhosis or ascites, it’s best to receive furosemide in the hospital. Furosemide can cause very low electrolyte levels, which can cause serious liver damage and loss of brain function. (Electrolytes are minerals that help control the fluid balance in your body and help with other important functions.) Your doctor will monitor you closely.

For people living with diabetes: Furosemide can make it harder to control your blood sugar (glucose) levels. Before taking this drug, be sure your doctor knows you have diabetes.

For people living with bladder disorders: If you have severe problems with emptying your bladder completely, furosemide can make your condition worse. Before taking this drug, be sure your doctor knows you have a bladder disorder.

For people living with thyroid problems: High doses (over 80 mg) of furosemide can cause low levels of thyroid hormones. Be sure to tell your doctor about your thyroid problems before you start taking furosemide.

Warnings for other groups

For pregnant people: Talk with your doctor if you’re pregnant or planning to become pregnant. Research in animals has shown adverse effects on the fetus when the mother takes the drug. There haven’t been enough studies done on humans to be certain how the drug might affect the fetus. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

For people who are nursing: Furosemide may pass into breast milk and can cause serious side effects in a child who is breastfed. It may also cause your body to produce less milk. Tell your doctor if you are nursing. You will need to decide either to stop nursing or stop taking this drug.

For children: In premature infants and children younger than 4 years of age, furosemide may cause kidney problems. It can lead to kidney stones and calcium deposits in the kidneys. If furosemide is given to premature infants during the first few weeks of life, it may increase the risk of problems with the lungs and heart.

This dosage information is for furosemide oral tablet. All possible dosages and drug forms may not be included here. Your dose, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Forms and strengths

Generic: furosemide

• Form: Oral tablet
• Strengths: 20 mg, 40 mg, and 80 mg

• Form: Oral solution
• Strengths: 10 mg per 1 mL, 40 mg per 5 mL

Brand: Lasix

• Form: Oral tablet
• Strengths: 20 mg, 40 mg, and 80 mg

Dosage for hypertension (high blood pressure)

Adult dosage (ages 18–64 years)

• The usual starting dose is 80 mg per day, taken as 40 mg twice each day.
• Your doctor may change your dose or add other blood pressure medications. This depends on how your body responds to the drug.

Child dosage (ages 0–17 years)

This drug has not been studied in children for treating high blood pressure.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Furosemide is removed from your body by your kidneys. If you have kidney problems, more of the drug may stay in your body longer. This can cause dangerous side effects. Your doctor may start you on a lower dose and monitor how well your kidneys are working to make sure this drug is safe for you.

Dosage for edema

Adult dosage (ages 18–64 years)

• The usual starting dose is 20–80 mg, taken once per day. Your doctor may change your dose depending on how your body responds to the drug.
• Once your doctor determines your long-term (maintenance) dose, you may take it once or twice per day.

Child dosage (ages 0–17 years)

• The usual dose is 2 mg per kg of body weight taken once per day.
• It is not recommended to use doses greater than 6 mg per kg of body weight.
• Your doctor may change your child’s dosage depending on how your child’s body responds to the drug.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Furosemide is removed from your body by your kidneys. If you have kidney problems, more of the drug may stay in your body longer. This can cause dangerous side effects. Your doctor may start you on a lower dose and monitor how well your kidneys are working to make sure this drug is safe for you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Furosemide oral tablet is used for short-term or long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: If you are treating high blood pressure, your blood pressure may rise. This raises your risk of serious problems such as stroke or heart attack.

If you are treating edema, your swelling could get worse. This increases your risk of serious problems such as pain, infections, leg ulcers (long lasting sores), and blood clots.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• extreme tiredness
• dizziness
• thirst
• low blood pressure

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: If you’re treating high blood pressure, your blood pressure should be lowered. But you will likely not feel any different. Your doctor will monitor your blood pressure. You can also check it at home using a home blood pressure monitor. If you’re treating edema, your swelling should go down.

Keep these considerations in mind if your doctor prescribes furosemide oral tablet for you.

General

• Furosemide causes you to urinate more, so you should avoid taking it at bedtime.
• You can cut or crush the furosemide tablet.

Storage

• Keep furosemide at room temperature of 59°F (15°C) to 86°F (30°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you or in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

If you’re treating high blood pressure, your doctor may suggest that you monitor your blood pressure. You can do this using a home blood pressure monitor. Your doctor can tell you where to buy this device and how to use it.

Clinical monitoring

Your doctor will monitor the following:

• Blood pressure: Your doctor will check your blood pressure to make sure this drug is keeping your blood pressure under control.
• Electrolyte levels: This drug can cause changes in your electrolyte levels. This includes potassium levels. Your doctor will check your levels to make sure your electrolytes are in a healthy range. (Electrolytes are minerals that manage the fluid levels and other functions in your body.)
• Kidneys: This drug can make kidney problems worse, or even cause new ones. If this drug causes problems for your kidneys, your doctor may need to reduce your dose, or you may need to stop using it.
• Liver: This drug can increase the level of liver enzymes in your body. A raised enzyme level can mean you have liver damage. Your doctor may monitor your enzyme level.
• Thyroid levels: This drug can cause low thyroid hormone levels. Your doctor may do blood tests to monitor your thyroid levels.

Your diet

Furosemide can cause low blood pressure. A low-salt diet puts you at even higher risk of low blood pressure. If you are on a low-salt diet, talk with your doctor about whether this drug is right for you.

Your doctor may suggest that you eat foods high in potassium. These include bananas, dark leafy greens, and avocados.

Sun sensitivity

Your skin may be more sensitive to sunlight while taking furosemide.

• Avoid staying outside directly under the sun for long periods of time.
• Wear protective clothing that covers most areas of your body.
• Use protective sunscreen products.

Hidden costs

You may need to buy a home blood pressure monitor to check your blood pressure at home. Your doctor can tell you more.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Arpimed

What Furosemide is and what it is used for

Furosemide belongs to a group of medicines called diuretics.

Furosemide is indicated for the treatment of edematous syndrome, which is an excess accumulation of fluid in body tissues due to problems with the heart, lungs, kidneys, liver, blood vessels, or high blood pressure. With the help of Furosemide, excess water is excreted from the body by the kidneys.

What you need to know before you use Furosemide

Do not take Furosemide if you:

• are allergic (hypersensitive) to furosemide, other sulfonamide derivatives or any of the other ingredients of the drug,
• severe damage to the kidneys, resulting in renal failure, which is manifested by a violation of the process of urine formation,
• hypokalemia, hyponatremia, or decreased blood levels of other electrolytes or hypovolemia (doctor’s recommendation required),
• dehydration,
• arterial hypotension,
• the use of potassium preparations or potassium-sparing diuretics for the treatment of arterial hypertension (for example, amiloride or spironolactone),
• cirrhosis of the liver (fatigue, weakness, water retention, feeling unwell, loss of weight or appetite, yellowing of the skin or eyes, itching) or hepatic encephalopathy (confusion, decreased concentration and hepatic coma due to liver failure),
• Addison’s disease (low secretion of corticosteroids),
• digitalis intoxication (feeling unwell, hyperkalemia, bradycardia, tachycardia or irregular heartbeat),
• breastfeeding period.

Talk to your doctor or pharmacist before taking Furosemide if you have: tension,

You must be seen by your doctor who can do additional blood tests while you are taking this drug, if needed.

Other medicines and Furosemide

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. Specifically:

• blood pressure lowering drugs such as ACE inhibitors, renin inhibitors, alpha blockers, calcium channel blockers, diuretics, phenothiazines,
• antipsychotics (eg pimozide, amisulpride, sertindole),
• antiarrhythmics (e.g. sotalol, amiodarone, flecainide),
• digoxin, cardiac glycoside,
• moxisilite, for the treatment of Raynaud’s Syndrome,
• nitrates (for the treatment of angina pectoris),
• lithium preparations, for the treatment of depression and mania,
• sucralfate, for gastric ulcer,
• cholestyramine or cholestipol, cholesterol-lowering agents,
• non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen,
• aspirin, analgesic,
• antibiotics, for treating kidney or ear infections (cefaclor, colistin, gentamicin, vancomycin),
• amphotericin, for the treatment of fungal infections,
• chloral hydrate (for insomnia),
• antidepressants (e. g. monoamine oxidase (MAO) inhibitors),
• anti-diabetic drugs such as insulin or oral hypoglycemic agents,
• antiepileptic drugs, such as phenytoin or carbamazepine,
• corticosteroids or antihistamines (for the treatment of allergic reactions),
• drugs for the treatment of ADHD (Attention Deficit Hyperactivity Disorder),
• anticancer drugs, e.g. aldesleukin,
• levodopa (for the treatment of Parkinson’s disease),
• birth control pills,
• alprostadil, in the treatment of erectile dysfunction,
• certain asthma medicines such as theophylline or salbutamol,
• probenecid, for the prevention of gout,
• laxatives used for a long period of time,
• medicines or foodstuffs containing licorice,
• If you are considering a medical procedure involving a curare-like muscle relaxant (such as vecuronium) or the possible use of anesthetics, please consult your anesthetist/dentist or other qualified healthcare professional.

Furosemide and alcohol

Avoid alcohol while taking Furosemide as it may further lower your blood pressure.

Pregnancy and breast-feeding

Talk to your doctor before taking Furosemide if you are pregnant, planning to become pregnant or breastfeeding.

Effects on ability to drive and use machines

Do not drive or use machines if you feel your alertness is reduced after taking Furosemide tablets.

Important information about some of the ingredients in Furosemide

The product contains lactose.

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

How to take Furosemide

Always take Furosemide exactly as prescribed by your doctor. If you have any doubts, you should consult your doctor or pharmacist.

Swallow the tablets with a glass of water.

Dosages

Fluid retention: The recommended starting dose is 40 mg in the morning, then 20 mg daily or 40 mg every other day. The daily dose can be up to 80 mg.

Arterial hypertension: 20-40 mg twice a day.

Old age: doses may be reduced for this age group.

Children under 12 years: it is recommended to use a more convenient dosage form of the drug for this age group.

Dose adjustment may be necessary in patients with:

• hypoproteinemia,
• liver enlargement/dysfunction.

If you have taken more Furosemide than recommended

If you have taken more Furosemide tablets than recommended, contact your doctor immediately or go straight to the hospital and take the package of medicine with you. Overdose symptoms include dehydration and changes in blood levels of certain substances.

If you forget to take Furosemide

If you forget to take your next dose, take it as soon as you remember. Then take the next dose at the usual recommended time. Do not take a double dose to make up for a missed dose.

If you stop taking Furosemide

Talk to your doctor before stopping Furosemide.

Possible side effects

Like all medicines, Furosemide can cause side effects, although not everyone gets them.

If you have any of the following side effects while using this drug, call your doctor or nearest hospital right away:

• A severe allergic reaction that may include skin rash, itching, dermatitis, skin peeling, sensitivity to sunlight or sunlight lamps or fever, swelling of the face, lips, tongue or throat, or difficulty breathing or swallowing.
• Blisters or peeling of the skin around the lips, eyes, mouth, nose and genitals, flu-like symptoms and fever, which may occur with Stevens-Johnson syndrome.
• Inflammation of the blood vessels (vasculitis, which can cause rash, fever, and joint or muscle pain) or inflammation of the kidneys, which can affect the frequency of urination or the presence of blood in the urine. You may have a fever, drowsiness, or swelling in your ankles.
• Thrombosis causing pain, swelling or tenderness in the legs.

Tell your doctor or pharmacist if you experience any of the following side effects:

Very common: may affect more than 1 in 10 people 013

• Dehydration, changes in the body’s fluid and electrolyte balance (eg, sodium, potassium, chloride, calcium, and magnesium) causing dry mouth, weakness, fatigue or drowsiness, restlessness, seizures, muscle pain, lethargy or seizures, hypotension causing low concentration and slow response, water retention, fast or irregular heartbeat, and nausea and vomiting.

Common: may affect up to 1 in 10 people

• Reduced blood volume (hypovolemia).
• An increase in the concentration of creatinine and urea in the blood (detected by the results of a blood test).

Uncommon: may affect up to 1 in 100 people

Rare: may affect up to 1 in 1000 people weight.

Periodic blood tests should be done by the attending physician to make sure there are no changes in the blood.

• Mental disorders causing delusions, hallucinations, speech disorders.
• Tingling sensation in limbs.
• Confusion, headache, fatigue, general malaise, fever.
• Tinnitus, hearing loss, usually reversible.
• Symptoms of shock such as changes in heart rate, shortness of breath, cold and damp skin.
• Inflammation of the pancreas causing abdominal or back pain and nausea.
• Liver dysfunction causing yellowing of the skin or sclera of the eyes.
• Skin rash.

Very rare: may affect up to 1 in 10,000 people:

• Inflammation of the kidneys or kidney failure, which may cause back pain or changes in the number and frequency of the urge to urinate.

The frequency of adverse reactions is unknown:

• Deterioration in the presence of water and electrolyte balance in the body.
• Acute generalized exanthematous pustulosis (AGEP) (acute drug-induced skin injury).
• Dizziness, syncope and loss of consciousness due to symptomatic hypotension.
• Hypokalemia.

Additional adverse reactions seen in children:

• Increased risk of developing or persisting patent ductus arteriosus in preterm infants.
• Nephrolithiasis in infants.

Reporting side effects:

Tell your doctor, pharmacist or nurse if you notice any side effects. This includes any possible side effects not listed in this package insert. You can also report side effects to Arpimed LLC by going to the website www.arpimed.com and filling out the appropriate form “Report a side effect or ineffectiveness of a drug” and to the Scientific Center for Expertise of Drugs and Medical Technologies named after. Academician E.Gabrielyan, by going to the website www. pharm.am in the section “Report a side effect of a drug” and fill out the form “Map of reporting a side effect of a drug”. Scientific center hotline: +37410200505; +37496220505.

How to store Furosemide

Keep out of the reach of children, protected from moisture and light at a temperature of 15-25 ⁰ C.

Shelf life – 3 years. Do not take Furosemide after the expiry date which is stated on the package. When specifying the expiration date, the last day of the specified month is meant.

Do not dispose of medicines in wastewater or sewers. Ask your pharmacist how to dispose of a medicine you no longer need. These measures are aimed at protecting the environment.

Contents of the pack and additional information

What Furosemide contains

One tablet contains:

active ingredient: furosemide – 40 mg;

excipients: microcrystalline cellulose, lactose monohydrate, magnesium stearate, sodium starch glycolate, povidone, corn starch.

What Furosemide looks like and contents of the pack

White, flat tablets with inclusions and score on one side.

Packaging description

40 tablets in a blister pack (PVC/aluminium). 1 blisters (40 tablets) together with the leaflet are placed in a carton box.

10 tablets in blisters (PVC/aluminium). 4 blister packs (40 tablets), together with the leaflet, are placed in a carton box.

Holiday conditions

Available on prescription.

Furosemide tablets 40mg №10×5 – Health Planet

Name

Furosemide.

Description

Tablets white or almost white, flat-cylindrical, bevelled.

Main active ingredient

Release form

Tablets.

Dosage

40 mg.

Special instructions

Pharmacotherapeutic group

Highly active diuretics. Sulfonamides.
ATX code: C03CA01.

Pharmacodynamics

Loop diuretic; causes a rapidly advancing, strong and short-term diuretic effect. The diuretic effect is dose dependent. When taken orally, the onset of action is after 20-30 minutes, reaches a maximum after 1-2 hours, the duration of action is from 3-4 to 6 hours.
Inhibits the reabsorption of sodium and chloride ions, mainly in the thick segment of the ascending part of the loop of Henle. Furosemide has a pronounced diuretic, natriuretic, chloruretic effect. In addition, it increases the excretion of potassium, calcium, magnesium ions.

In heart failure, after 20 minutes it leads to a decrease in the preload on the heart. The maximum hemodynamic effect is achieved by the second hour of the drug’s action, which is due to a decrease in the tone of the venous vessels, a decrease in the volume of circulating blood and interstitial fluid. It has a hypotensive effect due to an increase in the excretion of sodium chloride, a decrease in the response of vascular smooth muscles to vasoconstrictor effects and as a result of a decrease in the volume of circulating blood.

Pharmacokinetics

Absorption is high, the maximum concentration is observed in blood plasma when taken orally after 1 hour.
Bioavailability 60-70%. The relative volume of distribution is 0.2 l / kg. Communication with blood plasma proteins – 98%. Penetrates through the placental barrier, excreted in breast milk. Metabolized in the liver. It is secreted into the lumen of the renal tubules through the anion transport system existing in the proximal nephron.

60-70% is excreted by the kidneys, the rest – by the intestines. The half-life is 1-1.5 hours.

Indications for use

Edema of cardiac or renal origin.
Edema of hepatic origin, usually in combination with potassium-sparing diuretics. Arterial hypertension in patients with chronic renal failure who are contraindicated in the appointment of thiazide diuretics (especially with creatinine clearance below 30 ml / min).

Dosage and administration

Taken orally. The dose depends on the course and severity of the disease.
Adults. With edema of cardiac, renal or hepatic origin:

– moderate condition: ½-1 tablet per day,

– severe condition: 2-3 tablets per day in 1 or 2 doses, or 3-4 tablets per day in 2 doses.

For high blood pressure in patients with chronic renal failure: in combination with other antihypertensive agents (antagonists of the renin-angiotensin system), the usual doses of 20-120 mg per day in one or two doses are recommended.

Children

For the treatment of edema, the daily dose is 1–2 mg/kg of body weight in 1–2 divided doses.

Use in elderly patients

Dose selection and adjustment in elderly patients should be done with caution, usually starting at the lower end of the therapeutic dose range.

Use during pregnancy and lactation

During the first trimester, in the II-III trimesters of pregnancy, furosemide can be used for health reasons.
Excreted in milk in women during lactation, in connection with which it is necessary to stop breastfeeding for the period of treatment.

Precautions

Accidental use of the drug may lead to hypovolemia, dehydration.
In hepatocellular insufficiency, treatment should be carried out with caution, under strict control of electrolytes, given the risk of hepatic encephalopathy. If necessary, treatment should be stopped immediately.

Taking furosemide in case of partial obstruction of the urinary tract can lead to urinary retention. Diuresis should be closely monitored, especially at the start of treatment with furosemide.

Patients with hypersensitivity to sulfonamides and sulfonylurea derivatives may have cross-sensitization to furosemide.

Photosensitivity reactions have been reported with thiazide diuretics. If photosensitivity reactions occur, furosemide should be discontinued. If necessary, it is recommended to protect exposed areas of the skin exposed to sunlight or ultraviolet radiation from artificial sources.

Since the medicinal product contains lactose, its use is not recommended in patients with galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome.

Electrolyte balance

Natremia. It is necessary to control the level of sodium before starting therapy and regularly monitor it thereafter. Treatment with diuretics can provoke hyponatremia. A decrease in the level of sodium in the blood is initially asymptomatic, regular monitoring should be more frequent in patients at risk: advanced age, cachexia (malnutrition) or cirrhosis.

Potassium. When using loop diuretics, a decrease in sodium levels with hypokalemia is possible. The risk of sudden hypokalemia (Glycemia. The frequency of glycemia is low, however, in diabetes mellitus, it is necessary to systematically monitor the level of glucose in the blood and urine.

Uricemia. The release of uric acid decreases, therefore, with hyperuricemia and especially gout, the use is not recommended.

Careful monitoring of patients at high risk of developing electrolyte disorders (vomiting, diarrhea, profuse sweating) is necessary. Dehydration, hypovolemia or acid-base imbalance requires adjustment of therapy and / or temporary discontinuation of treatment.

Creatinine. Regular monitoring of serum creatinine is recommended during treatment with furosemide.

Careful monitoring of patients at high risk of developing electrolyte disorders (vomiting, diarrhea, sweating) is necessary. Dehydration, hypovolemia, or acid-base imbalance require treatment adjustment and/or temporary discontinuation of treatment.

Athletes.

The presence of furosemide results in positive tests in anti-doping controls.

Against the background of course treatment, it is necessary to periodically monitor blood pressure, the content of electrolytes in blood plasma (including Na +, Ca2 +, K +, Mg2 +), acid-base state, the content of residual nitrogen, creatinine, uric acid, liver function and, if necessary, carry out an appropriate correction of treatment.

Patients with hypersensitivity to sulfonamides and sulfonylurea derivatives may have cross-sensitization to furosemide.

When prescribing high doses of furosemide, in order to avoid the development of hyponatremia and metabolic alkalosis, it is not advisable to limit the intake of table salt.

For the prevention of hypokalemia, the simultaneous administration of potassium supplements or potassium-sparing diuretics (spironolactone), as well as a diet rich in potassium, is recommended.

Selection of the dosage regimen for patients with ascites on the background of cirrhosis of the liver, liver failure should be carried out in stationary conditions (disturbances in water and electrolyte balance can cause the development of hepatic coma). Regular monitoring of the content of plasma electrolytes is shown.

With the appearance or increase of azotemia and oliguria in patients with severe progressive kidney disease, it is recommended to suspend treatment.

In patients with diabetes mellitus or with impaired glucose tolerance, periodic monitoring of blood and urine glucose levels is required.

In patients who are unconscious, with benign prostatic hyperplasia, narrowing of the ureters or hydronephrosis, control of urination is necessary (acute urinary retention is possible).

Due to the presence of lactose in the composition, this drug is contraindicated in case of congenital galactosemia, glucose-galactose malabsorption syndrome, lactase deficiency.

Interactions with other drugs

Combinations not recommended
Co-administration of furosemide and chloral hydrate is not recommended.

The ototoxicity of aminoglycosides and other ototoxic drugs may be increased by concomitant use of furosemide. Such combinations should be avoided, as the resulting hearing loss may be irreversible. An exception is the use of this combination for health reasons.

Concomitant use of furosemide and lithium preparations is not recommended.

Combinations requiring special precautions

If forced diuresis with furosemide is required during treatment with cisplatin, furosemide may be given at low doses (up to 40 mg) in normal renal function and no fluid deficit. Otherwise, it is possible to increase the nephrotoxic effect of cisplatin.

Treatment with furosemide can lead to severe hypotension and deterioration of renal function, and in some cases to the development of acute renal failure, especially when prescribing angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists (sartans) at the first dose or increased doses. It is necessary to cancel furosemide, or reduce its dose 3 days before the use of ACE inhibitors or sartans.

Furosemide should be used with caution in combination with risperidone, as mortality may be increased in elderly patients. The need for joint use must be justified taking into account the risk and benefits of this combination. The risk of mortality increases in the presence of dehydration.

Significant interactions of furosemide and other medicinal products

Co-administration of non-steroidal anti-inflammatory drugs (NSAIDs), including acetylsalicylic acid, may reduce the effect of furosemide. In patients with dehydration or hypovolemia, NSAIDs can cause acute renal failure. The toxic effect of salicylates may increase.

Furosemide may be less effective when phenytoin is given concomitantly.

With the simultaneous use of glucocorticosteroids, carbenoxolone, licorice in large quantities, and prolonged use of laxatives, hypokalemia may increase. Hypokalemia or hypomagnesemia may increase myocardial sensitivity to cardiac glycosides and drugs that prolong the QT interval.

The effect of drugs that lower blood pressure (antihypertensive, diuretic and other drugs) can be enhanced when used simultaneously with furosemide. Simultaneous use of probenecid, methotrexate and other drugs that are excreted by tubular secretion may reduce the effectiveness of furosemide. Furosemide can lead to a decrease in the excretion of these drugs. It is possible to increase their levels in the blood serum and increase the risk of side effects.

The effectiveness of hypoglycemic agents and vasoconstrictive amines (epinephrine / adrenaline, norepinephrine / norepinephrine) may be weakened, and theophylline and curare-like agents – enhanced.

Furosemide may increase the damaging effect on the kidneys of nephrotoxic drugs. In patients receiving concomitant treatment with furosemide and individual cephalosporins in high doses, deterioration in renal function is possible.

Co-administration of ciclosporin A and furosemide may increase the risk of developing secondary gouty arthritis due to furosemide-induced hyperuricemia and deterioration of urate excretion by the kidneys caused by ciclosporin.

Patients with a high risk of developing nephropathy, when using furosemide in conjunction with radiopaque agents, are more susceptible to impaired renal function.

When used in conjunction with thiazides, photosensitivity reactions may develop. In the event of an unexpected photosensitivity reaction when taking furosemide, it is recommended to stop therapy. If repeated administration is necessary, ultraviolet radiation or solar insolation should be avoided.

Contraindications

– hypersensitivity to furosemide or any of the excipients;
– acute renal failure;

– hepatic encephalopathy;

– obstruction of the urinary tract;

– hypovolemia or dehydration;

– decompensated hypokalemia;

– decompensated hyponatremia;

– pregnancy, breastfeeding;

– combinations with lithium;

– galactosemia, glucose-galactose malabsorption syndrome, lactase deficiency;

– hepatitis and hepatocellular insufficiency in patients on hemodialysis with severe renal failure (creatinine clearance

Composition

One tablet contains: active ingredient: furosemide – 40 mg; excipients: lactose monohydrate, potato starch, starch 1500 (corn starch partially pregelatinized ), magnesium stearate. alkalosis
Treatment: correction of water-salt balance and acid-base balance, replenishment of circulating blood volume, symptomatic treatment. There is no specific antidote.

Side effects

From the side of the cardiovascular system: arterial hypotension, orthostatic hypotension, collapse, tachycardia, arrhythmias.
From the nervous system: dizziness, headache, muscle weakness, spasms of the calf muscles (tetany), paresthesia, apathy, weakness, weakness, lethargy, drowsiness, confusion.

From the senses: visual and hearing impairments.

From the digestive system: anorexia, dry mouth, thirst, nausea, vomiting, diarrhea, constipation, cholestatic jaundice, exacerbation of pancreatitis.

From the genitourinary system: oliguria, acute urinary retention (with benign prostatic hyperplasia), interstitial nephritis, hematuria, impotence.

Allergic reactions: purpura, urticaria, exfoliative dermatitis, erythema multiforme, vasculitis, necrotizing angiitis, pruritus, chills, fever, photosensitivity, anaphylactic shock.