DRUGS & SUPPLEMENTS
Furosemide is a loop diuretic. This medication violates the reabsorption of sodium and chlorine in the large segment of the ascending loop of Henle. Due to increasing separation of sodium ions occurs secondary increased excretion of water and increased secretion of potassium ions in the distal renal tubule. Simultaneously increased excretion of calcium and magnesium ions.
Furosemide has secondary effects caused by the release of neurotransmitters and intrarenal redistribution of intrarenal blood flow. On the background of a course of treatment does not occur the weakening effect.
When heart failure Furosemide quickly leads to a reduction of preload on the heart through the expansion of large veins. This drug exerts the hypotensive effect due to increased excretion of sodium chloride and reduction reactions of vascular smooth muscle to vasoconstrictor effects and by decreasing the BCC. Effect of Furosemide after IV injection occurs in 5-10 minutes; after oral administration within 30-60 minutes, a maximum of the action is after 1-2 hours, the duration of effect is 2-3 hours (if reduced kidney function - up to 8 hours).
Furosemide reduces the incidence of atrial natriuretic factor in the plasma, causing vasoconstriction.
Diuretic effect develops in 3-4 minutes after IV injection and lasts 1-2 h; after oral taking - 20-30 minutes, lasts up to 4 hours.
After oral administration absorption of Furosemide is 60-70%. In severe kidney disease or chronic heart failure, extent of absorption is reduced.
Vd is 0.1 L / kg. Binding to plasma proteins (mainly albumin) is 95-99%. Furosemide metabolized in the liver. Excreted by the kidneys is 88% with bile - 12%. T1/2 in patients with normal renal function and liver is 0.5-1.5 h. When anuria T1/2 can be increased up to 1.5-2.5 h, with concomitant renal and liver failure - up to 11-20 hours.
Why is Furosemide prescribed?
Edematous syndrome of different genesis, including in chronic heart failure II-III stage, liver cirrhosis, nephrotic syndrome. Pulmonary edema, cardiac asthma, cerebral edema, eclampsia, conducting forced diuresis, severe hypertension, some forms of hypertensive crisis, hypercalcemia.
Dosage and administration
Dosing regimen set individually, depending on the evidence, the clinical situation, the patient's age. The treatment dosing regimen is adjusted depending on the value of diuretic response and the dynamics of the patient.
When Furosemide administered orally an initial dose for adults is 20-80 mg / day, further, if necessary, the dose gradually increased to 600 mg / day. For children a single dose is 1-2 mg / kg.
The maximum oral dose for children is 6 mg / kg.
For IV jet or IM administration the dose for adults is 20-40 mg 1 time / day, in some cases - 2 times / day. For children the starting daily dosage for parenteral use is 1 mg / kg.
Furosemide side effects, adverse reactions
Cardiovascular system: decreased blood pressure, orthostatic hypotension, collapse, tachycardia, arrhythmias, decreased BCC.
CNS and peripheral nervous system: dizziness, headache, myasthenia gravis, calf muscle cramps, paresthesia, apathy, weakness, fatigue, lethargy, drowsiness, confusion.
Senses: blurred vision and hearing.
Digestive system: anorexia, dry mouth, thirst, nausea, vomiting, constipation or diarrhea, cholestatic jaundice, pancreatitis (acute).
Urogenital system: oliguria, acute urinary retention (in patients with prostatic hypertrophy), interstitial nephritis, hematuria, reduced potency.
Hemopoietic system: leucopenia, thrombocytopenia, agranulocytosis, aplastic anemia.
Water and electrolyte metabolism: hypovolemia, dehydration (the risk of thrombosis and thromboembolism), hypokalemia, hyponatremia, chloropenia, hypocalcemia, hypomagnesemia, metabolic alkalosis.
Metabolism: hypovolemia, hypokalemia, hyponatremia, chloropenia, hypokalemic metabolic alkalosis (as a result of these violations - hypotension, dizziness, dry mouth, thirst, arrhythmias, muscle weakness, cramps), hyperuricemia (with the possible aggravation of gout), hyperglycemia.
Allergic reactions: purpura, urticaria, exfoliative dermatitis, erythema multiforme exudative, vasculitis, necrotizing vasculitis, pruritus, chills, fever, photosensitivity, anaphylactic shock.
Other: for optional IV injections - thrombophlebitis, renal calcinosis in preterm infants.
Acute glomerulonephritis, stenosis of the urethra, obstruction of urinary tract stones, acute renal failure with anuria, hypokalemia, alkalosis, precomatose state, severe hepatic failure, hepatic coma and precoma, diabetic coma, hyperglycemic coma, hyperuricemia, gout, decompensated mitral or aortic stenosis, hypertrophic obstructive cardiomyopathy, increased central venous pressure (greater than 10 mm Hg), hypotension, acute myocardial infarction, pancreatitis, impaired water-electrolyte metabolism (hypovolemia, hyponatremia, hypokalemia, chloropenia, hypocalcemia, hypomagnesemia), digitalis toxicity, increased sensitivity to Furosemide.
Using during pregnancy and breastfeeding
In pregnancy, the use of Furosemide is only possible within a short time only, when the intended use of therapy to the mother justifies the potential risk to the fetus.
As Furosemide may be excreted in breast milk and to suppress lactation, if necessary use during lactation, a breastfeeding should be discontinued.
Category effects on the fetus by FDA - C.
With careful use Furosemide with prostatic hyperplasia, SLE, hypoproteinemia, diabetes (impaired glucose tolerance), stenosing atherosclerosis of cerebral arteries on the background of long-term therapy cardiac glycosides, elderly patients with severe atherosclerosis, pregnancy (especially first half), during lactation.
Before the treatment by Furosemide it should be compensated for electrolyte disturbances. During treatment with Furosemide it is necessary to control blood pressure, electrolytes and glucose in the blood serum, liver and kidney function.
For the prevention of hypokalemia there is expedient to combine Furosemide with potassium-sparing diuretics. With the simultaneous administration of Furosemide and hypoglycemic agents it may be require dose adjustment of the latter.
There is not recommended to mix a solution of Furosemide in the same syringe with any other drugs.
Furosemide drug interactions
Aminoglycosides, ethacrynic acid and cisplatin increases ototoxicity of this medication (especially when impaired renal function). Furosemide increases the danger of kidney damage with amphotericin B. if prescribed high doses of salicylates increases the risk of salicylism (competitive renal excretion), cardiac glycosides - hypokalemia and related arrhythmias, corticosteroids - an electrolyte imbalance. Furosemide reduces muscle relaxant activity of tubocurarine, potentiates the effect of succinylcholine. This drug reduces the renal clearance (and increases the likelihood of intoxication) lithium. Under the influence of Furosemide increases the effect of ACE inhibitors and antihypertensive agents, warfarin, diazoxide, theophylline, attenuated - antidiabetic drugs, norepinephrine. Sucralfate and indomethacin (by inhibiting the synthesis of PG, the level of violations of plasma renin and aldosterone excretion) reduce the effectiveness of Furosemide Kimia Farma. Probenecid increases the concentration of this medicine in serum (blocking excretion).
Furosemide in case of emergency / overdose
Symptoms: hypovolemia, dehydration, haemoconcentration expressed hypotension, reduction of BCC, collapse, shock, cardiac arrhythmias and conduction (including AV block, ventricular fibrillation), acute renal failure with anuria, thrombosis, thromboembolism, drowsiness, confusion, flaccid paralysis, apathy.
Treatment: correction of water and electrolyte balance and acid-base balance, supplementation of BCC, symptomatic therapy, the maintenance of vital functions. The specific antidote is unknown.
Furosemide pharmaceutical active ingredients containing related brand and generic drugs:
Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.
Furosemide available forms, composition, doses:
Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.
Furosemide destination | category:
Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.
Furosemide Anatomical Therapeutic Chemical codes:
A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.
Furosemide pharmaceutical companies:
Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.
Frequently asked QuestionsCan i drive or operate heavy machine after consuming Furosemide?
Depending on the reaction of the Furosemide after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Furosemide not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.Is Furosemide addictive or habit forming?
Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.
Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.
ReviewsDrugs.com conducted a study on Furosemide, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Furosemide consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.
One visitor reported frequency of useHow often in a day do you take the medicine?
Are you taking the Furosemide drug as prescribed by the doctor?
Few medications can be taken 3 times in a day more than prescribed when the doctor's advice mentions the medicine can be taken according to frequency or severity of symptoms. Most times, be very careful and clear about the number of times you are taking the medication. The report of sDrugs.com website users about the frequency of taking the drug Furosemide is mentioned below.
Four visitors reported dosesWhat is the dose of Furosemide drug you are taking?
According to the survey conducted among sDrugs.com website users, the maximum number of people are using the following dose 11-50mg. Few medications come in only one or two doses. Few are specific for adult dose and child dose. The dose of the medicine given to the patient depends on the severity of the symptom/disease. There can be dose adjustments made by the doctor, based on the progression of the disease. Follow-up is important.
One visitor reported age
The information was verified by Dr. Arunabha Ray, MD Pharmacology