Furosemide(fur oh’ se mide)
Apo-Furosemide (CAN), Furosemide, Special (CAN), Lasix
PREGNANCY CATEGORY C
Drug Class
Loop diuretic
Therapeutic Actions
Inhibits reabsorption of sodium and chloride from the proximal and distal tubules and ascending limb of the loop of Henle, leading to a sodium-rich diuresis.
Indications
Oral, IV: Edema associated with heart failure, cirrhosis, renal disease
IV: Acute pulmonary edema
Oral: Hypertension
Contraindications and Cautions
Contraindicated with allergy to furosemide, sulfonamides; allergy to tartrazine (in oral solution); anuria, severe renal failure; hepatic coma; pregnancy; lactation.
Use cautiously with SLE, gout, diabetes mellitus.
Available Forms
Tablets—20, 40, 80 mg; oral solution—10 mg/mL, 40 mg/5 mL; injection—10 mg/mL
Dosages
Adults
Edema: Initially, 20–80 mg/day PO as a single dose. If needed, a second dose may be given in 6–8 hr. If response is unsatisfactory, dose may be increased in 20- to 40-mg increments at 6- to 8-hr intervals. Up to 600 mg/day may be given. Intermittent dosage schedule (2–4 consecutive days/wk) is preferred for maintenance, or 20–40 mg IM or IV (slow IV injection over 1–2 min). May increase dose in increments of 20 mg
in 2 hr. High-dose therapy should be given as infusion at rate not exceeding 4 mg/min.
Acute pulmonary edema: 40 mg IV over 1–2 min. May be increased to 80 mg IV given over 1–2 min if response is unsatisfactory after 1 hr.
Hypertension: 40 mg bid PO. If needed, additional antihypertensives may be added.
Pediatric patients
Premature infants, do not exceed 1 mg/kg/day. Stimulates prostaglandin E2 synthesis and may increase incidence of patent ductus arteriosus and complicate RDS.
Edema: Initially, 2 mg/kg/day PO. If needed, increase by 1–2 mg/kg in 6–8 hr. Do not exceed 6 mg/kg. Adjust maintenance dose to lowest effective level.
Pulmonary edema: 1 mg/kg IV or IM. May increase by 1 mg/kg in 2 hr until the desired effect is seen. Do not exceed 6 mg/kg.
Patients with renal impairment
Up to 4 g/day has been tolerated. IV bolus injection should not exceed 1 g/day given over 30 min.
Pharmacokinetics
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